Sorry it took me so long to get here. Hello, Selcen! Hello, classmates!
Here’s what I sent Selcen earlier … as a sketch of what I’m doing: the business sketch, the rough sketch of the sitemap, the mockup of the first front page of the relaunch.
The original beta site is still up, at http://clearhealthcosts.com, though it is soon to relaunch.
The development site is at http://chc.clearhealthcosts.com/ … and under construction. Many things about it are right, and many need fixing.
Oddly, some of the functionalities of this WordPress aren’t working like my other one: uploading files from dropbox, the “insert more” tag. Oh, well, sigh.
–hosting at Webfaction;
–under development on WordPress for my modest beta relaunch, with a developer who’s done three hyperlocal sites (http://jennschiffer.com/);
–Wufoo for data collection, both staff interviews and crowdsourcing;
–probably Mailchimp instead of Constant Contact, because it works with 37signals Highrise, which i have been told might be useful.
All free and open-source where I can get it and it works; rejected Google forms because the Wufoo functionality was so much better with no huge price difference.
Jeanne Pinder – Jeanne.email@example.com; 914-450-9499; Confidential, and not for public use
clearhealthcosts.com — bringing transparency to the health-care marketplace
The problem: Say you need minor surgery. For your half-hour procedure, the anesthesia cost could be $2,000, or it could be $6,000. You have no idea, and you can’t find out in advance. Maybe you need a colonoscopy. The price could be $800, or it could be $5,544. An MRI of the lower back? It could be $500, or $2,463. A drug that was billed to me at $1,419 from a hospital surgery was available for $2.49 in volume on line, and was reimbursed for $10.11 via Texas Medicaid and $24.36 via Medicare.
In most cases, you have no idea what things cost in health care before you buy. The marketplace is full of information asymmetry; the consumer isn’t able to see price information (although insurance companies and providers, like hospitals and doctors, have lots of information). Even after you buy, you don’t know what it costs – until the insurance company has finished its magic.
The solution: Transparency. Using web tools, I plan to bring health-care cost information to the consumer. My site has four main components:
- Sourcing and curating existing public and private data from the web.
- Crowdsourcing – by using simple survey tools, I am inviting consumers to contribute information anonymously to a database that will be free and accessible so that people may give and get real information about costs, insurance coverage and the like.
- Reporting. We are calling providers and asking for their self-pay or cash prices, and they’re telling us some surprising things. I’m also writing a newsy, reported blog about these central questions: Why does it cost so much? And what can we do about it?
- A forum, where people can give and get information in narrative form.
It all adds up to a community of people talking about health-care costs. Consumer-driven. Easy to use. Interactive.
My business is driven by: 1. Markets’ move toward transparency, and our habit for comparison pricing (gas prices, airline tickets, books, electronics); 2. Pain in the health-care arena from rising costs, 3. Disruption in the industry, and 4. Web 2.0 interconnectedness, which brings new ways of having conversations about all sorts of things, including pricing.
Who will use it, and what for? Uninsured or underinsured people looking for low prices. People going out of network, or out of pocket. People on high-deductible plans. People with high co-pays or payment denials who want to argue with an insurance company. People shopping for a provider; people wanting real information to compare health insurance plans.
People who share a health issue, say, perhaps the infertility community. Using a transparency platform with a few simple common procedures, they can anonymously enter their info and compare their provider, their insurance coverage, their charges, with those of others.
A union trying to beat back health-care costs? A nonprofit like AARP or the National Women’s Law Center? Businesses seeking to reduce their costs? All could find good ways to use a transparency platform.
Hey, wait: I’m insured, so why should I care? The insurance company pays, right? Well, your premiums are going up, partly because prices are going up. Each of us will be out of pocket at some point. Finally, businesses and governments are groaning under the weight of rising costs. It is important to us all to know what things cost and to be consumer-conscious. For most of us, this the second biggest item in the family budget – and yet there’s no price information.
It’s quite like airline ticket sales, real estate sales and car sales once upon a time. The seller had all the information, the buyer had none. It’s time for that to change.
Business model: The site will be free and open to all. The database and the forums and the blog, all free. It should feel like a community, with a certain presence to guide it. On the other hand, I intend to be profitable. I used to run my own business, and I sold advertising to support it.
For revenue, two separate streams:
1. Consumer. Sponsorships, banner ads, Google ads (targeted), shopping/buying guides.
2. Business-to-business. Consulting, white papers, custom reports. Events.
I intend to have something to sell against in 3 months, and to be covering costs via sponsorships and ad sales in 6 months; a fast build of the database, crowdsourcing and community functions, along with a vibrant newsy blog presence, are essential to drive traffic. Given what I expect to be the modest costs of the launch (web site development, survey tools, database analysis and development are the key costs) I think that will be do-able. Also I am bringing my own sweat equity in the form of writing, reporting and, eventually, ad sales – with a strict observance of the “old media” morals: if you buy an ad on this site, it does not allow you to dictate content.
There may also be a freemium model; maybe a membership for those who want an extra level of service (both individual and business).
