The health industry, a behemoth of rules, regulations and opaque pricing schemes, is in dire need of a shake-up. Three start-ups are attempting to shift power back to consumers by helping them negotiate lower medical costs.
Vimo, a comparison-shopping site for health care, collects data on medical procedures, so that consumers can search and compare prices. People can also submit details about incurred charges. If the amount to be paid isn’t the lowest wholesale rate available from a hospital or other provider, Vimo will negotiate a lower price for a cut of the savings. Vimo will also make money from referrals to insurers and, eventually, physicians and products. (The company received USD 10 million in funding from Bessemer and Trinity Ventures.)
While Vimo offers a variety of services, from price comparisons to doctor ratings, another start-up is focusing purely on negotiating bills. “The average provider — doctors or hospitals — has between 5 and 100 reimbursement rates for the exact same procedure,” said Timothy Cahill, president of My Medical Control. “A hospital chain with multiple locations may have 150 rates for the same procedure.” (Source: nytimes.com.) Reimbursement rates are negotiated between health care providers and insurers, and are far from transparent. My Medical Control takes customers’ medical claims, looks for over-charges and contacts the provider directly to discuss and settle the claim at a reduced amount. The entire process takes 7-10 days and My Medical Control charges a fee of 35% of the savings.
Last but not least, MedBillManager is free software that consumers can use to manage their medical bills, but also to check aggregated data to see what other people in their area are paying for similar procedures.
In countries that don’t offer full coverage health care for all, medical costs are some of the largest expenditures consumers make. Usually without being able to compare prices or even know costs in advance. Which means there are plenty of business opportunities for entrepreneurs who can reduce medical bills on their behalf, or who can put consumers back in charge by creating greater price transparency.