SmartPlanet correspondent Sumi Das on Mobile Remote Data Capture

Texas-based USAA bank has developed a mobile application that allows customers to make deposits using an iPhone.

Authors@Google: Thomas Goetz

March 08, 2010 — THE DECISION TREE stems from Goetz's unique experience as an editor at WIRED and as a student working on a Masters in Public Health. Goetz was struck by the unfortunate disconnect between the public health world and the tech world. Wasn't there was a way to combine the promise of technology with the rigor of public health in order to engage people more predictably, strategically, and effectively with their own health, he wondered? In the book, Goetz looks at the tools and technology available to us now from DNA analysis that can predict future health issues, to social networks that can keep us abreast of the latest treatments. Goetz balances the science and ideas in the book with stories of real people who are utilizing these tools allowing us to see the opportunities and possibilities in action. The Decision tree is an organizational system that maps out our options, factors in all relevant info (family history, our habits, conditions, etc), and guides us toward the best possible health care choices. A Decision Tree has the power to turn the chaos of medical science into a system that makes sense by prioritizing facts and evidence over instinct and tradition. It puts the patient in the central role as decision maker not the doctor, insurance company, or hospital administrators.

Call for Topic and speaker proposals, Smart Card Alliance Annual Conference, May 17-20, 2010

Educational conference tracks are still being finalized by a multi-industry conference steering committee, led by a members of the Smart Card Alliance. The Smart Card Alliance committee is seeking new topics for consideration for this year’s conference program consistent with its theme of “Smart Cards in Action: Issuers and Users in Payments, Identity, and Mobile.” The proposed topics should involve the issuance and usage of smart cards and alternative smart technology (i.e., UICCs, smart tokens, embedded chips) that fall into one of the following categories:

• Identity management and security implementations
• Payments and emerging payments implementations, Open or Closed Loop models
• Mobile and NFC-enabled access and payments implementations
• National or international government–issued citizen ID programs
• Pilots based on emerging smart card and related technologies and applications

The conference steering committee favors vendor-neutral, educational presentations that focus on the real-life applications of payments and digital security technologies and systems.

Proposals must be submitted using the online form below. The deadline for proposal submission is Monday, March 8, 2010.

For additional information contact please contact Randy Vanderhoof at [email protected].

The Social Credit Card [presented at IdeaBlob]

Posted by ED

IdeaBlob started out as an internal collaboration/innovation engine. It has since been turned outward to benefit from remunerated crowdsourcing (you get $10,000 if you win the contest). Since I'm always whining about the fact that fed taxes don't account for hours donated to NGOs/NPOs I thought this was a cool approach to track "social capital". This would be an excellent way to do a "census" of how much healthcare related volunteerism goes unnoiticed/uncompensated. Why, yes, open source/standard healthcare programming would count. Think also about the impact it could have on HSAs -- or a whole new class thereof. Oh, and if you wonder how to implement it just determine at what rate a federal employee would be compensated to complete the same or similar task. Also, accountants could volunteer their time to NGOs/NPOs to help track these things (and of course the shift to international accounting standards and adoption of extensible business reporting language and standard universal charts of accounts could be utilized as well).

The Social Credit Card

Credit card companies and banking institutions develop a social credit system whereby activities like volunteer hours are tracked and compensated. Every time we make a social contribution (helping a neighbor, volunteering at a homeless shelter, donating to charity, etc.) we accumulate points that appear on our monthly statements. These points are then redeemable, similar to frequent flyer miles, for the purchasing of goods or services. The points can also be used to pay down debt or donated to other individuals or charities as a financial contribution. By combining social with financial capital we create incentives for good works and a more comprehensive picture of our net worth.

