I like their long-term marathon approach. They want to win in this industry and have a strategy that seems to focus on pacing their effort by breaking down the problem into smaller steps. I only wonder, as brought out in the article, if it requires just too many things to go right? I think the bet is not on the strategy as much as on the team.
The interesting part and biggest reason I joined is: booking appointments/seeing the doctor and paying bills should be simple but there are many players across the tech/services that needed to be aligned to make it happen.. thus to drive this alignment you need the three pronged approach over time to bring all players into the mix: dentists/doctors, patients and developers
This is incredible. I remember digging into this a lot a couple years ago and asked myself, why aren’t there better consumer apps to manage your personal health? Lack of interoperability and infrastructure. That’s why. Love the NexHealth mission! When the platform starts to take off, will be really exciting to see the consumer apps that get built. Should build a fund or venture arm to seed some of these. NexVentures? 🤔 That will be an exciting role! Thanks for sharing Packy and Alamin! Love this space :)
Good read. What it slightly overlooked is the need for a centralized B2B network for claim fulfillment and resolution. My main issue with the healthcare system is the insurance claim resolution process and that (anecdotally) about one third of customer service reps (CSRs) at insurance providers or healthcare billing services are actually helpful. Why not automate the process? Claim gets filed, API sorts and approves what's correctly submitted at whatever the negotiated rates are; anything that is off gets kicked back to the provider for resolution.
In the current landscape all of that falls on me, the layman in the transaction, the person that pays for the insurance yet has to facilitate the transaction if anyone else messes up. What this typically entails is: no less than 3 phone calls (initially), a wait/hold time of 10-30 minutes per call, talking to the previously mentioned two-thirds of CSR's that provide bad info and cause repeat phone calls; fast-forward 2 weeks for processing, rinse and repeat the entire process until resolved or I get so frustrated I just pay the difference.
I have the time to do this and to appeal claims as necessary, I also have an insider for a spouse, but think of the millions of people that do not have the resources to spend hours on the phone, let alone the knowhow to correctly gather and draft an appeal letter (first and/or second level).
It's broken... I'm not sure sure what fixes it but in my mind it's some sort of API with Blockchain/smart contract backbone, semi-private/HIPAA compliant with unique identifiers for patients linked to continuous updates on coverage levels and insurance provider info, and coordination of benefits. It would be a massive database but it's not new information, it just all needs to be centralized.
Sorry for the rant...cheers.
P.S if you stumble across a company that does this I'd be happy to sell it.
A misleading post title. The title of this post should be: "How a start-up plans to make money from our Healthcare mess". There is nothing in their ambition that offers ideas to cure what ails our health care system.
Very Interesting article. On the one hand Dentistry may be easier than Healthcare in the United States that has such a complex, fragmented payer system, but in the rest of the world (Canada, Europe) that have more government funded healthcare systems, it may actually be easier in Healthcare than Dentistry (I know Dentistry is oral Healthcare, but the systems are different in these countries). A bigger risk that I see in European countries and Canada are increased privacy regulations (eg GDPR). Overall, great vision and I look forward to being a part of it!
Very interesting company with a world-class team that has a impressive long-term vision. Two questions that immediately came to my mind: (1) Understand the value prop of the SaaS product and really like the idea of using that as a Trojan Horse into fragmented EHR systems, but once you gain access, how do you team maintain integration? Is it predicated on keeping that same SaaS customer (whose credentials granted you access) / what happens if they churn? (2) the 3-sided platform play is still a little unclear to me: my read from this article is that both doctors and patients would presumably go on NexHealth's marketplace to purchase / use apps developed by developers who integrate with EHRs through NexHealth's API, is that the right way to think about it? If NexHealth and others solve EHR interoperability, the market for consumer health / health tech would increase by orders of magnitude, and at that point, it doesn't seem unfeasible that competing Health Tech marketplaces emerge and startups can just integrate with EHRs through NexHealth but be on various marketplaces? I'm just struggling to understand how NexHealth providing the connecting layer API necessitates that startups using NexHealth will / must list on NexHealth's marketplace. I'm guessing I'm missing something here so would love to learn more :)
wanna cure HC - have everyone die at 50. OR, cut drug pricing by 50% like every other country.
But this is not the solution - this is another example of mildly improving the system to continue to skim off the huge margins that have no business existing in a normal environment.
the huge lump of costs come in the last 18 months of life, or in chronic situations.
Cut drug pricing, tax obesity, and you get MASSIVE savings . . .
