Managed Care - January 2009 - (Page 21)

records. Big pharma may play a small but important role by creating linked diagnostic tests that make it possible to rescue drugs in trial that show levels of toxicity in certain populations but not others. The advent of genetic testing and precise pharmaceuticals heralds product line fragmentation, according to Christensen et al. “Volumes per therapeutic compound will drop significantly as the number of therapeutic compounds expands. Blockbuster drugs will become rare. This will necessitate reshaping the business model of today’s pharmaceutical companies In the future there will be fewer big gushers to cover the costs of drilling a lot of holes.” as ringtones and music are today. After a medical service, the patient enters a security code into the phone and calls the point-of-sale scanner at the provider’s office, just as consumers conduct online banking now. The amount owed for copayment and deductible will be configured and the doctor’s copayment as well as the insurance/employer payment will be transferred electronically from the patient’s bank account and the carrier’s bank account to the doctor’s bank account. “It’s online banking but using a cell phone,” Burrus says. Cell phones have already taken over functions of land lines, personal computers, games, cameras, televisions, and MP3 players. Mobile commerce is the next frontier, as these activities have migrated from computer screens and coalesce with advances in insurance and banking. It is part of an up-and-coming field called mobile banking and mobile wallets. Vivotech makes One disruptive technology gaining traction is the retail scanners; Mastercard and Visa are testing point-of-care medical payments via cellular phone. the technology. Burrus says it already exists in Africa A patient pays his complete medical bill as an inand Europe and will be common in the United surance copayment and/or deductible right after States in three years. These scanners are equivalent care is rendered. It’s not a health care disruption but to credit card terminals but are used instead a disruption in medical payfor contactless transactions. The ment systems. patient might wave a special card or “If you think about how much cell phone over the scanner. Such money is spent to process claims, reppayments are faster and more conetitious bills, and so on, the amount is venient for consumers than convenstaggering,” says the technology futional payments in which shoppers turist and medical consultant Dan insert their magnetic strip credit or Burrus, author of Technotrends debit cards into a reader. (HarperCollins, 1993) and six other Health insurers could be much books. “The whole process can be revleaner and patients and doctors hapolutionized with point-of-care transpier. actions, which can be done electroniA significant number of patients cally. The transaction will be verified — about 20 percent — will still reinstantaneously, electronically, on the quire intuitive care to reach a definspot. We will get rid of billions of dol- A staggering amount of money is spent to process claims, says the itive diagnosis, Christensen et al lars of waste in paper and postage, not consultant Dan Burrus. Revoluto mention man hours.” tionizing the process means avoid- write. However, by applying rules of The technologies that makes it pos- ing unnecessary costs of manthumb and other heuristics, the work sible are cell phones, computer chips, power, postage, and paper. that many physicians do today will software, and point-of-sale terminals. progress through the intuitive and empirical phases The business rationale is on-the-spot convenient and will be very nearly all precision, or rules-based, payments, another step in a move toward a cashless, medicine. paperless society. It has the potential to put skyThis will result in profound changes to the proscrapers of employees devoted to medical insurance vider-payment system, irrespective of the effects billing on unemployment lines. of many of other technological, sociological, and How does it work? Health plan card information political engines of change. MC will be downloaded to the patient’s cell phone, just POINT-OF-CARE PAYMENTS JANUARY 2009 / MANAGED CARE 21

Table of Contents Feed for the Digital Edition of Managed Care - January 2009

Managed Care - January 2009 Editor's Memo Contents Legislation & Regulation News and Commentary Medication Management Compensation Monitor Health Care's Disruptive Innovations Q&A With Clayton Christensen 'Disruption' May Be Plans' Best Bet Avoid the PBM Rebate Trap HealthPartners Puts Diabetes on Notice Formulary Files Plan Watch Tomorrow's Medicine Ad Index Outlook Unmet Needs in the Management of Plaque Psoriasis Impact of RSV: Implications for Managed Care

Managed Care - January 2009

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