Keynote Panel - Banking on Better Healthcare

Moderator:

John Casillas, Chair, Medical Banking Institute

Panel:

Al Briand, Division Head, BNY Mellon Treasury Services Product Management and Strategic Development, New York, NY

Making the case for standards allowing for economies of scale and will determine the success of medical banking

Mentioned SWIFT and messages moving capabilities; they should be studied to see how they produced their standards

Paula Fryland, Senior Vice President and managing Director- Corporate Banking, PNC Bank, Louisville, KY

Local level:

Community involvement, community development

Boards members at community hospitals

Charitable giving - building facilities, fundraising

Financing:

Health NPOs liquidity markets have collapsed, banks have stepped up

New solutions:

Extending and/or customizing current products or services

Point of Sale technologies

Whole new solutions

Pete Wheeler, Wells Fargo

Leading by example to create knowledge dissemination

WF 281,000 employees; HSAs, wellness program

Huge deposit base, huge lending base, huge brokerage presence, huge mutual fund presence, huge geographic reach

As employees go to other companies they bring their knowledge of the medical banking options to others firms

John:

Global angst re: banks

PNC: Virtual wallet, healthcare 10s of millions of dollars in business investment, incredible opportunities in administrative transactions of hc, including noncredit products to build relationships

BNY Mellon: Can't count on certain aspects of traditional business so discovery of new opportunities must be explored; there must be a business case for them; friction (not seemlessness in transactions) means opportunity; consumer-centered healthcare; health custodians

WF: Opportunities coming from the synergies of combining 2 banks

Question from floor: quality rating on bonds

How will existing clearinghouse and transaction engines be tied together; current "RAILS" in place

How will XBRL and international standards impact -- bring as many players to the table to create and apply the standards

Economy of scale is THE DRIVER

Super-regional and community banks: Smaller banks have many healthcare related account; train a couple of SMEs first, build portfolios over time; attend conferences and be involved in groups active in the space

Will banks repeat their earlier investment in automation to accounts receivables

Health Wealth Portals? Convenience for either business or retail banks is important; cell phone convergence metaphor

How does hc impact your strategy? PHRs??? Wealthy individuals request new services; back office accounting of wealth management tools

How does the money saved by more efficient transaction being targeted to indigent care by hc orgs impact your banks? Banks have not recognized indirect benefits of their efficiencies investment in the communities they serve

TAKE AWAY: Economy of scale is THE DRIVER, standards are THE ENABLERS

Deven McGraw on the Great Privacy Debate: Impact of ARRA 2009

[email protected]

Health Privacy Resources

Health Privacy Project at Center for Democracy and Technology

• Health IT and electronic health information exchange have tremendous potential to improve health care quality, reduce costs, and empower consumers
• The public wants health IT – but also has significant privacy concerns
• Failure to build foundation of trust is an obstacle to achieving greater health information exchange

Health Privacy Project at CDT

• For years there was no progress on resolving the privacy and security issues raised by e-health
• Project’s aim: Develop and promote workable privacy and security policy solutions for personal health information

Evolution of Federal Privacy Protections

1996 – Enactment of Health Insurance Portability and Accountability Act (HIPAA)

• Congress gives itself 3 years to enact privacy legislation

Rulemaking

• 1999 – Proposed rules
• 2000 – Final rule
• 2002 – Regulatory changes
• 2003 – Effective for most

Era of Health Information Technology

Health IT bills stalled in 108th &109th

• Privacy was framed as the obstacle – but it wasn’t the only issue

Legislation moved furthest in 110th – but economic woes stalled progress

ARRA (Title XIII- HITECH)

• Broke the privacy "logjam"
• Most significant change to the healthcare privacy and security environment since the original HIPAA privacy rule
• Not a change to everything about HIPAA – but some significant changes that will need to be addressed by many entities handling health care information
• Most provisions require further regulatory clarification

Privacy and Security Provisions – Overview

• Substantive changes to HIPAA statutory provisions and privacy and security regulations
• Enhanced enforcement of HIPAA
• Provisions to address health information held by some entities not covered by HIPAA
• Misc: Administration/Studies/Reports/Educational Initiatives

Substantive HIPAA Changes

Breach notification requirement

• Definition of breach
• Safe harbor for “protected” data
• Detailed requirements re: timing and content of notice; how provided to individual and HHS
• Business Associates must notify covered entities
Strengthened individual right to restrict disclosures to health plans for payment and operations

• Secretary guidance on minimum necessary
• Use of limited data set where possible in interim
• Discloser determines minimum necessary
Minimum necessary still does not apply to treatment
Accounting for disclosure requirements for entities using electronic health records

