Last year, I facilitated three discussions for HISA on Innovation in Healthcare as part of the Innovating Health series. HISA’s Innovating Health series has the ambition to connect senior participants in healthcare from many different parts of the system to discuss how to use innovation to address challenges and realise new opportunities. A common topic of those discussions was that there is plenty of positive innovation in the healthcare system. However, many participants were frustrated that innovations are isolated or unable to scale due to systemic issues, a siloed approach to health and care and a lack of collaboration between participants.
Across each of the three Innovating Health sessions discussion continued to return to the view that a step change in performance and policy outcomes will require:
- systemic innovation in healthcare beyond the boundaries any one organisation and the boundaries of our current siloed view of modalities and services
- greater connection of payers, providers and consumers to enable change and to increase choice and control
- creating ‘crucibles of innovation’ to enable policy makers, payers and providers to experiment, to learn and to demonstrate the value of new solutions; and
- parties coming together to take action on change.
Moving Beyond Silos in Health & Care Payments
Collaborative industry conversations are a powerful motivator of change because they enable participants to step out of their individual roles and see the wider picture of the system. These HISA conversations also highlighted to me the imperative to move from conversations to action. In August last year, I found a way to make a direct contribution to these four challenges by joining LanternPay as its Head of Markets, responsible for growing LanternPay’s propositions in healthcare, disability, insurance and ageing. This role brought together my passions for healthcare, collaboration, innovation and driving strategic change in complex systems.
LanternPay is a standardised claim payment platform across healthcare, disability, government and private insurance and aged care. Claim payments is a critical enabler for the necessary systemic innovation in the health and care, but too often in the past the solutions delivered to market have been siloed and not delivered to the broader needs of providers and payers. To improve the experience of the health and care system for all, consumers, providers and payers must all benefit, improve their choice and control and move forward together in a connected way.
Connecting Payers, Providers and Consumers in Choice and Control
In all my conversations around health and care, I have found providers are looking for standardisation of claim and payments workflow and greater certainty of payments to ensure. Providers want to maximise their revenue opportunities by delivering the widest range of services to consumers across health, disability and aged care. Providers don’t want to navigate multiple custom payment channels for each consumer, learning new processes and payment approaches on each new scheme and program. Having won the battle of getting the consumer to their practice or business, they don’t want to have to turn away consumers because of uncertainty or complexity of payment. Importantly, the provider doesn’t want to feel their direct relationship with the consumer is being managed by the payer or an intermediary.
LanternPay simplifies and standardises the claims experience for providers integrating it into their business processes and providing certainty of payment. Integration of claims and payments into provider systems reduces the cost to providers of adding new customers and new revenue sources. The effect of this change is significant. Here’s how a range of providers to the Transport Accident Commision in Victoria describe the experience of the change that LanternPay has brought to servicing TAC clients.
Health and care costs are rising faster than inflation. All payers and providers in health and care need to find ways to realise cost savings while continuing to improve care. Directly, LanternPay remove claiming costs and reduce customer & provider workload by simplifying and standardising the payment process for providers. LanternPay enables resources to be redirected from the administrative costs of claims and provider management to improving customer service and the quality of care.
LanternPay enables payers to work with consumers and providers to realise the benefits of consumer choice and control on costs. Our rules engine capabilities, deliver schemes the ability to shape authorisation and reporting with the participation of providers and consumers. The benefits are we turn authorisation rules into a real-time experience, improves data gathering and awareness of all parties of their choices. Our approach also enables schemes to move from payers after the fact to be a engaged participant in the delivery of care, helping consumers to understand more clearly the role of the scheme in assisting them to get care.
Consumers would like to make different choices to improve their care, but feel constrained by the lack of transparent, efficient & flexible payments platforms that deliver solutions where and how they choose to engage care. In a real-time omni-channel world, no payment scheme can afford force consumers to use only one channel of engagement. If payers want to avoid expensive costs for provider and consumer adoption, they need to provide solutions where the consumers are. Consumers want to focus on their care and recovery, not learning a new tool or process. For consumers, LanternPay enables choice of provider and ability to manage their care simply.
Systemic Innovation takes Collaboration & Action
LanternPay is already operational in the NDIS nationally and with the TAC in Victoria, but this is just the start of the wider vision for our platform. We have much work to do to develop the claim payment capabilities our platform and collaborate across the health and care ecosystem. We are actively working to engage payment schemes, both government and private, and to bring them together with providers who see the potential for new ways. We look forward to launching additional payment schemes as the year progresses.
To date, the response across health and care has been enthusiastic and we are finding great collaboration opportunities to showcase the innovation possible. As an example of our collaborative approach in action, Uniting Care’s LeapIn! has recently launched a new Android plan management application in the NDIS, based on our unique capabilities. We are actively collaborating with additional industry participants, providers, government and private schemes because they can see the growing scheme and provider benefits of a platform approach.
In our markets, we believe the best way forward is to demonstrate the potential for change in tangible ways. We are working to show the value of additional savings by bringing together providers, payers and other partners in pilots of new approaches. Transformative ideas need to be tested in practice with the widest range of participants in the health and care system. It is only through this action together that we will achieve the necessary innovation in health and care in Australia.
If you are interested in action to create innovation in heath and care, then reach out to talk. I would love to work with you to demonstrate what is possible when people come together to realise the value of innovation.