In its mission to make the healthcare industry more open, connected, transparent and user-friendly, CareCloud has found a kindred spirit in the Miami startup community: MD Clarity.
MD Clarity is a cloud-based software company whose solutions make it easy for patients, doctors and administrators to understand and analyze the pricing of healthcare services. Through easy-to-use web applications, MD Clarity uses data-driven analysis to help providers deliver clear patient payment estimates and guarantee accurate reimbursements from insurers. Additionally, MD Clarity places a strong focus on enhancing the simplicity of the healthcare user experience for consumers and stakeholders – a goal we at CareCloud wholeheartedly align with.
We spoke with MD Clarity founder Mike Albainy to learn more about his company’s innovative approach to achieving healthcare cost transparency and his thoughts on the importance of user-focused design.
How does MD Clarity help healthcare professionals and patients understand the pricing of healthcare services?
We combine a patient’s specific insurance plan benefits, the healthcare provider’s contract with the patient’s insurance company, and the individual charges (e.g. lab test, physical, etc.) information with a simple user experience that provides an exact price of care to a doctor, patient, or staff member in seconds. It also enables patients to understand the financial impact for an entire progression of care, like “Labor and Delivery,” “ACL Repair,” etc.
With this information transparent and readily available, it can at least enter the equation when making non-urgent clinical decisions. When you consider the intersection of evidence-based medicine guidelines with the availability of accurate cost information, we can start to realistically reduce some unnecessary spending.
Further, healthcare providers typically struggle in understanding the impact of their aforementioned contractual relationships with insurance companies. With the same analytics engine that delivers on-demand cost-transparency, MD Clarity combs through legalese, billing, clinical, and market data to ensure that the healthcare providers successfully negotiate the fairest possible agreements with insurance companies.
Are you achieving a high level of adoption among healthcare organizations? How is your business expanding?
Interestingly, in certain markets, there is a widespread desire on the part of healthcare providers to deliver price transparency to patients. We’ve seen a snowball effect of a few major providers getting on board in those areas. Those markets, such as the state of Minnesota, tend to be the most innovative in terms of attempting new models of healthcare delivery. That said, there is a consistent desire across all healthcare providers to better understand their insurance contracts. By being able to combine the legalese, billing, clinical, and market data we have a unique method of delivering this capability.
This is especially true for diverse healthcare systems (with clinics, urgent care centers, outpatient surgery centers, and hospitals), the increasingly prevalent clinically integrated networks, and organizations that have facilities dispersed geographically throughout a state, region, or nationwide. For these organizations, the impact of any decision can impact each node of the system differently, so being able to model and analyze data effectively is critical. This is the area where we’re now seeing the most aggressive adoption rates.
Your solution uses a lot of charts and graphs to communicate data. How important has UX design been in the development of your systems?
It’s the aspect of the product that we are most obsessed about. We are constantly reaching out to users for feedback, studying use-patterns, and tweaking the flows in our application to make it as easy as possible to get from point A to B. We pride ourselves on the fact that we rarely, if ever, need to train users on the use of the product. In today’s healthcare software market, which has a myriad of hard-to-use billing and electronic medical record products, we aim to differentiate through user experience. That’s our favorite compliment from customers.
Castlight Health, which is another company concerned with healthcare pricing, made a lot of news recently for earning a great deal of venture capital funding. What differentiates MD Clarity from Castlight, or from other competitors in your sector?
We’ve not sought any institutional funding because we’ve been able to achieve our early goals without it, but if we find the right strategic fit we’re open to it. Castlight’s value proposition is geared toward self-insured employers. That’s a use-case on our roadmap because it’s a logical extension of our existing product, and there will be a growing number of self-insured employers.
We’re servicing healthcare providers and patients directly right now because that’s where we see the largest demand and highest value proposition. That said, there are large, entrenched competitors in the provider market, including Experian and TransUnion. There are several finer points of differentiation, including our user experience and technology infrastructure, but bigger picture our ability to adapt to the paradigm shift in how healthcare is paid for will ultimately set us apart. We see that already in some cases where we were chosen over these larger companies.
Do you think cost transparency has the power to lower overall healthcare expenses? Or is it just important for people to know what they’re paying?
As I mentioned before, and we see this hypothesis being validated all the time, if you combine clinical knowledge and cost information you can save money. Decisions become a little more conservative, surgeries are not the first option, patients can shop for the best price on a commodity test, etc.
We’re thinking hard about how to combine this information to make it more easily available to clinicians on-demand (e.g. the sensitivity/specificity of tests relative to a diagnosis and the % chance it will improve outcomes relative to cost). It’s only part of the cost-savings equation, but an important part. It’s also obvious that in any “market” cost should be an available data point. Right now, pricing is simply not available to patients, or doctors
How do you see MD Clarity growing and changing to adapt to the evolving needs of the healthcare industry?
It’s a great time to be an involved in healthcare – no matter your politics or ideas, all the stakeholders who hope for a high-quality, cost-effective healthcare system, from patients to providers to insurers, recognize that the current approach is not sustainable. There are some fascinating ideas and trends emerging, from “gym-membership” type primary care models to patients self-reporting data on their health and lifestyle, to a desire to effectively integrate quality measures into the pricing of healthcare.
There’s no single answer to this complex domain, but where we can best contribute to the future is helping healthcare providers, patients, employers, and even insurance companies understand how to better value and price healthcare services when considering the underlying cost (i.e. basic costs to deliver the care) and quality of care (e.g. patient outcomes). There is a plethora of complex data which must be analyzed continuously to deliver these answers in an easy-to-understand fashion, and that’s what we’re best at doing.
Your company is working from various locations across the country: Seattle, Minneapolis, and Miami. How has South Florida been treating your business? What are your thoughts on the startup community here?
Thus far we’ve been in Miami for about six months. Seattle has a highly supportive entrepreneurial community with a nightly calendar of events and meet-ups, and Minneapolis is headed in that direction, especially for healthcare-focused start-ups. There’s a palpable entrepreneurial spirit in each of those cities, particularly Seattle.
We came here primarily because of a great market opportunity for our product, and we are also looking to tap into the talent pool here. From what I see, there are signs of a small community with enthusiasm and a commitment to helping each other through entrepreneurial adventure. That’s at least a start, and while there is no formula for building a great start-up community it doesn’t hurt to have couple of big local successes (IPOs, large exits, etc.), a high-powered local university CS department, and a mature investor community. Those obviously don’t happen overnight. That said, access to the Caribbean, South and Central American markets uniquely positions Miami to potentially be a fantastic community for start-ups building an international business.
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