• Requirement applies after standard and regulations are developed
• Phased in over time
• Covers only 3 years
Change with respect to how business associates comply
Patient right of electronic access

• Can direct record to another entity or individual (PHR)
Changes to definition of marketing

• Limited right to use information for marketing if the communication is paid for by an outside entity
• Exceptions for treatment communications and communications about current drugs and biologics
Opt-out for fundraising communications
BA contracts required for RHIOs – and PHRs in some instances
Prohibition on “sale” of health records or protected health information
Exceptions

• Public health
• Research
• Treatment of an individual
• Sale of a facility/business
• Payments to business associates
• Copies to individuals
• Designated by Secretary in regulations

HIPAA Enforcement

Business Associates accountable to authorities for compliance with some HIPAA privacy and security rules (+ new provisions)
Application of HIPAA criminal provisions to individuals
Ability to civilly enforce where violation qualifies as criminal but no criminal penalties pursued
Requirement to impose civil penalties in cases of willful neglect

• Corrective action may still be pursued for lesser offenses

Tiered increase in civil monetary penalties
Distribution of % of civil penalties to individuals (penalties also go to OCR)
State AG civil enforcement
Secretary required to do periodic audits

Provisions for Entities not Covered by HIPAA

Temporary breach notification provisions for PHR vendors and internet applications

• Breach definition
• Same safe harbor for protected information
• Enforced by FTC

Study by HHS & FTC with report to Congress on privacy and security recommendations for PHRs

• Which agency should regulate?
• Timeframe for regulations (no specific authority to regulate)

Misc. (Administration/Studies/Reports/Educational Initiatives)

• Strengthened authority for ONC
• New advisory committees on policy and standards
• OCR public education initiative on uses of PHI and individual rights under HIPAA
• Privacy Officers in each HHS region
• Chief Privacy Officer within ONC - Not charged with HIPAA enforcement/oversight

Misc. (Studies/Reports/Educational Initiatives)

Studies/Reports by HHS Secretary

• Annual report on enforcement
• Study on implementation of the de-identification requirements
• Study of HIPAA definition of psychotherapy notes with respect to inclusion of test data and materials used for evaluative purposes

GAO Studies:

• Methodology for providing individuals with a % of civil monetary penalties
• Report on best practices for disclosure of PHI for treatment purposes
• Report on Impact of ARRA provisions on health care costs and adoption of EHRs

Stuart M. Hanson on How Medical Consumerism and Medical Banking Align to Create Value

Presentation of White Paper: The Impact of Consumer Directed Healthcare on Providers

Consumer Directed Healthcare (CDH) typically combines a high deductible health insurance plan (HDHP) with a personal saving/spending account, from which medical expenses can be paid directly. Most common spending account plans are Health Savings Accounts and Health Reimbursement Arrangements.

Consumer Directed Healthcare Research Study

Objectives

• Gain thorough understanding of impact of Consumer Directed Healthcare (CDH) trends on healthcare providers, financially & operationally
• Ensure that feedback & findings were unbiased and broadly based

Research Methodology

• Fifth Third engaged the Boundary Information Group
• The research was conducted over a two month period: July – August 2008
• The methodology consisted of a detailed one hour interview with CFOs, Patient
• Accounting Directors and selected thought leaders from hospitals and physician groups from across the nation
• Key findings of the research were compiled into a white paper “Impact of Consumer Directed Healthcare on Providers”

  Key areas of focus

  • Are providers seeing an impact on cash flow and operations from CDH?
  • What Best Practices are providers pursuing to handle CDH?

