Introducing Clear Health Costs
Nine finalists will present their ideas for new ventures at the We Media NYC conference on April 6, 2011. A panel of judges will select two winners – and each will receive $25,000 and access to a network of mentors to help them launch. Clear Health Costs is one of the finalists. To register for the conference, click here.
Clear Health Costs
Location of operations: New York, N.Y.
Presented at We Media NYC by Jeanne Pinder
Jeanne Pinder, founder and CEO, email@example.com, 914-450-9499
Jeanne Pinder founded Clearhealthcosts.com. She volunteered for a buyout from The New York Times in late 2009 after more than 20 years there as an editor, reporter and human resources executive. While she was reinventing herself post-Times, she was lucky enough to take a class at the CUNY Graduate School of Journalism with Jeff Jarvis (”What Would Google Do?” and www.buzzmachine.com) and Jeremy Caplan (director of education for the Tow-Knight Center for Entrepreneurial Journalism) in the fall of 2010, during which she developed and refined the idea for clearhealthcosts.com while she acquired new journalism skills and sought new frontiers in the form of a job.
At the end of that class, in a capstone new-business pitching competition with her fellow students, she won a $20,000 grant from CUNY to move forward with this project. She’s humbled and gratified by the support she’s received and by the votes of confidence from Jeff and Jeremy and others, and she’s been working on clearhealthcosts.com fulltime since early January.
In addition to her New York Times career, she also worked at The Associated Press and The Des Moines Register, and as a Russian-language teacher and graduate student at Indiana University and at Leningrad State University.
She learned journalism at her family’s small-town newspaper, The Grinnell Herald-Register, in Grinnell, Iowa, which her grandfather bought in 1944 and which continues valiantly in family hands today.
We’re bringing transparency to the health-care marketplace. We are creating a transparency platform, a Web 2.0 community for a broad, consumer-driven conversation – with actionable information – about the enormously important topic of rising health care costs.
Rising health care costs are one of the biggest problems facing this country today, coupled with the opaque nature of the marketplace.
Nobody knows what things cost in the health-care marketplace. Prices are a complete mystery. Why would anesthesia for a half-hour operation in the New York area cost $2,000 in one place and $6,000 in another? Why would a simple New York area procedure like an MRI cost $2,426 one place, and $500 another place? Why does a New York area colonoscopy run from $750 to $7,500? How do insurance companies decide whether to reimburse $750 or $7,500? And why should I have to pay a bill that’s incomprehensible?
The system is rife with information asymmetry, just one symptom of the crisis. Because our health-care system is so problematic, and because of waste and inefficiency, rising costs threaten family budgets. Everyone knows someone who’s uninsured, or has a story of foregone doctors’ appointments, skipped prescriptions, and small conditions that become big.
In the worst cases, people are denied treatment. Sometimes they die. Sometimes they are bankrupted.
Businesses and governments are seeing a rising tide of cost increases for health care. But the question of what a procedure or an item actually costs is a mystery. Meanwhile, another symptom: my Cobra bill is approaching the size of my mortgage payment.
How is your idea a useful solution to the problem?
My site has five main components:
Sourcing and curating existing public and private data from the web.
Crowdsourcing – by using simple survey tools, I am inviting consumers to contribute information anonymously to a database that will be free and accessible so that people may give and get real information about costs, insurance coverage and the like.
Reporting. We are calling providers and asking for their self-pay or cash prices, and they’re telling us some surprising things.
We’re also writing a newsy, reported blog about these central questions: Why does it cost so much? And what can we do about it?
A forum, where people can give and get information in narrative form.
It all adds up to a community of people talking about health-care costs.
If the marketplace is transparent, consumers and businesses will be better able to make choices about health-care costs.
The Web has brought transparency to any number of markets. Airline ticket sales used to be opaque: Now we have kayak.com and itasoftware.com – and Expedia, Orbitz, Travelocity and so on.
It’s the same with real estate: once it was a mystery; now there’s Zillow and Trulia, and local realtors’ listings. It’s the same with car sales.
The health-care marketplace is the last big opaque marketplace. It’s time for that to change.
What’s the big innovation?
