The U.S. healthcare system is broken. Costs are higher than other countries, while, dollar-for-dollar, outcomes are worse. There is a deep thirst among patients, healthcare providers and politicians for solutions, but today’s regulations can only point us in the right direction. The move toward a more outcome-focused healthcare industry, called for by the Affordable Care Act, demonstrates just how regulations alone cannot be the solution. That’s where private companies are needed to innovate.
Spreemo is positioned to help move the healthcare industry more towards outcome-focused care. Our cloud-based healthcare marketplace utilizes an intuitive interface to provide employers and their workers’ compensation insurers with robust management tools to easily refer and schedule patients and securely share data. With an initial focus on radiology services in the workers’ compensation market, we are injecting transparency and changing a system in which employers currently possess little visibility into the quality or actual cost of the medical providers examining their injured workers. That process is currently handed over to third-party middlemen who ultimately inflate costs.
Put simply, Spreemo believes that the quality of the healthcare team has a measurable impact on patient care. And, right now, that impact is being overlooked.
More specifically, Spreemo empowers employers with predicative modeling analytics and visibility into important quality metrics, which, when taken together, dramatically impact the quality and accurateness of the patient’s diagnostic study. By providing detailed and verified information, such as the type of equipment, experience of the radiology technologists and expertise of the radiologists, employers make more-informed referral decisions – and patients get back to work sooner.
However, it is not just the employers that benefit; Spreemo’s quality-first approach helps top-tier radiology practices attract patients based on the merits of their practice (instead of just on their price).
Spreemo’s goal is to give patients a higher level of care by bringing transparency to quality and price and to allow employers and providers to connect directly through a convenient and secure cloud-based platform.
2. What is your secret sauce?
Technology has shaped every facet of our lives; from the way we buy TVs to the way we plan vacations. Healthcare, in comparison, remains decades behind. Consumer-based transactions still occur in a black box; patients “buy” services without understanding the costs or the quality of the service. Consumers would never buy a TV on Amazon by only the price, without being able to know the model, make and features of the TV.
But, this is the way patients pick doctors every day – with little insight into their work-product (i.e., the outcomes of their patients) or the costs associated with their services. Many online offerings, such as HealthGrades and ZocDoc, provide subjective reviews regarding patient experience (e.g., is the office clean, was the doctor professional) and can even provide greater insight into the doctor’s training. This is valuable information, but it does not provide consumers information on the actual skills of their doctors and outcomes of prior patients.
Unlike on Amazon, where a bad TV selection can be returned, poor healthcare choices cannot be reversed and result in poor outcomes and higher costs. Spreemo’s online marketplace provides the tools enabling employers to make better referral decisions for their injured workers with visibility into price and meaningful quality metrics that can change the course of the patient’s treatment.
The healthcare industry is highly regulated and skeptical of change, but it can certainly benefit from new efficiencies and better ways to help consumers identify appropriately qualified doctors. At Spreemo, we are injecting transparency to give employers a more detailed view of the providers they send their injured workers to, with tools for predictive analytics, quality analysis, price comparison, direct communication and workflow automation. By bringing these parties together in a comprehensive environment built on transparency, patient care is optimized.
In addition to our actual product offering, I think part of our “secret sauce” is also that we are listening to both sides – employers and providers – and finding a solution that’s beneficial for both. Many have told us that we’re the first to do that.
3. How did it help you win?
We never think of running our business as winning. Whether you are IBM or a just-launched startup, you always face competition. But, we do measure success on two distinct timeframes.
On a daily and weekly basis, we see Spreemo as a change agent. As we build momentum and share our story with employers and providers, we build support for our vision, driving very strong growth in users of the Spreemo cloud.
Over the long-term, we are certain we’ll continue to see an evolution in healthcare towards a more outcome-centered system. So, we are positioning Spreemo to help consumers of healthcare get to that point more quickly.
4. What were the alternatives? What did it replace?
Spreemo is competing against much larger, much more established companies that rely on traditional phone and fax methods of managing referrals, which is both costly and unreliable. Moreover, these networks manage the payments between payers and providers, so their priority is to route injured workers to the lowest cost medical providers in order to increase their own margins.
When workers’ compensation was challenging to manage, with lots of paperwork moving back and forth, this expensive third-party system made sense and may have even added value. However, as it failed to adapt with technology over time, it led to an opaque marketplace where quality and outcomes were ignored, resulting in little control and visibility into the qualifications and quality of providers examining patients.
Spreemo is taking a different approach – one that provides full transparency of cost and quality and enables all stakeholders to communicate, share medical data and ultimately make more informed healthcare decisions in a secure, online environment.
This is the right approach for healthcare in general, but especially so in workers’ compensation, where employers and their insurers are responsible for an injured worker’s care throughout the life of the claim. For example, an injured worker that is poorly or incorrectly diagnosed will end up with suboptimal care, costing the employer millions in medical expenses and lost wages.
The workers’ compensation structure incents employers to take a course of action that prioritizes the long-term cost associated with poor outcomes, not the short-term costs alone for a medical procedure. A $50 savings in routing a patient to an MRI center with old equipment and substandard imaging techniques will pale in comparison to the added expense of multiple surgeries and years of physical therapy that may result if the patient is poorly diagnosed.
5. What did you learn to do better?
As with many startups, our business model has evolved and improved as we have learned more. In Spreemo’s early days, our objective was to create an online marketplace where employers could identify and interact with providers more efficiently and at reduced costs as compared with traditional networks.
Over time, we understood that in order to have an effective marketplace the consumer not only needs to know what is being paid, but also what is being purchased. The market’s desire for a solution for quality metrics was overwhelming both from the employer and provider. In consultation with leading industry experts and stakeholders, Spreemo developed (and is constantly improving) its predictive-modeling tools to enable quality providers to differentiate themselves from poorly performing ones and enable employers to identify the right medical specialist for their injured workers, based on the specifics of that patient.
Our space had previously been dominated by middlemen who made managing workers’ compensation claims all about price, leading quality to suffer. Employers struggled to find the right facility, and providers had little incentive to invest in powerful new equipment or top talent because they wouldn’t get a sufficient return in a price-first environment.
The Spreemo cloud brings transparency to the forefront – providing a platform where radiologists can highlight their group’s quality, the power of its equipment and the breadth of their experience. In addition, radiologists can set their own prices, instead of being browbeaten by third parties.
On the other side, Spreemo gives employers control of patient care, with the power to choose a provider based on a more accurate and complete picture of the quality of their healthcare practice. Ultimately, we believe this transparency will lead to better outcomes for patients and lower medical costs for employers.