CDH is a Growing Portion of $2 Trillion Market*

• CDH plans grew by 43% in 2008. CDH plans will reach 14.9M accounts by January 2009
• There is $5.3B value held in Health Savings Accounts which is expected to grow to $16B by 2010
• Consumers spent over $250B on out of pocket healthcare expenses in 2008. $242B paid for by cash, check, credit, debit. The remaining $8B was paid by some form of Healthcare card
• According to the US Census Bureau consumers will pay over $1000 annually in out-of-pocket healthcare related expenses by 2012 up from $800 today. The proportion of patient payments is projected to rise over the next few years from 15% to 21%

*Source: Consumer Driven Market Report, US Census, Celent, Forrester Research

Key Stakeholders:

• Consumers: Provides economic incentives to manage their own care. Ability to build a medical nest egg.
• Employers: Reduce benefit costs from lower premiums and FICA tax savings
• Government: Proponents hope to drive down healthcare costs by stimulating market competition
• Payers: Deliver high deductible health plans along with consumer tools such as quality and health information
• Banks: Deliver Health Savings Accounts linked to a debit card. Offer online payment tools.
• Providers: Must manage rising patient payment portion resulting from higher co-pays and deductibles. Less predictability in collections as responsible party becomes blurred further

What Does CDH Growth Mean for Providers?

As responsibility for payment shifts more to patients…

• Importance of financial arrangements at or before time of service increases Predictability of collections becomes less certain
• New set of tools and processes are required to minimize negative financial impact of CDHP growth
• POS Collection methods are stretched

According to a recent interview with a well respected industry expert: "In a nutshell, healthcare providers need to recognize that the tools they need today are not the tools they have from yesterday…they have to realize that they’re at a severe disadvantage unless they re-tool for this new patient responsibility paradigm … today many providers are basically bringing knives to a gunfight"

CDH Research Study: Key Findings

CDH Impact

• Geographic Variability – but momentum building across all geographies
• Providers Lack Processes, Tools, Resources
• CDH Impact Far Greater Than Prior Experience with Self Pays
• Result Could Include Higher Costs and Lower Revenues

Process Challenges

• Negative Public Relations Impact
• Lack of Price Transparency
• Financial Complexity Demands More Experienced Staff

Technical Challenges

• Legacy Systems are Challenged with “Consumer Debt” Issues
• New Vendors are Emerging>
• Providers Struggle with Limited IT Budgets
• Providers Seeking Single Vendor Solutions

Recommendations for Providers

• Assemble project team for examining current practices, evaluating options, making recommendations, and implementing new programs to adapt to CDHP growth trends and impact on your organization
• Evaluate existing processes and tools in place today, especially against best practice conclusions from this analysis
• Analyze method for managing commercial and governmental posting of EOB, ERA to speed posting process and potentially free up resources
• Work with strategic banking partner to streamline revenue cycle activities as much as possible and to understand financial tools and options that are available
• Determine suitability for new processes, tools, and/or possible upgrades to existing systems and capabilities
• Prepare to implement new tools, software, staffing model, training programs, financial tools as needed

John English, Vanderbilt University, Highlighting 2 New Medical Banking Credential Programs

Medical Banking is now a recognized field of discipline!

Growing demand for executives that understand and can market and sell programs in this new field

Two levels of professional certification available

Medical Banking Professional (MBP) - strategic and treasury management 9 month online program

MBProject and the University of Missouri have collaborated to create a Medical Banking Executive Training Program. (Patricia Alafaireet, Director of Applied Health Informatics, School of Medicine, University of Missouri, Columbia, MO.)

9 month online training provides subject matter expertise

Involves a project of value to the industry and the employer

Objectives of Medical Banking Certification

• To stimulate and disseminate the theory and principles of medical banking.
• To help banks and healthcare groups to understand the value they can mutually bring to health and healthcare.
• To provide tools and expertise that can drive improvements in marketing medical banking services.

6 modules

MBS: Professional Medical Banking Sales Program

Cross-industry Sales Training

An intensive day and a half executive training course to improve selling of medical banking services

Introduction to the fundamentals of medical banking

• Market segmentation and size
• A typology of medical banking convergence

Refine sales skills for medical banking

• Videotaping and critical evaluation
• Developing the sales presentation
• Answering objections

Opening classes will be scheduled for July

Send inquiries to [email protected]

IPayX Healthcare Improvement Webinar

Healthcare reform discussion moderated by Medical Banking Project’s John Casillas.

You need to attend the MBP webinars to get the meat on the bones rather than just the skeleton.

