Cutting-edge technology continues to drive advancements in healthcare on the clinical side and – importantly – on the business side. Rectangle Health is no stranger to leading technology trends; we currently have our eye on enabling straight-through processing (STP) for insurance payments and leveraging artificial intelligence (AI) to streamline processes. These types of innovative technologies have become the norm when it comes to adding administrative efficiency and impacting the bottom line.
We spoke with Mike Peluso, Chief Product and Strategy Officer with Rectangle Health about some key trends that will surely benefit the entire healthcare industry.
Rectangle Health: Rectangle Health recently announced that we would be enabling straight-through processing (STP) capabilities in the Practice Management Bridge platform. Can you explain why STP is such a huge opportunity for providers?
Mike Peluso: Overall, payers are looking to build better relationships with providers. Years ago, the provider would sign up with an insurance network. After becoming an in-network provider, they would deliver care to the patient, and receive what would often be a very low reimbursement for their services. For example, they might be reimbursed $50 for a $300 cleaning.
After the Affordable Care Act was passed in 2010, reimbursement for providers increased. The act mandated that 80%-85% of insurance premiums had to go directly to medical care and quality improvements, meaning the payers could only keep about 15%-20% to cover administrative, overhead, and marketing costs. But reimbursements were still less than what providers wanted, and it became very critical for them to be in-network.
It’s a lingering issue and we’ve been spending a lot of time with payers recently to understand how we can help enhance their relationships and create efficiencies for the providers—reimbursement efficiencies, credentialing efficiencies, negotiating efficiencies, etc. The one that we’re focused on here at Rectangle Health is that reimbursement efficiency. How can providers receive reimbursements and get paid in a simpler, faster, and more efficient way?
Rectangle Health: And that’s where STP comes in.
Mike Peluso: Exactly. Electronic reimbursement for services has existed for years, but it’s very manual. The goal of STP is to eliminate all of the time-consuming reconciliation. Typically, insurers pay claims by mailing large check payments that cover multiple patients and procedures. That can mean hours of staff time applying payments accurately to patient records. With STP, the insurer can still send a lump payment via a virtual credit card, which is easy for them, and the appropriate money is allocated to the individual patient accounts within the provider’s practice management system—a game-changer for them. There are no checks or plastic cards, no human interaction where someone has to connect the payment to a claim; the money automatically reconciles.
Rectangle Health: We’re hearing a lot more about transformative technology, especially AI. Can you explain about how we might see some of these new, innovative technologies work their way further into healthcare—an industry that’s generally not one to quickly hop on the tech bandwagon unless it can identify a very specific need for it?
Mike Peluso: The healthcare industry is one industry where there is still a lot of human interaction. Patients generally still feel most comfortable with the human component of healthcare. Even if they are doing mostly virtual appointments with their doctors, they’re still relying on a real person to diagnose and treat.
No amount of technology will ever replace that human component, but there’s a tremendous amount of technology coming out that’s making physical care more efficient. Technology like Practice Management Bridge exists to improve the process of visiting and paying the provider, as well as unburden the provider’s staff so that it’s easier for them to focus less on administrative activities and more on care. I don’t think the healthcare industry fully grasps how much technology can help them in all aspects of running a practice.
But development of new technology is by no means slowing down. We all hear buzzwords like artificial intelligence and machine learning and think, ‘How is that going to apply to healthcare?’ Maybe it’s not a robotic hand in your mouth, scraping your teeth for plaque—at least not yet. But there’s certainly intelligence that can help facilitate all the administration around it today.
When we think about AI and what it might impact in the future, we’re not looking to impact the actual physical care. Rectangle Health is very focused on finding new ways to help providers see the right patients at the right time, for example. Technology to help detect trends in patient records or detect urgency through information submitted in appointment requests or intake forms—there’s so much that’s possible.
Rectangle Health: Do you see it as Rectangle Health’s goal to help providers embrace this type of technology?
Mike Peluso: Yes. That’s our job as a technology provider in this space. It’s our role to understand what it would mean to them—not only to find solutions for problems, but to find opportunities for improvement. Healthcare providers are using their brain capacity to focus on some really important stuff and they need partners who can bring ideas and technology to them. That’s us.
Rectangle Health: You’re covered solutions for payers and providers… now, let’s talk patients. We’re in this era of healthcare consumerism, in which patients are being selective about their healthcare when they can be. So, in this increasingly competitive environment, what can providers do to improve patient engagement and retention?
Mike Peluso: Our mission is to simplify the business side of healthcare. And it’s an important one. But the business side of doing just about anything has changed dramatically over the past 10 years. People shop online, use apps for ride-shares, stream movies… and companies have had to adjust or overhaul their business models to keep up. And so, when we think about the patient—you and me, we want to be able to engage with a healthcare practice the same way we engage with these other businesses. And that’s digitally. Providers need to be aware of that and keep up with patient expectations.
Patients have also become super cost-conscious. They want to engage with providers digitally, for the least amount of out-of-pocket cost as possible. They’re also looking to cut costs by using providers who are in-network. That’s how the world works today; we search for a product on Amazon, but then we look at Walmart to see if it’s cheaper there. Providers need to catch up with that and then layer in tools that will allow that type of analysis by the patient. It could be discounts, in-network configurations, financing, etc.
At one point in time, paying a provider with your credit card wasn’t a thing. Then, Rectangle Health’s original founders decided that it was going to become a thing. We’re really just following that same trajectory with today’s technology. We want to help providers run successful businesses, so that patients can have better experiences with them.
We can’t wait to show you what Rectangle Health has in store, so stay tuned. And if you’d like to learn more about how Practice Management Bridge can improve your processes, schedule a demo today.