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

项目摘要/摘要 该SBIR第一阶段项目将开发一种新的医疗成本估计器和计费管理移动设备 应用程序帮助美国少数族裔健康和差异人口找到负担得起的医疗保健和 精准支付医药费。美国是世界上人均卫生支出最高的国家，而美国人 承担这方面的重大负担，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遇到了困难，这对少数族裔的健康造成了不成比例的影响 和不平等的人口，导致在获取和最终健康结果方面的不平等。例如, 黑人/非裔美国人在支付医疗费用方面遇到困难的可能性比平均水平高25% 美国人、西班牙裔/拉丁裔-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完全知情的决定，并防止意外账单，患者必须 提前了解商品或服务的价格和质量。约73%的住院护理和90%的 花费最高的门诊护理是由多个提供者通过市场提供的，这意味着如果 患者在做出明智的选择之前对这些进行了研究和比较，他们可以看到显著的节省 机会，文献[4]中显示的数字高达19%。然而，这方面的证据相互矛盾[5]。 2021年1月1日，医院首次提供服务和程序的定价数据，以及 虽然这些数据是可以访问的，但医疗保健市场的强大参与者被鼓励将其商业化 敏感数据对公众不透明[4]。访问可简化研究和比较的直观工具 这一过程将使寻找低成本、高质量医疗服务的努力最小，激励措施更高。有能力 保存与患者可能需要的提供者和服务以及自付成本相关的定价信息 它们将避免意外账单，并允许在收到账单时进行对账。这有助于避免 过高的收费并授权患者查询不符之处。 在这个SBIR项目中提出的科学范围是开发一个新的成本估计器搜索工具，该工具由一个 医院价格信息的聚合数据库与自动计费对账工具相结合运行 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如今已为企业所用，并已被证明可以改善员工 医疗服务的参与度、可获得性和可负担性。然而，那些买不起的人 医疗保健没有保险的可能性是3.4倍(2890万美国人)，部分有收入的家庭 低于400%的贫困率(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确实拥有智能设备[7]。这个 通过该项目开发的移动医疗、成本估计器和计费管理应用程序将为 首次推出与雇主和健康保险公司无关的直接面向消费者的解决方案，致力于 社会经济弱势群体及其需求。 这一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更多 普遍可用，保护患者，降低护理成本，最终缩小 美国医疗保健的可及性和可负担性。 在第一阶段，我们将评估移动应用程序的技术可行性和有效性。在随后的 我们将通过人体受试者研究来评估可用性和有效性，同时构建 开发商业上可行的产品所需的合作伙伴关系和销售渠道。

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.