Thank goodness that Page knows his place! (just kidding). During the life of a start-up company, the ability of a team to keep a sense of humor makes the day go by quicker. We’ve got a great team.

During our meeting today, Page serenely said, “I should be flogged!”

Ran across this blog entitled medical bills suck. Have to say we empathized with their situation. This is a young couple with a new baby and lacking insurance. That’s a tough spot. They are getting hit with medical bills for the birth of their child now, and the mom despairs about not being able to realize the rest of her dreams of owning a home, etc. because of the medical bills that keep holding them back.

But like the comment I posted says, they probably won’t have to pay the whole bill amount. If they just pick up the phone and call and ask for a discount or failing that, ask to make monthly payments, the hospital will probably negotiate. Some rediculous percentage of people (I think around 60% or more. If I find the source, I will come back and add it) who called and asked for a discount got one.

Making that call can be hard for someone with high moral standards and a strong sense of responsibility. After all, if you incurred the bill, you should pay it. The problem is, the docs and hospitals are not burdened by those same standards. Yes, they are healers and are bound by the hypocratic oath, but that oath says nothing about fair payment between patients. It really would not hurt to add something to that end.

Providers (docs and hospitals) generally charge everyone the same for services. However, what they get paid varies drastically between the uninsured and the insured. It also can vary widely between insured. Uninsured usually wind up with the biggest payments made to providers. Then the privately insured. And then the low cost payors – Medicare and Medicaid.

So. All of that to say that chances are she’s looking at paying the equivalent of MSRP (Manufacturer’s Suggested List Price) or the sticker price for the healthcare. Nobody pays MSRP for a car. You should not for medical bills either.

So pick up the phone and negotiate. You’ll be talking to someone in the back office, not the doc. And there’s little need to be worried that the doc won’t take your appoinment next time. Hell, the doc probably won’t even know what you paid.

Even though providers don’t have to charge fairly, if you need them in the future, the hypocratic oath does require them to provide you with care whether you paid the full amount for your previous bill or not.

Christopher and I are in NY. Met with Steven Krein and Unity Stoakes of Organized Wisdom last night. Great guys – really great. And brilliant. Got a chance to see what they are doing and where they are headed. They are really onto something, and we are excited that we will be working with them on some upcoming projects.

Next step is to get them out of Gotham and down to Music City USA.

Internal emails were going around post-Wyoming and also our updated bios for media (yeach… too stuffy for my tastes but i’ve been told to get used to it). Anyway, in the back-and-forth emails, Robert added this “inside joke” gem regarding Matt’s official title. See if you can guess what happened in WY with Matt and Katrina:

We were tempted to start off with “Semi-deity project manager yet
unable to rent a car Mueller” but opted for brevity.

Sheesh, we all have a dry sense of humor!

No matter your candidate or your party, let them know you’re passionate about reforming healthcare!

The new change:healthcare bumper stickers are in!

Shoot me an e-mail at rhendrick [@ symbol] changehealthcare [dot] com with you mailing address, and we will get one to you in time for the remainder of the primaries (unless of course, they move them up some more – there is talk here of moving ours to last week).

want a hint of what’s coming? I can honestly say that this has been in development for the past 5 months and hopefully the team will let me begin to share some of the cool things that we are preparing to release.

Ok, twist my arm a little

HERE… sadly, that “thing” under the crowd is supposed to be an engine (therefore it is apparent that drawing is not my forte)

As we’re working on the patient experience (with their providers) rating system, we got into an interesting “verbal brawl” of what quality means. No clear answer as everyone, and I do mean EVERYONE has differing opinions as to how quality is defined or what is meaningful to them.