Clearhealthcosts.com is using the interconnectedness of Web 2.0 to make a place for people to get and give useful price information to consumers. It’s consumer-driven, easy-to-use and interactive. Health-care pricing information is closely held by providers, by insurance companies, by drug companies and other manufacturers, and by employers. Many of the prices represent not so much the cost of the thing, but something more akin to “manufacturer’s suggested retail price.” Or something else. How can the price of the same procedure in the same locale vary by a factor of 10?
The people who don’t have good pricing information and need it most are the Crowd (or the people formerly known as the audience). If we join together, in crowdsourcing, in sharing knowledge, we can collect price information and use it for good.
How did you come up with the idea?
A few years ago, we had three 30-to-45-minute surgical experiences in my family in the space of 14 months. The bills varied widely: anesthesia alone was $2,000 for two, and $6,000 for the third, the shortest one. One of the drugs used in that surgery was billed at $1,419; I found I could buy it in that size online in bulk at $2.47.
This experience gave me comparative health-cost information, which few patients have. I asked naïve questions, which is a journalist’s habit. I came to the conclusion that the prices often can’t be explained cogently; quite often, it seems, the price is “what the market will bear.”
What’s driving your business?
Several factors are driving the health-care marketplace toward change:
- Markets’ move toward transparency, and our habit for comparison pricing
- Pain in the health-care arena from rising costs
- Disruption in the industry
- Web 2.0 interconnectedness, which brings new ways of having conversations about all sorts of things, including pricing
Change is inevitable. In the next 10 years, the system will look quite different. We can help that change happen.
Who will use it and what for?
Uninsured or underinsured people looking for low prices. People going out of network, or out of pocket. People on high-deductible plans. People with high co-pays or payment denials who want to argue with an insurance company. People shopping for a provider; people wanting real information to compare health insurance plans.
People who share a health issue, say, perhaps the infertility community. Using a transparency platform with a few simple common procedures, they can anonymously enter their info and compare their provider, their insurance coverage, their charges, with those of others.
A union trying to beat back health-care costs? A nonprofit like AARP or the National Women’s Law Center? Businesses seeking to reduce their costs? All could find good ways to use a transparency platform.
Can you pull this off? What background, skills, network are you bringing to the project?
I’m a lifelong journalist. Reporting and understanding complicated problems at a world-class level and at world-class speed is what I did at The Times. I’ve developed a strong, smart collection of advisers, and a widely spread “kitchen cabinet” of medical professionals, people in the industry, health economists, consultants, current and former Times journalists, consumers, neighbors, friends and other interested people. They are on my beta tester list, which grows every day — every time I tell someone what I’m doing, and they say something like “transparency in health care – now that would be a wonderful thing.”
I’ve made some extraordinary connections – perhaps most important, with some people inside the industry who want change.
Among my advisers: Jeff Jarvis (“What Would Google Do?” and www.buzzmachine.com); Jeremy Caplan (director of education for the Tow-Knight Center for Entrepreneurial Journalism; Lee deBoer, founding partner, Propeller Partners; Carl Lavin, managing editor, MainStreetConnect.
What’s the current status – have you raised any funding, is there a prototype, have any partnerships, developers, designers or other team members been recruited; etc.
I won a $20,000 grant at CUNY, as I noted above. In an interview after the competition, Jeff Jarvis, my lead professor, said: “I’m proud of all the students who took the course and presented today. And Jeanne’s success was well-deserved. It’s a great message to other similarly motivated journalists. Not only are we launching a program as part of the Tow-Knight Center that will lead to the nation’s first Master of Arts in Entrepreneurial Journalism, we’re also offering a Certificate in Entrepreneurial Journalism for professionals looking to find new opportunities amid the profound changes that are disrupting the news industry.”
Then on Feb. 15, I was chosen one of three inaugural winners from more than 100 proposals by the International Women’s Media Foundation in its Women Entrepreneurs in the Global Digital News Frontier grant program. Key criteria included innovation in delivering the news and a clear business plan for sustainability.
“Promoting women journalists’ professional advancement — in both traditional and new media — is a central tenet of the IWMF’s mission,” said Liza Gross, executive director of the IWMF in a press release announcing the awards. “We look forward to working with these pioneering women entrepreneurs as they launch their exciting digital media startups.”
My beta site has been up since last November at http://clearhealthcosts.com/.
