6 Comments
Feb 23Liked by Brendan Keeler

> Patrick Bateman voice: Look at that subtle transparent blue coloring. The tasteful consolidated length of it. Oh, my God. Just two payers over the same time, spanning seven different providers.

10/10

Expand full comment

All good until I hit this line:

"You see, a patient might have multiple healthcare providers, but they usually have just one payer at a given point in time (aside from edge cases like dual eligibles, veterans, or cash pay scenarios)."

It's not just edge cases.

Employers change payers/networks often - and employees are with the same employer for typically less than 5 years. That dual-sided "churning" creates enormous fragmentation - and about 155 million Americans get their coverage through their employer. This is one of the reasons that "administrative complexity" is estimated (2019) to cost our healthcare system ~$266 billion per year.

Expand full comment
author

Time-based fragmentation is a different and simpler problem set than concurrent fragmentation seen on the provider side

Expand full comment

Fair point - but neither is desirable - and there's still no continuity of care. We just had a payer change (BCBS to Aetna) - and it's a completely reset. Any/all history - poof. Gone.

Expand full comment
author

Which is why the upcoming payer to payer API is good

Expand full comment

... not if it supports the status quo of tiered coverage. Which it will - and tech is the easy part. Liability of data xfer less so.

We need employers out of the healthcare biz. http://hc4.us/esi20

Expand full comment