So to set the stage internally, here are the “Eleven Dimensions of Quality” (yes, one more than ten):

1. Access: How easily accessible healthcare services are to patients – unrestricted by geographic, economic, social, organizational, or linguistic barriers
2. Technical performance: How well tasks are carried out by health professionals and facilities. Whether they meet expectations of technical quality and adhere to standards
3. Effectiveness of care: How well desired results/outcomes of care are achieved
4. Efficiency/Continuity of services: How well services are performed in relation to cost (do you only have to do an x-ray once or multiple times). Delivery of care by the same healthcare provider throughout the course of an individual’s healthcare needs. Appropriate and timely referral and communication between providers (follow-up by primary physician).
5. Personal relationship/bed-side manner: Trust, respect, confidentiality, courtesy, responsiveness, empathy, effective listening, and communication between providers and clients
6. Safety: The degree to which the risks of injury, infection, or other harmful side effect are minimized
7. Physical space and comfort: The physical appearance of the facility, cleanliness, comfort, privacy…
8. Choice: As appropriate and feasible, client choice of provider, insurance plan, or treatment
9. Peer Considerations: Peer referrals and reputation amongst other providers
10. Timeliness: Capacity to provide health care quickly after a need is recognized, Wait time spent in doctors’ offices and emergency departments, Interval between identifying a need for tests and treatments and receiving them
11. Patient Centeredness: Healthcare that establishes a partnership among practitioners, patients and their families, Ensure decisions respect patient wants and needs as well as preferences, Education and support mechanisms

Now, the REAL challenge is how to enable Consumers to easily, quickly, and simply convey their Provider experiences as well as intertwine meaningful yet “grandma friendly” information that provides consumers with some insight about their providers as it relates to all or most of the eleven quality dimensions.

Now you know why we were in a brawl… sigh.

Let it be known that I am officially “coining” the term Health Graph. Why?  Heck, I don’t know but I figured that I better claim it before Mark Zuckerberg or some other Web2.0 company started to mention it.

Actually, the notion of the term came up today as we met with a large company who we used Facebook as an analogy of change:healthcare’s forthcoming enhancements to our current offering for employers.  We began to construct the following premise – If your friends relationships and the many inferred linkages that you have and maintain via Facebook reflect your “Social Graph”, then change:healthcare enables consumers to self-manage and leverage their own medical expenses, provider and prescription experiences with others and determine one’s own consumer Health Graph.

Nahhhhhh. Sounds too pie-in-the-sky healthcare consumerist.

Or is it?

So as we ratchet down, focus on, and refine our platform — Robert and team threw these questions out that may seem obvious on the surface but actually require some thought. I figured that I’d pass them along. It was interesting to see how I answered some questions vs. others on the team. I’d like to challenge some of the other Health2.0 gang to test these out on their offering. It was a good exercise for us and forced us to stand back and challenge some of our own individual assumptions:

1. What do people want?
2. Who is our audience?
3. Who is our target (is it the same as our audience)?
4. What do we want them to do?
5. How do we want them to do it?
6. How do they get/realize value from that?
7. How do we get/realize value from those willing (not willing) to pay for our service?
8. Where do our customers go (e.g. websites/stores/providers) for information?
9. Why do they want our product?
10. What will they pay for our product(s)?
11. Why won’t they sign-up? Why will they?
12. What draws them in?
13. What makes them stay?
14. What makes them come back?
15. What makes them stay away?
16. Where else do they get (or think they get) our info?
17. Do they want our info?
18. How do they know about us?
19. What do we do for them?
20. How do we make them better?
21. How do we carry thru on the initial wow?
22. Is there an initial wow and what is it (pick “the” main 1 wow)?
23. What do consumers care about?
24. What do consumers not care about?
25. Who pays for our services?
26. Who benefits the most from our service(s)? …Now who pays for our service(s)?
27. What is the ROI to the purchaser?
28. What is the ROI to the User?
29. Why do they want to be a part of us?
30. Why do they want to share info about their expenses/health issues?
31. Can we help them?
32. What matters most?
33. What do people understand about their healthcare? …Not understand?
34. Why do people care?
35. Why SHOULD they care?