Paul Ketchel, MDSave CEO and founder
A heath IT company that wants to automate the bundled payment process has received a $5 million investment from Cambia Health Solutions, a group that’s aligned with Blue Cross and Blue Shield businesses in the Northwest section of the country and invests in healthcare startups. Although Cambia published a news release about the investment recently, the amount was only revealed this week in a Form D filing with the U.S. Securities and Exchange Commission.
MDsave combines an automated bundled payment service with a price transparency tool for patients. Users interested in, say, getting an X-ray can check out its website, see what kind of a discount it can get on the procedure in their region. They can purchase the procedure through MDsave’s website, regardless of their insurance plan. That purchase could go towards their deductible. The company encourages users to contact their insurance companies for full deductible eligibility requirements.
Behavioral Health, Interoperability and eConsent: Meeting the Demands of CMS Final Rule Compliance
In a webinar on April 16 at 1pm ET, Aneesh Chopra will moderate a discussion with executives from DocuSign, Velatura, and behavioral health providers on eConsent, health information exchange and compliance with the CMS Final Rule on interoperability.
Although bundled payments might sound like a good idea in theory — that a flat fee would be used to cover a procedure and the inevitable follow-up care and is parceled to each stakeholder — as MDsave CEO and Co-founder Paul Ketchel sees it, the devil is in the details. How do you get each stakeholder’s payment to them in a timely manner? It’s a labor-intensive process and automation is essential to scaling bundled payments to a level where thousands can be processed each week. He believes MDsave has the platform to do it.
In a phone interview, Ketchel said his Brentwood, Tennessee company “is now offering pieces of its platform white labeled to payers and stand alone health systems running [accountable care organizations].”
MTS Health Partners out of New York has been MDsave’s lead investor, but Cambia is MDsave’s first strategic — and Ketchel expects there will be more. He said part of its strategy is to only take strategic money from companies that allow it to grow. Although the company has hospital customers in the Northwest part of the country, now it has a partner for which it will develop products for customers in the payer space.
Although it has grown rapidly since its launch in 2013, Ketchel said the business was fortunate in that its predictions for things like bundled payments were on the mark. Over the past year, it has grown by about 10 percent to 30 percent month over month, according to Ketchel. “At times we were pushed up against scale barriers but we managed to get there.”
A Deep-dive Into Specialty Pharma
A specialty drug is a class of prescription medications used to treat complex, chronic or rare medical conditions. Although this classification was originally intended to define the treatment of rare, also termed “orphan” diseases, affecting fewer than 200,000 people in the US, more recently, specialty drugs have emerged as the cornerstone of treatment for chronic and complex diseases such as cancer, autoimmune conditions, diabetes, hepatitis C, and HIV/AIDS.
Although Ketchel references Optum when asked about competition, Ketchel claims he doesn’t see any other companies doing exactly what it is doing.
“We have been doing this longest and we are the only ones who have engineered the human factor out through an automated process.”
