A giant leap in the quest for clear health costs? PokitDok offers an API to parse pricing

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healthcare pricing

California-based startup PokitDok is adding another tool in its quest to provide clear healthcare costs to patients.

Today it will unveil its API, “PokitDok Platform,” filled with hard-to-reach pricing data. Third-party developers, health systems, insurers and employers will track in real time the life of a claim to see how efficient, or inefficient, a given doctor’s office or outpatient center may be.

At its core, the platform is aimed at other healthcare businesses to develop their own systems using the PokitDok API to accommodate their specific needs, such as HMOs looking at what sort of procedures consumers search for the most or a physician hoping to glean insights on utilization costs.

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“It’s information you would expect to see before any major purchasing decision, it just hasn’t happened in healthcare yet,” said Lisa Maki, PokitDok’s co-founder and CEO.

“Treatment doesn’t have to be this costly for consumers and providers who deserve to be swiftly compensated for care. This is a data arbitrage problem the PokitDok Platform solves today,” she said.

The platform could be particularly attractive for insurance carriers looking to offer a better consumer experience for scores of newly insured patients. It could help medical practices that have in the past had to contend with a slow and costly reimbursement system that provides little to no information on healthcare pricing, Maki said.

“The revenue loop has been closed,” she said. “Why does healthcare cost so much? A lot of it is contained within that closed system. With the API we released you can drive that cost close to zero, and we have to think that some of those savings will be passed onto the consumer.”

PokitDok API screenshotScores of top companies are in hot pursuit of providing clear costs in healthcare, whether its PokitDok or the likes of Castlight Health, which went public earlier this year. The winners get to be the shepherds for a new world of consumer-driven healthcare (and inherit the lucrative spoils of that position).

“This real-time internet-enabled integration of patients into the healthcare marketplace is about to get VERY busy,” Dwayne Spradlin, CEO of Health Data Consortium, wrote in an e-mail.

“We need to better enable individuals with the information they need in a complicated buying environment,” he added. “Why is it complicated?  Lack of information, pricing transparency, uncertainty and wide variability in coverage to name a few.  And a very small percentage of the population are conversant in the language of healthcare, much less health prices, insurance, and billing.”

Spradlin, who perused the PokitDok Platform briefly Monday at the request of MedCity News, stated he found the platform “intuitive, but clearly oriented toward very simple services and often the ones ripe for cash payments or simple insurance reimbursement.”

“Of course this is a good place to start,” Spradlin stated. “It is unclear whether the system does much to bridge the language gap, but it does promise a valuable service.

“Licensing the API is a brilliant and a typically Silicon Valley approach to scaling – build an ecosystem of organizations utilizing the gateway,” Spradin added. “This is a very credible way to scale quickly while owning and controlling the underlying assets – since the gateway and the data are the real assets here.”

The platform launch marks an important milestone for PokitDok, which was started in 2011 and last year raised $4 million from a group of investors.  It rolled out its web and mobile offerings in 2013, and the platform launch is the culmination of those efforts, with the focus now on hoping to spur further innovation from other developers.

The company expects to see demand increase, with more patients obtaining health plans, many of which are high-deductible plans and health savings accounts that will likely spur increased consumer attention on pricing. Similarly, shared-saving accountable care organizations need up-to-date data to best determine how to eliminate redundancies in care and preventable hospital re-admission rates.

“We have a large health system building out an ACO with our API because it’s the most transparent,” Maki said. “The only way to save money and have that translate to the patient is real-time access, and that’s what this is.”

Maki said PokitDok will measure progress in terms of adoption, how many queries and demos the platform gets, along with watching the diversity of who is utilizing the platform.

“With each question, we will start to really see a snapshot of the businesses of health,” she said.

[Photo from Flickr user Infocux Technologies]

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Dan Verel

By Dan Verel MedCity News

Dan Verel writes about how hospitals and health insurance companies are leveraging cutting-edge technologies to transform the industry -- from telemedicine to analytics to healthcare social media. Previously, he was a reporter at the North Bay Business Journal, where he covered healthcare, insurance, HR and employment, law and hospitality and tourism. His byline’s also appeared in the Oakland Tribune and the San Francisco Bay Guardian. He attended San Francisco State University and obtained a BA in journalism. He is based in San Francisco.
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