It’s hardly radical to suggest that the current healthcare model is broken to the core – and it’s almost by design. Even with insurance, patients find paying for healthcare an unnecessarily stressful experience sorely lacking transparency.
Healthcare providers don’t fare much better, having to deal with increasingly aggressive payors, mountains of paperwork, and tightening regulations.
Commercial Payer Volume On The Decline
According to the annual benchmarking reportfrom the Urgent Care Association, visits related to commercial payers declined from 67% to 47% in only one year from 2017 to 2018.
Even more alarming, accelerating competition from external players like CVS, Walmart, and employer-sponsored clinics are chipping away market share from urgent care centers faster than ever. Telemedicine providers like Teladoc and DoctorOnDemand are gaining consumer adoption rapidly. And Silicon Valley investors are pouring hundreds of million dollars into a new breed of “à la carte” direct-to-consumer startups to compete with urgent care business.
The numbers are staggering. CVS Minute Clinic now commands over 55% of the retail health industry and is planning to convert their 1000+ locations into urgent-care-like health hubs. Blue Cross Blue Shield in various states have plans to open their own walk-in clinics. Ro, Hims, and LemonAid both raised a combined 400M from venture capital with less than three years in existence.
All of which left the already-fragmented urgent care industry in an awkward position: lower-priced compared to the emergency department but twice or three times more expensive compared to virtual care equivalents.
And Overhead Is Eating Up Your Margin
A system full of wastes. According to a 2019 study in JAMA, administrative complexity and pricing failure are the two largest categories of waste in U.S. healthcare, accounted up to 54% of the total $1T annual waste.
Pay to get paid. In a medical practice setting, like in urgent care, the Altarum Institute estimates one out of four dollars in revenue went into administrative activities. In which, billing and insurance-related activities contributed to over half (52%).
With the transition toward population health and value-based care, the burden of implementing new systems to measure process and outcomes are being shifted to providers without any additional increase in reimbursement.
But that’s the system - you can't do anything about it, right?
Fortunately, there is a away out.
By now, you probably have heard of direct primary care, a rapidly growing trend among your family practice counterparts. Direct Care Network (DCN) is an increasingly popular concept sweeping the country and it is one that has the potential to save providers from industry demise.
Direct Care Network (DCN) networks aggregate supply and demand in real-time, connecting providers directly to patients who typically pay out-of-pocket, but often skip care due to unpredictable pricing and fragmented experience.
While some urgent care networks had attempted this, setting this all up themselves can be time-consuming, tricky, and worst of all, risky.
How A Direct Care Network (DCN) Can Help
Rather than an individual practice performing a major overhaul to offer fixed pricing and on-demand availabilities, urgent care centers could join a DCN instead.
In technical terms, DCNs function both as a management service organization (MSO) and a payor.
In layman terms, DCNs take care of patient acquisition, simplify payment, and reduce overhead - making pricing predictable to attract new patients and helping prorviders maintain a stable margin.
By using a global rate and leveraging the network effect, DCNs allow provider to participate in bigger and more sophisticated contracts with demand aggregators like contractors placement agencies and gig-economy services.
All of this means more patients, better care, lower overhead, and most important of all, stay relevant in the new ultra-competitive healthcare landscape.
How Does It Work?
Healthcare providers and patients both sign up for a platform to connect. As there is no insurance involved, the concept of an “out-of-network provider” flies out the window. So long as a provider is signed up with the platform, a patient is free to get medical care from whoever they want.
This allows healthcare providers to increase patient volume by opening them up to more prospective patients than ever before. They don’t lose out on large swathes of potential patients because they’re not aligned with the “right” insurance provider; they get to see whoever, whenever.
DCNs Keep Costs Down – For Everyone
More than that, for the patients, DCN platforms offer incredibly affordable prices, usually a monthly subscription, with a fixed copay per visit. This empowers more people than ever before to get healthcare even without insurance, again increasing the prospective pool of patients for a healthcare provider.
All of this is usually wrapped up in a system that streamlines all of the tiring administrative work of onboarding a patient, billing, and collecting payment. Most of the processes become automated, cutting overheads and speeding up workflows dramatically.
DCNs Boost Your Marketing - For Free
But offering convenient, streamlined payment systems and affordable prices is only half the battle. As any healthcare provider knows, the other half – and perhaps the biggest headache – is the marketing.
Online DCN platforms will also market your healthcare practice to their massive user base. You provide them the marketing material, and they’ll get the word out for you. You just sit back, relax, and watch the patient volume increase.
Mira is the industry-first Direct Care Network developed to connect self-pay patients with healthcare providers in a way that benefits both sides – tapping into a $38B growing market.
The company was featured in the Washington Business Journal as one of the most promising healthcare innovations and surpassed over 3000 companies to win the Accenture Innovation Challenge.
Mira has many unique features that help set it apart
Global reimbursement rate. Healthcare costs are completely transparent with Mira. Every visit type has a fixed fee attached; no matter where you are or who you see, you know that your urgent care visit, for example, will cost the same every time.
Growth & retention. Urgent care has been historically transactionally and the cost to re-acquire patients is skyrocketing. Mira intelligently aligns each member with preferred clinic overtime to increase care continuity and help providers maintain recurring revenue.
Streamlined payments with virtual credit cards. Providers are assigned a virtual credit card as a form of payment when they get onboard to the platform. When an appointment occurs, a payment amount will immediately become available for processing. There’s no manual billing, no chasing up unpaid bills – payment is upfront, automatic, and digital, cutting your payment processing time from an average of 24 days to less than 5 seconds.
Patient education pre-appointment. Mira will let your patients know what to expect before their visit, so you don’t have to. This helps streamline your workflow so you can spend more time helping patients and less time going over administrative duties. You can also get patients to pre-fill forms before their visit by uploading them to the Mira platform.
Intelligent scheduling. Mira makes it easier than ever to make sure your appointment book is not only full but free of conflicting schedules and errors.
Marketing and advertising. Mira helps advertise your practice when you sign up. Mira will send you outreach materials to be displayed in the office. Members who sign up via your practice will get access to the entire Mira’s network with your clinic being the preferred medical home.
It’s free to join. No billing, no administrative fee, no sign-up cost. Mira is 100% free for providers to join. Considering the average cost of each patient acquisition is $50-$80, your practice will save thousands very quickly.