A mobile application to offer upfront healthcare prices and automated medical billing for socioeconomically disadvantaged Americans

一款移动应用程序，可为社会经济弱势的美国人提供预付医疗保健价格和自动医疗账单

• 批准号: 10494210
• 负责人: Ahmed Marmoush
• 金额: $ 23.74万
• 依托单位: HANDL HEALTH LLC
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-23 至 2022-10-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10494210
• 关键词: Address; African American population; Algorithms; Ambulatory Care; American; Americas; Back; Black Populations; Businesses; Caring; Charge; Complex; Conflict (Psychology); Current Procedural Terminology Codes; Data; Databases; Decision Making; Development; Devices; Effectiveness; Employee Engagement; Ensure; Family; Future; Goals; Grouping; Health; Health Care Costs; Health Expenditures; Health Insurance; Health Personnel; Healthcare; Healthcare Market; Hispanic Populations; Hospital Shops; Hospitals; Human Subject Research; Improve Access; Incentives; Income; Individual; Inequality; Insurance Benefits; Insurance Carriers; Intuition; Knowledge; Label; Language; Latino Population; Legal; Literature; Medical; Modeling; Natural Language Processing; Nature; Outcome; Outpatients; Patients; Phase; Population; Poverty; Price; Procedures; Process; Provider; Public Health; Publishing; Quality of Care; Research; Role; Running; Sales; Savings; Science; Services; Small Business Innovation Research Grant; Time; Translating; Underserved Population; Uninsured; Ursidae Family; Visual; Work; barrier to care; base; care costs; cost; cost estimate; data harmonization; database query; design; digital; disadvantaged population; disparity reduction; effectiveness evaluation; experience; health care availability; health care service; health disparity; health disparity populations; health management; improved; inpatient service; insight; laptop; mHealth; minority health disparity; mobile application; novel; referral services; searchable database; socioeconomic disadvantage; success; tool; usability; user centered design; user-friendly

Project Summary/Abstract This SBIR Phase I project will develop a novel healthcare cost estimator and billing management mobile application to assist minority health and disparity populations in America find affordable healthcare and accurately pay medical bills. America has the largest per capita health expenditure in the world, and Americans bear the significant burden of this with medical debt reaching US $81 billion in 2016 [1][2]. Over a quarter of Americans have challenges paying for medical care and this disproportionately impacts those minority health and disparity populations, leading to disparities in access and ultimately health outcomes. For example, Blacks/African Americans are 25% more likely to have challenges paying for medical care than the average American, Hispanics/Latinos - 30% higher and socioeconomically disadvantaged populations - 60% higher for those who earn less than $50,000 [3]. To make fully informed decisions about their healthcare and be protected from surprise billing, patients must know the price and quality of a good or service in advance. Approximately 73% of inpatient care and 90% of outpatient care with the highest-spending are offered by multiple providers through the market, meaning if patients researched and compared these before making informed choices they could see significant savings opportunities, with figures of up to 19% shown in literature [4]. However, the evidence for this is conflicting [5]. On January 1st 2021, hospital pricing data for services and procedures became available for the first time, and while this data is accessible, powerful players in the healthcare market are incented to keep this commercially sensitive data opaque to the public [4]. Access to intuitive tools that simplify the research and comparison process would make the effort minimal and incentives high to find low-cost, high quality care. The ability to save pricing information related to the providers and services a patient may need, and the out-of-pocket costs they may incur will avoid surprise bills and allow for reconciliation when bills are received. This can help avoid excessive charges and empowers patients to inquire about discrepancies. The scope of science proposed in this SBIR project is to develop a novel cost estimator search tool fed by an aggregated database of hospital pricing information combined with an automated billing reconciliation tool run on a smart device or laptop for a dynamic, user friendly experience completely free to the public. Digital products of this nature are available for businesses today and have been shown to improve employee engagement with, and accessibility and affordability of, healthcare services. However, those unable to afford medical care are 3.4 times more likely to be uninsured (28.9M Americans), and part of families with incomes below 400% of the poverty level (24.5M Americans) [6]. These individuals often don’t have the support of employer-sponsored insurance and benefits, further widening the inequalities across the population. Approximately 70% of socioeconomically disadvantaged populations do, however, own a smart device [7]. The mobile health, cost estimator and billing management application developed through this project will offer for the first time a direct-to-consumer solution agnostic of employer and health insurer, dedicated to socioeconomically disadvantaged populations and their needs. The benefit of this pioneering work will be meaningful pricing information and billing tools becoming more universally available, protecting patients, reducing the cost of care and ultimately bridging the gap in accessibility and affordability of healthcare in America. In Phase 1, we will evaluate the technical feasibility and validity of the mobile application. In subsequent phases we will evaluate the usability and effectiveness through human subjects research, while building the required partnerships and sales channels to develop a commercially viable product.