John Casillas Panel Presentation for HFMA ANI in San Diego, CA

Good afternoon. Two weeks ago I spoke at an Advisory Board with the incoming chair of HFMA, a previous chair and a past chair of the AHA. Just prior to that, I testified at HHS at America’s Health Information Community, organized during Dr. Brailer’s reign as President Bush’s health IT czar. These groups had something in common: both were intrigued by how medical banking will impact the future of healthcare.

Many groups I address throughout the country are engaged, so I marvel at those who say it will never happen. They say well that’s impossible. It could never be. I can think of lots of examples where those kinds of people have been proven wrong. Man will never fly. We’ve been to the moon and back. A woman will never be president…could happen next year. The Berlin Wall will never come down. Today East and West Germany are united. How wrong they were!

What I’m trying to get at, is that over the past 15 years creating the thesis of medical banking, I’ve heard a lot of nay Sayers. Yet medical banking has arrived! Not just locally either. This is a global movement. Our members are in Canada, Australia and the European Union. And the key player in this global revolution is the banking community. The nay Sayers are wrong again!

Consider the slides as bonus material. Rather than talk at slides I want to engage you directly.

Now, there might be some in the audience who have been in that group of nay Sayers. Let me remind you that there was a time when 98% of the population believed the world was flat. The other 2% were burned at the stake as heretics. I feel that burning sensation sometimes, but I know we’re right. Today a growing team of cross-industry visionaries agree with us – over 50 corporate members at MBProject in banking, healthcare and policy. Many national leaders agree, who attended our Institute – HIMSS, Centers for Disease Control, National Governors Association and others. They see a brighter future by marrying banking and healthcare systems. Now some may still believe the world is flat, but I know there is one thing we can all agree on. The current system is broken, its just not working. Over 45 million good folks are uninsured and we have a rising tide of bad debt.

That’s why I’m here today – to give you 4 good reasons why medical banking offers solid footing for our healthcare system and hopefully get you involved with our movement. My reasons are based on the idea of the bank as a Trusted Infomediary in the healthcare system of the future. Now, the natural question most of you are asking is why banks? So let me respond with a question: where do you put your money? You see, most people really do trust banks, and there’s more.

A “Bank Infomediary” can do four things for healthcare: one, banks can revolutionize the revenue cycle by pushing the boundaries of automation and real time payments; in fact we will soon launch a common medical banking platform called BoardTrust, that will open up brand new possibilities; two, banks will help America to finally build a “medical internet” that uses all the bank touch points – 99% of all providers and plans on one side and 55 million plus online banking customers on the other; three, banks offer a valuable channel for educating consumers about better healthcare choices; and four, banks can assist the community to coordinate healthcare resources which helps to increase access to the underserved.

So let’s peel back the onion. In the revenue cycle, I believe that existing systems in healthcare has exhausted the cost-cutting potential of EDI, not due to lack of great technology but because of challenges in distribution of that technology. I hear this from healthcare groups all over the country. There is frustration as to why we can’t move more quickly to a digital framework, not just for the claim but eligibility, COB, remittance and more. I’ll tell you one reason why: we haven’t embraced the capabilities of the bank. Let me tell you why I think this is true.

First, the bank’s lockbox is morphing in functionality and can integrate workflows not just using the remittance but all the EDI transactions. This creates new value for hospitals and plans, and can synchronize the market.  For example, the new lockbox unifies paper and electronic remittances into one digital stream and automate routine patient accounting tasks. Some national banks are working with clearinghouses like CareMedic, SSI or McKesson to provide this service. In one case, the clearinghouse is the bank – PNC. Banks cannot do this alone, so they will align or acquire. In 1996 we forecasted a wave of convergence like this, integrating banking systems with digital tools that manage medical transactions. And it’s happening today. Yet what makes this powerful is the bank’s reach. We may finally get all providers on the EDI bandwagon, and that will save at least $35 billion in administrative costs each year.

A futuristic CEO panel convened by QHR, an MBProject member, had two recurring themes. First, that medical banking can offer a return that extends well beyond payment and remittance management. This is true, because it encompasses two forms of liquidity: (2.) financial liquidity – through high value transaction processing and more access to corporate and consumer credit, and (1.) health data liquidity, through on-demand movement of electronic health records.

