Building a new financial infrastructure for healthcare

C. Martin Harris, MD

While there has been much talk in healthcare about using information technology on the clinical end to build an interoperable industry, the financial side of healthcare has been given short shrift.

C. Martin Harris, MD, the chief information officer at the world-renowned Cleveland Clinic, wants to change that. Harris delivered a keynote address Wednesday at the Summit for Healthcare Information & Financial Technology, during which he proposed the creation of a comprehensive financial management infrastructure for healthcare that would match the vision of networked clinical information exchange.

“We need to keep the clinical and the financial tied closely together,” Harris said. “What I have in mind is a patient-centric financial management infrastructure that would clearly optimize the value of care to patients.”

The patient is currently disconnected from a clear sense of financial responsibility, Harris said.

In the current reimbursement model, the patient is unaware of the cost of care, and does not have the tools to compare cost across providers and facilities. Harris called for a system that allowed for more transparency in costs, so patients could access accurate, real-time estimates of what charges insurance would cover and what a patient would be responsible for paying.

“The contemporary healthcare billing process is cumbersome, inefficient and expensive,” Harris noted. As an alternative, he asked the audience to imagine a system in which patients presented a “universal” healthcare card at the point of service, a card that combined the resources of a health insurance card and a credit card. Providers could get real-time patient identity and insurance information, while patients would be able to get a clear sense of what they owed. After the visit, patients could access an updated bill online via a patient portal.

A transparent financial system in healthcare would be developed in a metrics-driven manner, Harris said. He raised the example of the HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) survey, claiming that there should be similar metrics generated for financial transactions in healthcare.

Harris acknowledged that his vision of a transformed healthcare financial management infrastructure was not yet refined, and invited contributions and insights from both the IT and the finance communities.