I like their long-term marathon approach. They want to win in this industry and have a strategy that seems to focus on pacing their effort by breaking down the problem into smaller steps. I only wonder, as brought out in the article, if it requires just too many things to go right? I think the bet is not on the strategy as much as on the team.
The interesting part and biggest reason I joined is: booking appointments/seeing the doctor and paying bills should be simple but there are many players across the tech/services that needed to be aligned to make it happen.. thus to drive this alignment you need the three pronged approach over time to bring all players into the mix: dentists/doctors, patients and developers
This is incredible. I remember digging into this a lot a couple years ago and asked myself, why aren’t there better consumer apps to manage your personal health? Lack of interoperability and infrastructure. That’s why. Love the NexHealth mission! When the platform starts to take off, will be really exciting to see the consumer apps that get built. Should build a fund or venture arm to seed some of these. NexVentures? 🤔 That will be an exciting role! Thanks for sharing Packy and Alamin! Love this space :)
Good read. What it slightly overlooked is the need for a centralized B2B network for claim fulfillment and resolution. My main issue with the healthcare system is the insurance claim resolution process and that (anecdotally) about one third of customer service reps (CSRs) at insurance providers or healthcare billing services are actually helpful. Why not automate the process? Claim gets filed, API sorts and approves what's correctly submitted at whatever the negotiated rates are; anything that is off gets kicked back to the provider for resolution.
In the current landscape all of that falls on me, the layman in the transaction, the person that pays for the insurance yet has to facilitate the transaction if anyone else messes up. What this typically entails is: no less than 3 phone calls (initially), a wait/hold time of 10-30 minutes per call, talking to the previously mentioned two-thirds of CSR's that provide bad info and cause repeat phone calls; fast-forward 2 weeks for processing, rinse and repeat the entire process until resolved or I get so frustrated I just pay the difference.
I have the time to do this and to appeal claims as necessary, I also have an insider for a spouse, but think of the millions of people that do not have the resources to spend hours on the phone, let alone the knowhow to correctly gather and draft an appeal letter (first and/or second level).
It's broken... I'm not sure sure what fixes it but in my mind it's some sort of API with Blockchain/smart contract backbone, semi-private/HIPAA compliant with unique identifiers for patients linked to continuous updates on coverage levels and insurance provider info, and coordination of benefits. It would be a massive database but it's not new information, it just all needs to be centralized.
Sorry for the rant...cheers.
P.S if you stumble across a company that does this I'd be happy to sell it.
A misleading post title. The title of this post should be: "How a start-up plans to make money from our Healthcare mess". There is nothing in their ambition that offers ideas to cure what ails our health care system.
Very Interesting article. On the one hand Dentistry may be easier than Healthcare in the United States that has such a complex, fragmented payer system, but in the rest of the world (Canada, Europe) that have more government funded healthcare systems, it may actually be easier in Healthcare than Dentistry (I know Dentistry is oral Healthcare, but the systems are different in these countries). A bigger risk that I see in European countries and Canada are increased privacy regulations (eg GDPR). Overall, great vision and I look forward to being a part of it!
Very interesting company with a world-class team that has a impressive long-term vision. Two questions that immediately came to my mind: (1) Understand the value prop of the SaaS product and really like the idea of using that as a Trojan Horse into fragmented EHR systems, but once you gain access, how do you team maintain integration? Is it predicated on keeping that same SaaS customer (whose credentials granted you access) / what happens if they churn? (2) the 3-sided platform play is still a little unclear to me: my read from this article is that both doctors and patients would presumably go on NexHealth's marketplace to purchase / use apps developed by developers who integrate with EHRs through NexHealth's API, is that the right way to think about it? If NexHealth and others solve EHR interoperability, the market for consumer health / health tech would increase by orders of magnitude, and at that point, it doesn't seem unfeasible that competing Health Tech marketplaces emerge and startups can just integrate with EHRs through NexHealth but be on various marketplaces? I'm just struggling to understand how NexHealth providing the connecting layer API necessitates that startups using NexHealth will / must list on NexHealth's marketplace. I'm guessing I'm missing something here so would love to learn more :)
wanna cure HC - have everyone die at 50. OR, cut drug pricing by 50% like every other country.
But this is not the solution - this is another example of mildly improving the system to continue to skim off the huge margins that have no business existing in a normal environment.
the huge lump of costs come in the last 18 months of life, or in chronic situations.
Cut drug pricing, tax obesity, and you get MASSIVE savings . . .
Success in dental is infinitely simpler than success in hospital/medical.