Telehealth Provider Pulls The Middleman Out Of The Equation

People are avoiding medical care over cost, and it’s literally killing them. A simple visit to a primary care physician (PCP) starts at $25 depending on one’s insurance. Those in need of a specialist are often looking at closer to $60 per visit. An urgent care walk-in clinic costs $80, and if one gets particularly unlucky and needs to make a trip to the ER, the bill will come to at least $300 for walking through the door. And in many cases, consumers don’t go because there are so many middlemen adding to the expense.

That is the most essential way the U.S. healthcare system is broken, Ran Shaul, co-founder and chief product officer for telehealth provider K Health, told PYMNTS. K Health’s first mission as a remote healthcare platform for consumers was very clear, Shaul said. It pulled the middleman out of the system by asking consumers to pay cash. People questioned their choice not to take insurance, he said. But mathematically speaking, taking it out of the equation entirely makes it cheaper for the patient.

“For $19 on a platform, you can solve 85 percent of all the reasons a patient will go to primary care doctor,” Shaul said. “So you don’t have to think twice. That’s the big promise here. Stop thinking about a doctor visit and go do it and do it now. That doctor visit is so important because it will determine your health adventure.”

K Health, he said, wants those determinations to end better, and with a $42 million funding round closed in late 2020 and a new partnership with the Mayo Clinic, the goal for 2021, he said, is expansion and making remote care accessible to the many millions who need it.

The New Healthcare Playing Field

For all the pain and harm COVID-19 has caused in the world, the one potential silver lining is it forced the door open for telehealth and remote health arrangements that until now consumers and providers had largely been hesitant to push on.

Necessity, he said, is a powerful inspiration for consumers. Given a choice between going to a doctor’s office and getting exposed to COVID-19 or giving telehealth services a try, the choice was obvious. Consumers learned that remote care could work for them as well, sometimes even better than the version where they have to make an appointment, find parking and sit in a waiting room. Some will go back when the pandemic is over, he said, but a lot of people will adapt to an easier variation that remote care offers.

Perhaps more importantly, physicians have gotten an education in the merits of offering remote services, particularly as the structural barriers to its adoption have come down.

“There’s a lot of other regulations that if you saw before the pandemic around HIPAA, that were constraining because to be compliant with HIPAA is actually very complex,” Shaul said. “You also saw the way reimbursement for work in telemedicine before the pandemic used to be low, so physicians didn’t want to do it. Like why would I want to talk to someone on a video and solve the problem and get paid one-quarter of what I can get if that patient would come to my office?”

However, as privacy law processes were streamlined to make them more telehealth friendly, and reimbursement parity came into place, physicians found out that they could do a lot of what they were doing in the office online. With the support of artificial intelligence (AI) tools, it helps make them both more efficient and effective. That’s set the stage for using technological tools to do healthcare differently — and in a way that is more accessible to patients everywhere.

Healthcare 2.0

Going to “Dr. Google” for a diagnosis, Shaul said, usually doesn’t work out as hoped since Google always assumes the worst.

“Every headache is a brain tumor,” he said.

K Health, he said, asks customers to fill out a 22-question survey that comes complete with descriptive animations to help them better and more clearly describe their symptoms to the system. The system then comes up with a diagnosis, say a migraine headache instead of a brain tumor. But the AI isn’t there to replace the doctor, he notes, but to supplement the work of doctors. From that questionnaire, the patient can still tap a button and be connected to a physician in less than 15 minutes to seek guidance on how to treat their migraine.

And that magic moment, Shaul said, is expanding — they’ve recently added kids to the platform form and much of the $42 million they’ve recently raised, he said, will go toward developing that pediatric part of the platform.

Because what technology can do best for patients everywhere is make care accessible whenever the consumer decides they need it, said Shaul. They don’t want to destroy the insurance industry as insurance has a place, he said. But, Shaul said, it should be more like car insurance — which we all pay for, but don’t expect to use when it’s time to get the oil changed. Insurance for major medical, he said, makes sense — but insurance for everything is just making the system expensive and inaccessible for too many people.

“We want to give patients the ability to understand their condition and then give them the chance to control their own destiny. They want to know what’s wrong with them, and then they can decide how to act with the right information,” Shaul said.