Wave Labs - November 2023

After identifying a need for more automation, a smoother prior authorization process, and greater transparency throughout the RCM process, we set out to characterize the solution set and meet incredible founders working to create disruptive innovations.

The result was our RCM Wave Labs event. Here are five quick takeaways:

Need for aligned incentives (Dan Wilson, Moxe Health) – Buyers and direct participants in care (e.g., taxpayers / employers and healthcare providers) should have aligned incentives to reducing the overall cost of care. Looking for opportunities to reduce loss to middlemen provides additional revenue that can go to innovations that help these stakeholders.
Improve transparency (Ted Ferrin, Rivet) – Patients don’t know how much they’re going to owe, and providers don’t know how much they’re going to make. Answering these questions requires analyzing an immense set of variables that are fairly patient specific. This is a challenging problem but one that holds value for patients and providers.
Reduce friction between payers and providers (Dan Friedman, Ethermed) – New solutions, especially those in prior authorization or other areas where payers and providers communicate directly, should aim to be invisible to involved parties. Automated solutions can integrate directly within existing workflows and reduce manual labor tasks.
Bring fintech innovation to healthcare (Sasha & Callum King, Anatomy Financial) – Healthcare can look to consumer fintech solutions as a roadmap for how technology can turn manual processes into digital ones.
Look to reduce complexity (Mark Newman, Nomi Health) – Reducing complexity in communication between payers, providers, and patients can eliminate some of the more burdensome aspects of RCM and reduce overhead costs.