The Digital Merchant 2022: e-Payments Ease Healthcare Pains

Whether or not all stakeholders fully grasp it yet, healthcare finds itself on a slingshot trajectory into a connected digital future of better care, more affordable medication and easier payments.

It was a long time coming, as a monolithic healthcare system for decades resisted change or was too busy dealing with life-and-death situations to focus on processes like payments. But the pandemic brought legacy issues to light, and companies in the space are moving to fix them.

For example, in a conversation with PYMNTS’ Karen Webster for the “Digital Payments Flip the Script: 10 Merchants and 10 Visions for Digital Transformation” series, a PYMNTS and PayPal collaboration, Truepill Co-Founder and CEO Sid Viswanathan noted that telehealth was hardly a blip before the pandemic arrived. Now, it’s a large industry segment that is evolving to become an expected element of care.

“Fast forward two years and ask consumers if they want to go back to the old way of healthcare,” he said. “You get a very glaring opinion on the new way being really the right way.”

People got comfortable with telehealth fairly quickly. Building on this new demand, healthcare providers must offer robust telehealth platforms that do even more.

As fulfillment partner for leading prescription discounting platform GoodRx, as well as high-profile startups like online discount pharmacy Mark Cuban Cost Plus Drug Company, Truepill is positioning itself to add value to many aspects of the new healthcare routines of Americans.

Gone are the days when you would “blindly trust the cost structure or design of your health plan and say, ‘I’m going to pay it,’” he said. “Now, you’re seeing a change in the consumer mindset.”

That change is about choice, price transparency and convenience in this rapidly reforming sector, where work is needed to deliver the digital health experiences we now expect.

Viswanathan said that despite pandemic breakthroughs, “the underlying technology and infrastructure and the incumbent stack just wasn’t there; it wasn’t ready to make that transition.”

He added: “What’s needed to get there for this next phase [is] investing in that infrastructure. It’s investing in that backbone to make sure every institution, whether it’s your largest health systems to your on-the-ground federally qualified health clinics, have modern technology stacks to deliver a high-quality accessible telehealth visit.”

With PYMNTS research finding that 33% of patients would now switch doctors for pre-care estimates and 36% think billing is antiquated, that evolution is in the air, but it takes support.

At present, “stats in the country are roughly 5% adoption for mail order pharmacy,” Viswanathan said, adding that “[t]he way our industry works, the way the stakeholder incentives are aligned or misaligned, frankly, has led to the current status quo of mail order” with partnerships with firms like GoodRx that can scale.

But Viswanathan noted: “If you don’t have buy-in from the largest healthcare organizations in our country, you don’t move this ball forward. I think we are seeing that change now.”

See also: Healthcare Tech Company Truepill Raises $75M to Expand

80% Telehealth in Three Years?

Saying that patient smarts is vital to healthcare’s future, Viswanathan said: “I don’t believe the education and awareness on how to shop for healthcare exists in the country today.”

“We’ve seen an evolution of these high deductible plans where now consumers can make trade-off decisions on what [a prescription] costs on benefit, what my deductible is, and what it costs on a cash basis,” he said. “It’s just in the last few years that consumer are empowered to ask those questions.”

Being empowered to control one’s healthcare prices and providers is a switch from the old way of letting the insurance plan call most of the shots, as consumers understood little.

It’s a lot like finance, which Viswanathan called “a perfect corollary in an adjacent industry that also is heavily regulated, that has sort of institutional ways of thinking, that has really kind of transformed in the last five to seven years.”

“We’re all probably now using Robinhood or using Venmo or something of the like to manage our consumer finance,” he said. “The stat I saw more recently was, I think, four out of five Americans today use some consumer finance application. We’re experiencing that now in healthcare.”

This has enterprise healthcare organizations now making five to 10 years of decisions on digital “moving in a matter of quarters, which is very exciting to see, and a huge opportunity for us as a business at Truepill to begin to amplify that and enable them to move a lot more quickly.”

Looking ahead three years, Viswanathan said he sees 80% of healthcare being delivered in virtual settings and at home.

“There are companies today setting up ICU-type environments in-home,” he said. “They’re demonstrating that the ROI of setting up in your home with remote monitoring with providers at a centralized location far outweighs the cost benefit of being in a physical ICU.”

Read also: Mark Cuban Cost Plus Drug Company Finds Online Pharmacy Sector Swimming With Sharks

Pandemic Learnings in Action

PYMNTS research found that 67% of digital-first patients — typically millennials and younger — visited a new doctor in the past year. It signals the broader shift taking hold.

Pointing to “a huge dilemma” around where consumers will seek acute versus episodic care and how information is shared back to primary care providers, Viswanathan said: “The future is one where you’re seeing the emergence of virtual-first health plans where the concept of the benefit design is being revolved around only a virtual offering, combined with maybe catastrophic care if you have to go into a hospital, for example.”

As people move more of their care into the digital domain, offline relationships with pharmacies and physicians must move seamlessly with them or threaten patient experience.

This is playing out across the sector, particularly the growing field of at-home care and how specialties and certain types of procedures cross over from hospital to home.

He gave the example of weight loss, where there are medications and treatments best understood by specialists, and “you can argue that clinically they know how to deliver the best quality care for that specific therapy area. The other school of thought is, how do you build continuity of care” with this model.

Platforms like Truepill and others are refining their methods after learning from the pandemic run-through.

Viswanathan said during the worst of the pandemic, “we figured out how to [deliver care and handle payments] kind of through brute force. That tells you sort of what the upper limit or bounds are if we build the infrastructure and technology and support to transition the world over.”

There’s a lot of work to be done in connecting the growing number of telehealth platforms with the rest of the healthcare ecosystem for a whole-patient approach that leverages data and digital technology.

We’re not there yet.

Viswanathan noted that partner GoodRx represents “a tiny fraction of the Americans that are on medications today,” adding, “I would bet many of them walk into pharmacies today and are paying a price that is either their benefit price that might be higher than the cash price, or in some cases, they’re underinsured or uninsured and paying the retail sticker price.”