项目总结/摘要 该SBIR第一阶段项目将开发一种新颖的医疗保健成本估算器和移动的计费管理 申请帮助美国的少数民族健康和差异人口找到负担得起的医疗保健， 准确支付医疗费用。美国拥有世界上最大的人均医疗支出， 2016年，医疗债务达到810亿美元[1][2]。超过四分之一的 美国人在支付医疗费用方面面临挑战，这对少数族裔的健康造成了不成比例的影响。 和人口差异，导致获得和最终健康结果的差异。比如说， 黑人/非裔美国人在支付医疗费用方面遇到挑战的可能性比平均水平高25% 美国人，西班牙裔/拉丁美洲人-高30%，社会经济弱势群体-高60%， 收入低于50,000美元的人[3]。 为了对他们的医疗保健做出充分知情的决定，并免受意外账单的影响，患者必须 提前知道商品或服务的价格和质量。大约73%的住院病人和90%的 花费最高的门诊护理由多个提供者通过市场提供，这意味着， 患者在做出明智的选择之前研究并比较这些，他们可以看到显着的节省 机会，文献中显示的数字高达19%[4]。然而，这方面的证据是相互矛盾的[5]。 2021年1月1日，服务和程序的医院定价数据首次可用， 虽然这些数据是可访问的，但医疗保健市场中的强大参与者被激励将其商业化 对公众不透明的敏感数据[4]。使用直观的工具，简化研究和比较 这一过程将使努力最小化，并鼓励人们寻找低成本，高质量的护理。的能力 保存与患者可能需要的提供者和服务相关的定价信息，以及自付费用 他们可能会招致将避免意外的账单，并允许对账时，收到的账单。这可以帮助避免 并授权患者查询差异。 在这个SBIR项目中提出的科学范围是开发一种新的成本估算搜索工具， 医院定价信息的汇总数据库与自动账单核对工具相结合 在智能设备或笔记本电脑上，为公众提供完全免费的动态用户友好体验。 这种性质的数字产品可用于今天的企业，并已被证明可以提高员工的工作效率。 参与、可获得性和可负担性。然而，那些无法负担 医疗保健是3.4倍的可能性没有保险（2890万美国人）， 低于贫困线的400%（2450万美国人）[6]。这些人往往得不到 雇主赞助的保险和福利，进一步扩大了人口中的不平等。 然而，大约70%的社会经济弱势群体拥有智能设备[7]。的 通过该项目开发的移动的健康、成本估算器和计费管理应用程序将提供 这是第一个直接面向消费者的解决方案，不受雇主和医疗保险公司的影响， 社会经济弱势群体及其需求。 这项开创性工作的好处将是有意义的定价信息和计费工具变得越来越多 普遍可用，保护患者，降低护理成本，并最终弥合差距， 医疗保健的可及性和可负担性。 在第一阶段，我们将评估移动的应用程序的技术可行性和有效性。在随后 我们将通过人类受试者研究评估可用性和有效性，同时构建 需要合作伙伴关系和销售渠道来开发商业上可行的产品。