employees also saves hospitals and clinics from having to collect deductible payments from patients.
Haberichter says Access HealthNet makes money by charging employers a “facilitation” fee—in most cases 6 percent of the total medical bill, he says.
Currently, about 20 employers that together manage the health plans of approximately 60,000 employees and their family members use Access HealthNet’s service, Haberichter says.
The startup’s competitors include EmployerDirect Healthcare, of Dallas, and Oldsmar, FL-based PriceMDs, says Wiesman, who is also Access HealthNet’s chief operating officer.
Before helping to launch the company, Haberichter co-founded another Wisconsin-based startup, Smart Choice MRI, in 2006. (Access HealthNet’s other two founding employees, both of whom are still with the company, are Leslie Kolowith and James Kolb; Kolowith is also a Smart Choice MRI co-founder.) Smart Choice MRI, which is now headquartered in Chicago, operates a chain of imaging centers that charge patients a flat rate of $600 or less for scans.
Many patients who get scans at one of Smart Choice MRI’s locations pay out of pocket. The company has capitalized on the trend of deductibles in patients’ health plans increasing in recent years.
Haberichter says both Smart Choice MRI and Access HealthNet are part of the move toward consumer-driven healthcare, and a “retail-ization” of the industry, where more care is delivered in lower-cost settings like strip malls, rather than in hospitals.
Another major trend in healthcare, and one which the introduction of new software and technologies is helping to accelerate, is the move to so-called value-based care. This emerging paradigm replaces fee-for-service payment models, where insurers reimburse providers for individual lab tests, procedures and other units of care. With value-based care, providers are instead reimbursed based on patient outcomes. The goal is somewhat similar to Access HealthNet’s: try to lower costs for patients and health plans by holding providers accountable.
“If I am able to look at a patient and say ‘I can do that hip surgery for $30,000 and I’m going to be held to it and provide a warranty for it,’ that’s predictable and that’s sustainable,’” Haberichter says.
