John Casillas on A Vision for eHealth Using Banks

Intro: Thank you Maureen and the entire team at the President’s Council, they deserve so much credit; Members and Sponsors.

Once a person visiting a restaurant in France was so taken by the entrée that she asked the Chef for the recipe. The following year she visited the same restaurant, ordered the same dish and asked for the Chef again. “I’ve tried it over and over again and its not coming out. What’s the missing ingredient?” The Chef replied, “madamme, after you follow the directions you must throw yourself into it”.

Today, during an unprecedented global crisis in banking and as our domestic healthcare systems strain under the weight of a growing underserved population, it may seem counter intuitive to link two ailing systems. But for those in banking and healthcare who have thrown themselves into the prospect of improving healthcare, a new vision of the future is emerging that is powerful, energizing and compelling! They have stumbled upon a missing ingredient in our national dialogue to improve healthcare – medical banking. And they realize there is simply too much at stake for banks not to be sitting at the table as we fix our healthcare system.

The recipe for economic disaster is a broken healthcare system. This was the central message of the President at last week’s healthcare summit. Thus all the things that drive the banking and financial services engine rely on healthy individuals and communities and a productive labor force. Dr. David Mirvis, who will be on our Federal Health Board panel today, researched this linkage and found that economies rise and fall based on the health of people in an article published in JAMA. Dr. Stephen Parente, who will also be on our panel today, wrote in our Dr. HSA Column that an economic stimulus pathway could be distributing using cards credited with $500 to be used for prescription drugs, adding that while he’s not very excited to see so much money being spent, if its going to happen anyway, let’s spend it smartly. Many see a clear link between healthcare and economic vitality so the real question is why wouldn’t banks be fully engaged, why wouldn’t banks use their resources in the national quest to fix healthcare.

We’ve all heard a common ingredient for success: “necessity is the mother of invention.” Perhaps it will be of necessity that we find healthcare using the rails of our banking complex to finally realize the national dream of real time data exchange between all the industry actors. When the dish is ready, we believe that banks can ramp healthcare onto a digital platform. Banking processes were at one time mired in paper too, and there is no question that the lessons they bring to the table, and in some cases their very systems and processes, in which they are highly invested, can fast forward our national eHealth strategy. Yet we don’t hear very much about this paradigm shift in the national process. We hear about spending billions of dollars to create a new digital system, but what about the digital system lying right under our nose?

Ultimately, our challenge is to forge a health-wealth view of the future, where banks join with fellow healthcare stakeholders to develop common solutions to help the uninsured and unbanked, to socialize better tools and information that families can use for their medical treatments, to help individuals get real time access to their healthcare records through online banking used by 55 million households in America and growing, and to enable community centers that President Obama is investing in with eligibility, funds and data transfer platforms that support far greater coordination of the finite healthcare assets in the community. Oh yes, we have a vital ingredient and a critical role in the national dialogue and don’t let anyone tell you otherwise.

Banks and financial services firms are teaming with health technology companies and others to create a new paradigm, starting with vastly improved administrative processes and moving up the value paradigm in phase 1, to automating workflows that remove the paper chase, leveraging the unique market position of the bank to process and capture payment data that improves revenue cycle decisioning through denial management or contract management routines that take up so much time in the business office, and finally moving to the top of the pyramid of value, to address the enterprise needs of the healthcare community. Different banks are evolving at different rates along this pyramid. As you do, know that the top contenders have found compelling prospects for profitability. As success stories come in, medical banking groups are following this strategic pathway, creating one of the nation’s most compelling “Green Tech” engines – another tie into the goals of the Obama Administration. Yes, we have a critical ingredient for the national dialogue to improve healthcare.

Moving to phase 2, we should align the immense annual investments in privacy and security in online banking with the unique data needs of each stakeholder. This calls for electronic integration of assets to liberate data so it can travel securely in real time. We’re all stirring this pot together – our own build-out of specialized banking platforms, NGA’s recent summit where former HHS Sec Leavitt called on leaders to “remember Argentina” and to invest in healthcare to stimulate the economy, John Halamka’s HISPC 11-state collaborative to normalize state laws that impede the flow of health data across state boundaries, WEDI’s leadership to move us toward the 5010, EHNACs program for clearinghouses, ABA’s HSA Council, TAWPIs new HPAS, HIMSS’ annual summit and much more – all of these efforts, in my view, are moving us towards greater data liquidity that at the end of the day will, and must, empower the consumer.