Since January, I have been building my database, using a group of freelance reporters to call New York area providers to get their cash or self-pay prices for a limited list of common procedures. We now have lists of abut 15 procedures, with anywhere from 10 to 30 cash prices, varying by a factor of as much as 10. I am also sourcing big datasets on the Web, while blogging a bit as well.
I think I just found an extremely knowledgeable and capable data partner (I can’t talk much about that at this point).
I’ve hired a freelance Web designer and am re-launching the Web site soon as a Minimum Viable Product, and making great connections and potential alliances. I am going to meet my self-imposed deadline of re-launching in three months.
How will it earn money/be sustained?
Consumer revenue stream: sponsorships, banner advertising, perhaps targeted advertising. Consumer buying guides? The site will be free for people to come and go; no pay model or subscription is envisioned.
Business revenue stream: this portion I understand less well at this point, but I am certain that there will be some business-to-business play. In the next few months I will take the information and the business plan to my potential customers (health-care-related companies, service providers, small businesses, trade unions, nonprofits like the AARP, patient groups) to better understand the business-to-business revenue side – consulting, white papers, analysis and the like are all potentials.
Other potential opportunities: a freemium model, events like conferences.
Market overview, competitive analysis
There’s a lot of medical information on the web. The big gap: price information for the consumer. That’s the gap I’m going to fill.
Four in five Internet users have searched the Web for health care information, often checking on specific diseases and treatments, a Pew Internet Project survey found. Pew also found that 61 percent of Americans regularly use the Web for medical advice, and that 20 percent have posted information about their health conditions at online forums.
A Harris poll found that 175 million Americans go online annually to look for health data, 32 percent of them regularly. Increasingly, they are looking for pricing information, partly as a result of the fact that more people are uninsured or on high-deductible plans, or because employers are pushing costs for premiums and co-pays onto employees.
Here are some web sites in the health space, and their users, in monthly uniques: Qualityhealth, 3.6 million; HealthCentral 1.7 million; Everyday Health 6.4 million; WebMD 15.1 million; patientslikeme.com, 71k.
In the health care costs space, there are a number of Web sites that are working to deliver some pricing information, many of them thoughtful but incomplete or vastly off the mark, for example: Healthcarebluebook.com 20,000 monthly uniques; Zocdoc.com 80k; Pricedoc.com 39k; outofpocket.com, 3k; Newchoicehealth.com, 25k; faircaremd, a total of 786 monthly uniques. (None of these are comprehensive sites.) There are also sites for consumers to shop and compare insurance plans (vimo.com, ehealthinsurance.com).
There are other companies that are not direct competitors, but are in that space: Some big companies use employee-specific information to beat back health costs. www.castlight.com, a California company, just got $60 million in venture capital to do something like that. Verisk, outside of Boston, was just described in Atul Gawande’s New Yorker article about using analysis of large amounts of data (employer source) to beat back costs. www.changehealthcare.com has a different company-service model: fee-for-service for self-insured companies. Qmedtrix, in Portland, Ore., analyzes data on behalf of the insurance industry.
As the health-care marketplace undergoes continued disruption over the next few years, there will be more opportunities, and more reasons for consumers to want this information.
April and May, after my site re-launches, are my target months for selling sponsorships and banner advertising to start to scale. I have been using the Times buyout money to live on, and that is running out, so I am motivated to make clearhealthcosts financially sustainable.
I used to sell advertising at the family newspaper, and I’m pretty good at it. I also intend to be strategic: founding sponsorships for chosen early supporters, for example, instead of remnant advertising.
My running costs are low: $2,500 for reporting so far, and $1,500 for developing the modest web site re-launch. Web hosting, Wufoo subscription, post office box, etc. are all minor.
If you win the challenge, how will you use the $25,000 to help you go further?
Three things, all needed immediately: data analysis to create a more robust service; a deep and thoughtful focus on user experience, building a community from the ground up; a COO or someone similar to help me.
Building a strong, viable product is tops on my list (and also paying the mortgage and my hefty Cobra bill).
Looking forward, my biggest costs are data services (analysis and visualization), where I think I have found that potentially very important partner; reporting and blogging; and the expectation that I will have to move off WordPress and onto Drupal; off WebFaction for hosting and onto some more robust server as I scale.
I am planning to add to the price list of procedures in the New York City area, then move out to other cities.
Final words: How will this investment impact the project?
This is a big problem. Together we can work to solve it. Thank you for your support.