This post was originally featured on HIStalk.
Some of the fundamental tenets of capitalism are that that markets are free, open, and transparent. Healthcare is notoriously opaque, with little to no price competition within a given region. As such, many have pushed for marketplaces in healthcare.
The marketplace proponents argue that marketplaces will increase transparency and competition, and in doing so, create value and usher in a new wave of innovation. The Obama administration recognized this some time ago, and gave up a lot of political capital to push for federal and state health insurance exchanges as part of the Affordable Care Act.
We are in formative era of marketplaces in healthcare. Intrinsically, marketplaces only work if they can connect parties that were once disparate. With approximately 70 percent (that number can easily be +- 15 percent depending on who you ask) of providers using EHRs and the proliferation of smartphones and the Internet, the technological infrastructure has been laid to support dozens of marketplaces throughout the multi-faceted, multi-partied, fragmented healthcare system.
The following list illustrates just some of the opportunities for marketplaces within the healthcare ecosystem:
Allerad – radiology readings.
2nd.md – second opinions.
Healthtap – healthcare Q&A.
New Choice Health – procedures.
ePatientFinder – provider education, patient education, and clinical trials.
Informedika – providers and labs. I believe Informedika is looking to connect providers to diagnostic imaging centers and other free-standing, non-provider medical facilities.
It’s interesting to note that there are two distinct types of marketplaces: those such as Allerad and Teladoc/Ringadoc that provide a platform to deliver care services, and the rest that simply try to connect existing players in the healthcare system.
This post of course begs the question: what other marketplaces are to be had? Here’s a quick brainstorm. Some of these aren’t intended to be real businesses, but simply outline the number of opportunities to connect disparate healthcare parties along different dimensions.
- Concierge medicine services.
- Games and books (i.e. a lending library) for patients stuck in hospitals.
- ERs. Perhaps the marketplace could aggregate and show wait times, congestion and other KPIs for the nearest 2-5 ERs. Within an integrated health system, this could be particularly significant for resource allocation and disaster recovery.
- Find nursing home for parents.
- Find at-home care givers for parents.
- Rehab and therapy services – smoking, alcohol, physical therapy, cancer treatment.
- Plastic surgery, including of course lots of pictures.
- Fertility services.
- Cosmetic and optional medical services.
- Renting at-home sleep diagnostics.
- Clearinghouses. Although this sounds redundant, it’s actually not providers because have very few resources to understand and select the best clearinghouse to contract with.
It’s interesting to consider that many of these marketplaces work on the premise of helping providers and medical facilities fill up previously unused time (ZocDoc is the most prominent example). Many of these marketplaces are predicated on a fee-for-service model. How will they hold up in an ACO world?