NEW YORK (MainStreet) — We're all weary of the stories about the flaws in the rollout of the Affordable Care Act, and the Obama administration is in full-on PR mode as a result. There are pros and cons, fans and detractors of Obamacare, but throughout the hullaballoo, an interesting phenomenon has emerged: startup companies that have stepped into the void to make the process of acquiring healthcare more seamless for consumers.
This is a real and relevant problem, as 15% of Americans are uninsured, approximately 2.2 million of them in New York alone. This causes a serious drain on the system; last year, uninsured people racked up a total of $42 billion in medical fees that never got paid, and the average U.S. family and its employers ended up paying an extra $1,017 in health care premiums to compensate.
From the beginning, the whole point of the Affordable Care Act has been to stem the tide of health care costs, but about seven in ten uninsured adults still don't understand how the ACA makes coverage more affordable, and only 29% know that the law might provide them with financial help, according to a 2014 study. For that reason, many of these new startups are tackling the educational component of the new law and by making it easier to sign up for a plan.
Here are some of the upstarts making a mark:
Founded by Sally Poblete, a former health insurance exec, after her own harrowing experience trying to navigate her medical bills following a difficult pregnancy, Wellthie services big insurance companies like EmblemHealth by providing tools to help them explain their plans (and the Affordable Care Act) to customers in real-speak. At present, Wellthie's signature tool is the Affordable Care Advisor, which helps consumers figure out which plans are best for them and calculates what kinds of subsidies they qualify for.
How it makes its mark: Wellthie is creating change from the inside out by helping insurance companies to explain their ACA plans—and consumers' benefits—better. Although the national and state health exchanges also allow consumers to browse plans and see how much they can receive in financial assistance, Wellthie lets users to see their options before inputting a ton of complex data and their Social Security number.
It's rare for the tech startup world to be so abuzz for a company in such a traditional industry—health insurance. But Oscar is just that darling, which has been valued at roughly $340 million and has raised more than $75 million in funding. Currently, Oscar only serves areas in New York, but it's nonetheless created waves.
How it makes its mark: The company is actually focused on consumers, which is actually pretty revolutionary for a health insurer. Oscar uses technology to make it easier to find doctors, search for your symptoms in natural language and receive free generic drugs and some free primary care appointments.
Covered and Gravie
With claims of "making health insurance human" and being a "Kayak for health insurance," Covered matches people with the perfect plan for them. As this new service is still in private beta, details are still forthcoming.
Gravie is similar. It helps you figure out what kind of health insurance coverage is best for you, whether you'll be best off buying it privately or through a public state health exchange, the best way to pay for it given your situation (like if you qualify for government assistance) and more.
How it makes its mark: Covered helps you search for a health insurance plan based on what you want, with three options—emergency coverage, typical care or coverage for an illness or major care event. Gravie is special because it includes access to experts to help you make your decision and provides unbiased advice. It's free to consumers, as Gravie makes its money from providers the way a traditional broker would.
PracticeFusion and CareCloud
The Affordable Care Act requires medical providers to switch to electronic health records and billing practices. Practice Fusion is a free certified electronic health record purveyor that also includes seamless connections to laboratories, imaging services, billing solutions and pharmacies. CareCloud is a similar cloud-based electronic health record service that includes a secure social network and medical billing.
How they make their mark: By putting medical records in the cloud, doctors and institutions can better connect and share information to help patients.
Turntable Health is an example of the new face of healthcare, in this landscape of murky charges and practices. For a flat membership fee, consumers can access doctors, a personal health coach, cooking and nutrition classes, yoga and more.
How it makes its mark: Members nab appointments on the same or next business day, rather than waiting forever, can call a physician 24/7, and can talk to their doctors by email, phone or video chat. Although this startup is based in Las Vegas, this all-in-one membership approach to healthcare is a growing trend, especially targeted toward a younger demographic that may be looking for check-ins but doesn't typically require intense emergency care.
After a recent Supreme Court ruling stating that naturally occurring human genes can't be patented, the genetic testing industry is poised to expand hugely. NextGxDx is a marketplace for various sorts of genetic testing. Targeted toward physicians, the website allows people to search through various certified genetic tests, compare those from various laboratories, seamlessly order those tests and then track the results.
How it makes its mark: The company, paired with the new law, may help bring genetic testing to the masses.
--Written by Allison Kade for MainStreet