Market research: A Harris poll found that 175 million Americans go online annually to look for health data, 32 percent of them regularly. Here are some web sites in the health space, and their users, in monthly uniques: Qualityhealth, 3.6 million; HealthCentral 1.7 million; Everyday Health 6.4 million; WebMD 15.1 million. In the health care costs space: Healthcarebluebook 20,000 monthly uniques; Zocdoc 60k; Pricedoc 61k. (None of these are comprehensive sites.)
It’s common wisdom that people don’t want to put their health care info online, but these crowdsourcing surveys are anonymous. Also people do put health information online: they’re out there talking about health, but not giving information to Google. The big gap in what’s out there: price information. That’s the gap I’m going to fill.
The conclusion: It’s a big problem. This is a simple solution, and a clear path forward. Thank you for your support.
The first sitemap
It’s changed a lot from this … Wish I’d had Gliffy.
Rough site map for clearhealthcosts.com 2-20-11
The basic goal: give and get information about health-care costs. Building a transparency platform, a community online, about the questions “why does it cost so much? how can we, the crowd, do something about rising health-care costs?”
the sensibility: earnest, thoughtful. people pitching in to fix something that’s broken.
The questions: who is your customer? what are you going to give her? how will she find you? what will keep her coming back?
Front page: see sketch
(this seems too busy to me at the top, and somehow i like the landing pages i’ve seen that have a series of 3-4 things that fade in and out talking about what you will see in the site….with no clicking required. … what do you think?)
(line under logo)facts about health care prices
(top of home page)
Health care costs are out of control.
It’s time for us, the consumers, to know more .. and to learn from each other.
(narrow stacked column far left )
example: an MRI can cost from xxx to xxx out of pocket
example: one insurance company may pay xxx for a colonoscopy, while another pays xxx
(in the middle, taking a bit less than two-thirds of the above-the-fold page)
(button) Get info
(button) Share your info anonymously
(button) If you’d like to know more, please join our mailing list *subscribe*
Under no circumstances will we sell or give your information to others.
(to the right, taking one third of the above-the-fold page)
Below the fold:
–Click on video of prezi presentation, narrated (2 minutes max)
–The “latest links” feature as on the front page of CommonHealth.wbur.org
families of pages:
Get info (this page should have click-through or pulldown bar for each of the below?)
Tests (each page has price list like this http://bit.ly/flgsDz derived from wufoo form, and also should also have an embedded wufoo form to give info; right now these are all “New York area” but it should be able to change)
Cardiovascular stress test
Echocardiogram with Doppler
MRI cervical spine
MRI lumbar spine
that’s it for now, but we need to be ready for more to come….
Give Info (each page should also link back to the “get info” page)
Cardiovascular stress test
Echocardiogram with Doppler
MRI cervical spine
MRI lumbar spine
that’s it for now, more to come….
Public and private data sources
(how many pages are needed for this?)
Consumer pricing guides
–Wondering how to negotiate with a provider?
–Insured but questioning a charge, a co-pay, a bill?
Forum–something like these forums, maybe we can come up with something better?
Static one-off pages to include
Contacts (email phone snailmail)
Invite a friend
Investors (like alex fair’s page)
Terms of Service
all sorts of ways to get in touch with us:
“tip the barista” — button
references every which way
flickr channel with a scan of your bill
how-to video on how to sign up for an electronic account
got a big issue you want to discuss with us?
Appendix on revenue: “Health Affairs,” the pre-eminent monthly magazine of the policy wonks, has support from organizations like this: Robert Wood Johnson Foundation, Kaiser Family Foundation, Wellpoint Foundation, W.W. Kellogg Foundation, Blue Shield of California Foundation. Think of Consumers Union, the Pew and Sloan foundations. Trade groups like AAMC (a nonprofit group of medical schools, teaching hospitals and academic societies), the National Pharmaceutical Council. The Rand Corporation. Project Hope itself, the publisher of Health Affairs, is a division of the People-to-People Health Foundation. Board members are from LA Care Health Plan, MIT, the Urban Institute, Harvard University, Stanford, the Center for Studying Health System Change. Health Futures Inc. is one of many advertisers who are consultants to the industry; its head is also on the board.
From another direction, thinking about categories for both banner ads and sponsorships: foundations; health-care delivery entities like hospitals and doctors’ groups; trade groups; consultants to the industry; schools that train doctors, nurses and other health professionals; think tanks; organizations like AARP and trade unions; Consumers Union and other consumer groups; nonprofits like the National Partnership for Women and Families and the National Women’s Law Center; publishers like the Journal of the American Medical Association, the New England Journal of Medicine and PubMedCentral.
Keeping in mind privacy laws (HIPAA): There are a multitude of ways for companies to use their own database with employee-specific information to beat back health costs. www.castlight.com, a California company, just got $60 million in venture capital to do something like that. Verisk, outside of Boston, was just described in Atul Gawande’s New Yorker article about beating back costs. www.changehealthcare.com has a different company-service model. As the health-care marketplace undergoes continued disruption over the next few years, there will be more opportunities for such partnerships, and more reasons for consumers to want this information.