Most patients and their families find it very difficult to understand their medical billing documents. Currently, there are no established standards for consumer medical billing documents and patients often receive multiple bills for the same episode of care, albeit varying in content and presentation, from different doctors, labs and hospitals. This makes it very difficult for the patient and their families to tally the bills; figure out what is covered in their insurance plans and finally how much they have to pay out-of-pocket. Added to the above problems for patients, is the medical jargon featuring in the bills, which is almost impossible to understand by the layman.
To ease the plight of the patients and their families, the Department of Health and Human Service (HHS) have decided to make changes in the way medical billing documents are made along with improvements in the medical billing system. In order to get the best possible options, the HHS has recently announced the “A Bill You Can Understand” design and innovation challenge. Offering an award of $5,000 each to the best submissions in the two categories, the challenge is open for any business or non-profit entity, individuals and teams of five or less. However, the contestants will have to be either US citizens or permanent residents, aged 18 years or older. Submissions to the contest will be accepted until August 10, 2016, with the winners being announced in September 2016.
The goal is to improve the patient’s overall financial experience with medical billing. According to Sylvia Burwell, HHS Secretary, “This challenge is part of HHS’ larger effort to put patients at the center of their own health care. We are creating progress toward a medical bill that people can actually understand and a billing process that makes sense – progress that includes creating a forum that brings everyone to the table: patients, doctors, hospitals, insurance companies and innovators.”
Participants taking part in the challenge will need to reinvent the entire medical billing journey. The challenge is split into two parts:
- To design a bill that is easy to understand for the patients and their families.
- The best transformational approach to improve the medical billing system.
Judging the contest
Judges will be looking for the most improved medical bill design and one that is easiest to understand. For the billing system, the focus of the judges will be on what the patient sees and des throughout the medical billing process along with the system’s alignment with modern consumer expectations. In both the cases, entries will be examined for all necessary data and information, their ease of understanding and usefulness. Entries will also be judged on transparency, uniqueness, creativity and the use of simple language. According to HHS, submissions will be judged based on understandability, creativity and how well they address the challenges outlined by patients, providers and payers, among other criteria explained on the challenge website.
All submissions have to include the design concept in the case of the medical bill and a journey map or wireframe in the case of the billing system. Submissions will also need to include both written and video explanations; the criteria for which will be provided on the challenge website. Judges will comprise of HHS leadership, with inputs taken from an advisory panel consisting of individuals who are in compliance with the requirements of the COMPETES Act.
Sponsorship and testing
Sponsored by AARP, a non-profit organization and administered by Mad*Pow, the challenge will feature its winning designs at the Health 2.0 Annual Fall Conference in September 2016, in addition to the challenge website.
According to HHS, organizations like INTEGRIS Health, Cambia Health Solutions, The MetroHealth System, Geisinger Health System, University of Utah Health Care and Providence Health & Services; which combined cover almost 3.5 million people and have over 10 million patient visits yearly, have agreed to either test or implement the winning designs and solutions.