As banks better understand the value of the complex UB04, a new credit market will emerge that uses the eHealth Lockbox as a business intelligence platform for unlocking $200 billion in non-working A/R assets sitting in your ATB. So medical banking offers a pathway for smarter resource utilization, starting with the digital lockbox and moving on to meet longer term organizational needs. By the way, those needs respond to community needs, which typically are the focus of investment by banks. Steering bank investment towards the hospital is good business. And that goes for banks too. A healthy community means growth in deposits, and that’s a good reason why banks are so involved in the community. Medical banking aligns incentives in the community leadership – who routinely get together at the bank or hospital board – and because of this, medical banking is evolving external to the patient accounting domain. Board members are talking about new synergies with banks. For this reason it seems prudent to become better informed about medical banking.

The second theme at QHR’s forum was that medical banking isn’t visible in the suburban or rural hospitals, and we agree. The early focus of banks is on major markets, but this will trickle down. Our mission is to convert digital savings into charitable resources, so we have a plan to get these new efficiency tools down to the level of solo practitioners, not directly, but through market mechanisms.  Now, this vision may not be what you read in HFMA literature, where some hospitals had mixed reactions about medical banking. That doesn’t surprise me. But what does is how long it takes to broaden the vision. When we coined the term “medical banking”, we articulated a vision that the provider groups we talked to embraced. So we hope these roundtables and articles will lay out a broader vision.

Banks, like any business, are in healthcare for compelling economic reasons some not as obvious others. A good example of this is a hospital closure in North Dakota. Local residents were left 61 miles away from the nearest hospitals, and their most common concerns were interestingly enough, medical banking issues. Let me illustrate: poor access to emergency medical care (a quality of life community issue and thus a banking issue), the loss of local jobs, further declines in the local economy, the suffering of elderly and children and out-migration of residents. This is one example of a disturbing national trend of closures, and that’s why this is a community-wide issue. Leaders are looking beyond parochial interests to solve a deep and broadening healthcare crisis. A hospital closure has long term economic consequences for banks.

So how does this translate into the revenue cycle? Well, I’ve explained how there is a greater economic picture here, and community incentive, for a bank. Today’s health IT firms compete for a slice of the IT budget. Banks compete for the hospital’s total economic impact to the community. The bank gains multiple revenue sources from the hospital – credit terminals, ATMs, payroll deposits, loans, and more. Packaging medical transactions into their services, especially as claims processes go digital and can be incorporated into a value chain, is inevitable. It’s a new tool set the banks can deliver to the hospital to reduce their cost for serving the community. PNC: $1-10 million. In 1996, we forecasted the emergence of a unified platform for healthcare and financial transactions. We said that if this happens, banks would start to compete for your medical transactions, just like they do your financial transactions. This would bring millions of dollars of investment into the hospital community and it tends to decrease costs. I’m sure you’ve heard the saying by now: when banks compete, who wins? You do.

Today this competition is in full swing. MBProject advanced the idea of a specialized lockbox program in 2001, and starting in 2003, banks like PNC, Mellon, Wachovia, Lasalle, US Bank, Fifth Third and others issued press releases and proved our point. McKesson is forming bank alliances and others are too. It’s driving the specialized lockbox for healthcare. We are seeing a virtual tidal wave of banking investment coming into health IT, and we think the outlook looks very good, and it comes at critical time when provider margins are suffering. Today, banks are pouring millions of R&D dollars into automating patient accounting tasks, like remittance and denial management, secondary billing, automated consumer credit decisioning that can mitigate self-pay risks in consumer-driven healthcare through companies like E-Duction, that automate payroll deductions for HSA/HRA holders and more. We believe the first digital tools will be well-established, ones that you already use, but placed in new, high value banking platform that offers new cost savings. It’s a classic market development, like SABRE, the airline ticketing system that, when linked to banks, changed the competitive paradigm in the airline industry for both businesses and consumers. Today we go online for ticketing, car rentals and hotels. The banking system made this change possible, and the same kind of paradigm shift in healthcare is inevitable as medical banking models flourish.