In phase 2, banks are embracing the power of their market position, reving up eHealth strategy, creating real time gateways with health IT partners, specializing card platforms to automate payment processing across stakeholders, leveraging online banking to support single-sign on for the consumer, giving families private access to health-wealth tools, and although Track 1 is a primary focus for many today, the recipes of the future belong to Track 2: innovations in medical consumerism.

So we ask you to apply yourselves diligently to the task of exploring how financial systems can align with the national process to improve healthcare; and this moves us to phase 3, examining how governance models, like the Federal Reserve, can spearhead common standards banks can use to empower business and consumers with mission-critical and family-critical tools…tools that hospitals can use to automate the routines in Phase 1, tools that health plans can use to reduce disbursement costs, tools that community care centers can use to access healthcare assets in real time, tools that will allow you and I to use a “healthcare ATM” just like we use the regular ATM, so if we travel abroad as a medical tourist or just across the country and we get ill, we have secure and private on demand access to our healthcare records and our financing resources at the swipe of a card. We can get this done!

Building an electronic medical banking community, the theme of our event, moves the President’s “Green Tech” agenda forward. Rationalizing the extreme paper chase in healthcare is core to modernizing our healthcare system. We’ve done good work digitizing the front door, sending the claim from the provider to the payor but the back door was left wide open and today, whenever you visit a care giver, a steady stream of paper follows you – almost all payment related. This mountain of paper invades our healthcare system, creating enormous barriers to efficiency, siloing data that needs to be securely liberated to improve healthcare at every point along the process and especially at point of service, where adverse drug events cause avoidable pain and loss.

Who will liberate this data? How will it happen? If you follow the trail, it leads through the banking world – a service is rendered, payments are processed. In this country, payments only move through banking systems. Thus banks can use their tremendous investments in information technology to ramp healthcare onto the on-demand paradigm that leads to better health programs for all the stakeholders. That is in large part what our educational program here is about. And what we need to do is understand how to add value to that data so it can address the unprecedented cash flow pressures our health care system is experiencing, not just from the economic downturn but because of the very complexity of our healthcare payment system. Today, I’m very proud to report success stories coming in from our members – one provider saving $4 million in 12 months after implementing a medical banking platform, another saving $660,000 and other stories that are catapulting medical banking into best practices. Yes, we have a Green Tech Message that is delivering compelling ROI and we need to spice up the national debate by making our voices heard. And I’m proud to say that that is what we can do at this Institute.

Sometimes when agonizing over problems you wake up to find solutions right under your nose. I want to suggest to you today that the medical banking build-out is inevitable. As banks linked with airline systems removed layers of inefficiency, enabling consumers with online tools, so medical banking is following a similar pathway, pushing paper out of the system, liberating data, fueling revenue cycles and decisioning; helping banks and their healthcare clients to gain a better view of the intrinsic value of the fundamental financial unit in healthcare, so taxed with myriad codes, and potentially unleashing $200 billion in credit from receivables that are wasting away on the books and records of our nation’s healthcare systems. Other industries have liquidated this asset. This is a mainstream practice except for healthcare, where the value of receivables is too often locked in a deep freeze. This will change in the new medical banking paradigm.

Now, do you remember how when growing up, Mom made you eat the peas? Some of you still don’t like peas because of that. Value should drive progress not legislative fiat. It may make sense to engage a legislative agenda at some point, but for now we’ve chosen to take our ideas to the marketplace and let the market decide. And they have. The 1100 employer strong Automotive Industry Action Group embraced medical banking as a strategy, helping us to create a new Tool Kit for Employers to diffuse medical banking practices in the marketplace, and we’re excited that LeapFrog and others are taking notice of our efforts. MBProject just aligned with NCPDP, the only group that is doing real time processing on a general basis, to cross-pollinate ideas with our banking members. The HFMA is here, a powerful healthcare group, and this is testimony to the power of our ideas. I look forward to hearing Bob Broadway tell us how we can help hospitals navigate one of the toughest times in the history of healthcare. As Obama said, we’re at that Thelma and Louise flashpoint in healthcare, where the car could go over the cliff. The medical banking community will not stand by idly and watch banking and healthcare crash burn. We’re in the game. Its Game On for Medical Banking!

We reached out to consumer groups too. Greg Scandlen, founder of Consumers for Health Care Choices, will share his ideas and I’m going to listen to him carefully. We need to listen to consumers, because our quest to build platforms that serve business will ultimately find critical mass in service to families. Banks know the power of scaling services for the masses, which they do everyday. As we collectively fine tune the vision in medical banking, new concepts will emerge of how to marry online banking, credit terminals, ATMs, branch systems, to personalized healthcare platforms that promote better lifestyles and better healthcare. Not only will this improve customer retention but banks may add three times more to the bottom line by creating a health-wealth portal, linked to online banking, based on an extrapolation of research done by Dr. Paul Whitman, here from California Lutheran University in Simi Valley.

