Today, we’re thrilled to unveil Turquoise Health, our venture to simplify healthcare reimbursement and lower the cost of care.
We've spent the last few months building our first software offerings and finishing off our pre-seed raise. In doing so, we've found a community of investors, industry insiders and startups that share our sentiment: healthcare reimbursement is broken.
It’s no secret that the United States overspends on healthcare. By some assessments, over a third of healthcare spending is on administrative costs like zero-sum claim wrangling, denials management and billing. These activities do little to advance patient care.
A lot of this administrative madness is hidden out of reach and hard for the outside observer to scrutinize. After all, if entrepreneurs can’t access the data or audit the cost of care in public, how can we fix the problem?
That all changes on January 1st, 2021, when hospitals are required by law to publish negotiated rates for standard charges for the first time. And, for the first time, third parties like Turquoise Health can build solutions to shine a light on healthcare costs. We can show disparities between the cost of the same service in the same city. We can help providers recognize where they offer competitive value. And best of all, we can put negotiating power back in the market's hands.
Here’s what’s in store for Turquoise Health
We're offering one-click price transparency to providers
Beginning in January of 2021, we’ll host the price transparency page of hospitals across the United States. There, potential patients can compare the costs of care relative to their insurance plan. Providers can connect with patients by offering clear prices in a refreshing, menu-like experience that’s currently uncommon to the industry.
We've already worked with a handful of hospitals to prepare their transparent, Turquoise Verified rates starting January 1st.
Although federal law only targets hospitals for 2021, we also welcome ASCs, multi-speciality clinics, specialist groups and primary care providers.
Using both public price rates data and Turquoise participating provider data, we plan to show providers that there is a market for transparency in healthcare.
With our standardized data formats and pre-built price transparency engine, we eliminate the burden of wrangling rates data for federal price transparency compliance. We truly want to enable providers to update their rates year over year with one click.
We're offering self-service managed care analytics
Part of the problem with high cost care lies in the lack of widespread available market data. If an independent hospital in Dallas wants to attract more patient volume for joint replacements, it should be able to analyze the cost of joint replacements elsewhere in the Dallas metro area. The provider should be able to ask questions like: What options do patients currently have? Where can we offer comparative value at a competitive price? And importantly, where are our current prices way out of line with the market?
Providers can order up custom reports and generate self-service analytics in our Managed Care Benchmarking Engine at a much lower cost than currently available rate extracts.
We’re launching do-it-yourself Direct to Provider Contracting
What better way to drive down the administrative cost of care than simplifying the negotiation process? Currently, managed care negotiation cycles last for years, and rate hikes rise at a rate that outpaces inflation. This cumbersome process prevents agile dealmaking with smaller group payers - leaving many providers at the mercy of big health systems and payers.
On the Turquoise Health platform, providers can connect with new group markets like self-funded employers, co-ops and purchasing alliances (traditional payers too). These same groups can create a presence on our platform and shop around for quality, affordable rates. We'll open up new markets. Providers and payers can build contracts from standard fee schedules on our platform and agree to simple rates without the need of expensive lawyers and consultants.
We're helping providers bundle services into one bill
Patients want clear, flat rates in advance of time of service. They don’t want unbundled bills for the same service two to three months after treatment.
Coming from rev cycle, we know the barriers that providers and payers face when creating simple, prospective global rates. One service - such as a knee replacement - could involve fees from the facility, surgeon, anesthesiologist, device supplier and more.
On the Turquoise Health platform, our DIY Service Bundling software helps providers construct global, all inclusive rates based on market benchmark data. We also help facilities manage professional agreements to ensure all parties involved receive fair reimbursement while minimizing billing complexity.
We’re creating simple software to chip away at a complex problem. Work with us!
We know the road ahead for Turquoise will be filled with the same obstacles many software companies in revenue cycle face, like messy data, slow product adoption, and complex legal requirements.
But we’re starting with a new foundation of price transparency and simplicity. We’re building for the future rather than patching legacy products of the past.
We’re looking for:
- Providers to partner with us that believe that clear pricing is quality care.
- Revenue cycle technologists to join our team.
We believe that no patient should face bankruptcy or financial uncertainty when navigating a health challenge.
Drop us a line on LinkedIn or via email, firstname.lastname@example.org.