Fortunately, we have hard evidence that when a bank gets involved, costs come down. PNC presented a case study at our Institute showing how a provider saved $4 million last year using their specialized lockbox. I know there’s not a person in this room, or CEO in the country, that wouldn’t like to increase their profit margin by $4 million.

Medical banking offers a holistic view of what banks bring to the table. The ROI of a digital lockbox should be comprehensive: decreased investment for IT, (new revenue cycle applications, maintenance), lower costs for imaging and for managing consumers, seamless integration with new programs that speed third party and self-pay collections using card technologies, credit networks, real time credit decisioning and online banking. We see a community-integrated revenue cycle that optimizes all the banking assets – ATMs, credit/debit terminals and branches – to increase collections and offer compelling consumer conveniences. The bank also opens up a new channel of 55 million consumers who already do online banking. This secure gateway, “single sign on for the consumer”, can manage financial and health data needs. Forrester reports a cost of $1.17 for resolving consumer disputes online vs. $33 using manual systems. When managing commercial payments, NACHA, a bank group, reported a manual cost of $11 vs. $5 or less for EDI. New bank platforms will bring these savings within the reach of most providers.

The issue of Public Trust is vital to our vision. Our members routinely assess HIPAA and other privacy rules – and there are quite a few – and we do this to instill Public Trust in medical banking. We started an Accreditation Review Council that will assure providers that the banks they use are HIPAA compliant. MBProject drove HIPAA into the banking world to win Public Trust. We know that privacy issues will evolve so we facilitate cross-industry dialogue with policy makers, industry groups and others who strive to keep our information confidential.

Today banks are locked into an Identity Theft Arms Race. How else can they keep your trust? One privacy institute - Ponemon – did a study showing that 57% of a bank’s online consumers will bolt if there is one breach of privacy. They also asked 30,000 business leaders what institution they trust. Guess who it was? The bank is who they trust the most. So make no mistake about it, security and privacy in banking is a top concern, and this bodes well for medical banking, especially as we roll out pilots that focus on point of service access to the current deductible, funded by UnitedHealthcare, and another pilot using online banking to distribute personal health records.

In a consumer-driven world, banks are becoming an epicenter for consumer research about their health conditions – our third area of focus. 4.5 million consumers use HSAs today; they’re now being offered by 1600 banks, up from less than 100, just 2 years ago. As banks compete for this new market, new consumer tools are being linked to banking systems, from Subimo, ConnectYourCare, or Best Doctors, that help the consumer to manage their HSA, select a provider or use new “health-wealth” calculators that predict health expenses and help families to better plan for retirement.

Economically speaking, banks want HSA holders to become wise healthcare consumers, because choosing better healthcare will keep more money in the bank. We started a joint task group with the Automotive Industry Action Group that address value in health and Sanofi-Aventis is helping us in this effort. Billions of dollars are at stake. This incentive aligns well with employers who need a healthy workforce, public policy, and ultimately the individual and family, where the head of household wants better health information, and I might add, turns to online banking for convenience and simplicity. This is why banks are emerging as a health information broker, and understanding what this means to marketing hospital services is important.

Finally, we envision banks offering a way to coordinate community healthcare programs, helping safety net providers to care for the underserved, and we link this population to the 40 million unbanked households because the demographic overlaps and this is quite a banking challenge – just as much as the uninsured is a health challenge. Targeting this group can solve problems for both camps, and so we believe that banks and employers will easily see that they can’t offer HSAs while winking at the underserved. It’s not in their best interest, and there are already new employer initiatives addressing this. Our initiative in this area is called CarevilleTV, rebranded from Charitable Communities Network. We believe that serving this market requires easy-to-understand communication programs that offer objective news on consumer options in the community.

In conclusion, as they say in sports, it’s important to keep your eye on the ball. Getting involved in medical banking is a good idea as it begins to shape our common destiny. Banks working with health IT firms can increase efficiency in many ways and they offer a stable partner in your revenue cycle that can deliver long term dividends. That’s what hospital CEOs are telling us they want to see, and it’s really where medical banking shows its greatest promise. Thank-you.