We need to gather other chefs into the kitchen who don’t mind the heat. So we reached out to national leadership like the Mayo Clinic Health Policy Center. Bob Schmoldt, a leading national figure from Mayo, recently concluded a high level meeting in DC to fine tune the concept of a US Health Board. We’ll explore this area today and gain your valuable input. So you better plan on throwing yourself into this discussion, which we will document and provide to the White House Office for Health Reform.

Healthcare and banking groups are sharing ingredients, they are finding common ground to improve healthcare in increasingly powerful ways. When I first started talking about this in 1996, I was met with a field of bank stares. Yet convergence is vital to the national dialogue to improve healthcare. The Medical Banking Project has pioneered new ground; we’ve thrown ourselves into the healthcare dialogue with a critical ingredient and with our members, we are making great strides. All of you, top executives in your domains, must know that you are an integral part of the process, not a bystander. You should not accept the fact that everyone in healthcare is sitting around a table and leaving you out. You must be in the process, you must, if necessary, throw yourself into the process to fuel an electronic medical banking community that provides powerful and relevant services for our ailing healthcare system.

This is not a time sit back. I know there are groups that are struggling. I know that you are coming here trying to find your footing in this dynamic and complex area. I know its not easy. But I exhort you to move forward. Hold on and invest. Your ideas are far too compelling and you have a very good chance of being rewarded well for your efforts. You must not give up! Your participation is vital to the healthcare interests of our nation.

To help you, MBProject has created new tools:

Our Gold Seal program, is the essential underpinning of our movement. Its not just a technology platform that we need; we must build a platform of trust for business and consumers and bankers know that all too well. One slip up, and 58% of your customers will change banks. Your margin for error is almost non-existent. I encourage you, because even though today’s climate of low confidence is tough, consumers are still depositing funds into your accounts, using ATMs, credit cards and more. Let’s not throw the baby out with the bath water. Banks will continue to provide a central driving force in the evolution of healthcare solutions.

Our Dispute Resolution Initiative is a key tool that Sheila Schweitzer will discuss at our National Roundtable during lunchtime.

Our Medical Banking Tool Kit for Employers will be unveiled tomorrow where we’ll hear from Scott Sharland, Executive Director of the Automotive Industry Action Group; about their initiatives to manage fiscal stress, and how medical banking offers a key ingredient for their long term viability.

Our International Journal of Medical Banking, as Maureen discussed, provides a peer reviewed tool that helps to get the mental juices flowing to spur creative strategies linking banking and healthcare systems.

Our Executive Training Program, as announced by John English, a professor at Vanderbilt University, will address a growing need to train new medical banking talent and to foster critical leadership standards in this emerging area.

And there are more exciting programs being developed our Tool Shed. Tools that are being honed by an awesome cast of executives – our members – who are building common standards for creating a Green Economy, A Digital Economy, A Lean Economy; (a lean, green, stimulus machine)…they are building an electronic medical banking community. We urge you to become part of the process! Don’t sit aside when we need you to come to the table. We can’t educate you in medical banking in three days! This is much like drinking water from a fire hydrant. To get the recipe right, you need to be involved 12 months out of the year, you need to join MBProject and help us to make a difference!

In closing, I want to emphasize again that necessity is the mother of invention. What if one of the most important and critical ingredients for fixing our banking and healthcare crisis was to find common ways to help each other? What if two broken, elephantine systems, prodded by a dancing mouse, discovered new ways to heal themselves? Cleary, a healthy community supports a productive workforce that ultimately results in healthy deposits. Healthcare and banking leaders truly have much in common. There is good reason to invest in healthcare to energize the bottom line, and get the economy moving forward again. I believe we have an historic opportunity to influence the progress of our nation by throw ourselves into the creation of an electronic medical banking community. Towards this end, we offer this Institute to inform the national process, so that we can collectively build a healthy-wealthy future for our families and communities. Thank-you.

Presentation of awards

Medical Banking Project is driven by a mission: to convert digital savings into charitable resources. We do this by optimizing banking resources for healthcare. What gives life to our mission are the executives that have come into our process as members and leaders of our workgroups and councils. We want to acknowledge each of these leaders for their hard work. Each year, one or two people rise to the surface.