This week I am talking to Mark Menton, General Manager for HealthSparq (@HealthSparq) who are focused on Helping people make smarter healthcare choices. Mark started his journey in healthcare back in 2002 creating paper based directories of physicians to help patients select a doctor for their care.
We talk about the progression into the digital work with all the additional capabilities that puts even more information at the finger tips of not just the patient but also the clinical team as they help patients navigate their care journey. They were able to add new data and filters to allow patients to find doctors that were closer matches to their needs including language requirements.
In their work with patients, health systems and insurance and payor they have identified key drivers for satisfaction, and top of mind for patens is transparency for the treatment they are looking to receive.
Listen in to hear Mark’s passion for incremental steps and their approach to solving for the problems that their members and customers are seeking – currently focused on finding doctors but moving towards pricing and transparency of cost for healthcare services. Historically this has been difficult to obtain and when it was available was often presented in forms that made it less helpful to the patients decision making process and oftentimes confusing. With recent legislative changes more data is becoming available and innovative organizations are working to make price transparency a critical differentiator for their services.
Hear their search for additional data to fill in gaps of knowledge for patients and how they are planning to add quality as an additional metric to present as part of the knowledge base to support individual healthcare decisions
Listen live at 4:00 AM, 12:00 Noon or 8:00 PM ET, Monday through Friday for the next week at HealthcareNOW Radio. After that, you can listen on demand (See podcast information below.) Join the conversation on Twitter at #TheIncrementalist.
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Raw Transcript
Nick van Terheyden
Today I’m delighted to be joined by Mark mentum. He is the general manager of Helzberg. Mark, thanks for joining me today.
Mark Menton
Thanks, Nick, happy to be here.
Nick van Terheyden
So, for the benefit of the listeners, tell us a little bit about your background and some of the recent changes, certainly in the company as well, if you would.
Mark Menton
Now, absolutely. Um, I’ve actually been in this business since 2002. Helping people find the right provider at the right time started back in the old days when used to sign up for your insurance and you get a phonebook of doctors. So they’ll provide a directory days and you can tell by the gray in my hair, I’ve got the scars to show for it. But but since then we’ve moved obviously to an online SAS platform, helping guide health plan members to the Find the right provider at the right time with the right modality of care. And that includes our platform does provider search, cost transparency, patient reviews, and also rewards which is a an engagement piece and sent people to look and shop for health care online. Health spark itself has been in business since 2012, we serve over 55 health plans nearly 100 million members across the country. And just this year, in 2021, we announced our acquisition by Kairos, which is a company based in Boston, that actually does very similar things, what healthbar does, except they start on the health system side where Hal Spark has been serving health plans and working with health plan data members thairis Does the data and consumer experience on the health system sides, we’re really excited about bringing those two together and what it means for patients slash member slash consumers of health care to access information across that continuum.
Nick van Terheyden
You know, I’ve just got to thank you for that blast from the past of physician provider. Books that we’ve looked through that, quite honestly, were just very overwhelming and very difficult to navigate to sort of find and I think the digital version was already an improvement, I think we’ve seen that shift into the digital world. Tell us a little bit about that shift from an organizational standpoint, that’s obviously opened up new opportunities. But I would imagine also challenges.
Mark Menton
Absolutely. When you think about healthcare, especially as we get into the mid 2000s. And moving forward, a lot of health care whether it was on the provider or the health plan side was kind of a black box, right? It was it was very highly protected information that the member used, go see your doctor, you didn’t really understand what your options or choices were, again, other than a phonebook and now we bring in this information that’s available. And then it can be overwhelming, right access to every doctor, my network. And if I’m you know, BlueCross BlueShield, I’ve got 50,000 doctors that I can choose from and what does that mean to me. So it’s really taking the evolution of the product has been from digitizing the information making it you know, searchable, quote, unquote, to then actually understanding from a personal standpoint, what’s your network? What are your benefits? And based on that? How can we curate those results into a way that makes it actionable and meaningful to you? So it’s really, I think the biggest transition has been digitizing is was the first step. But then it’s moving that toward an actionable meaningful experience and not overwhelming people with with all the options they have and giving them options that are quote unquote, best for them, or maybe that helped helping them make a smart choice.
Nick van Terheyden
So that data that you’ve got around the providers, does it offer more than just sort of basic specialty? Have you added additional insights that help people make decisions? Because most folks when they look at clinicians, you know, I don’t mean to diminish them, but they all look very similar, certainly from outside of the medical profession. If you’re inside, perhaps you’ve got a little bit more in the way of filters that you can apply. But for the general public, that’s going to be difficult. Have you managed to overcome some of that process for users?
Mark Menton
Absolutely. That’s a it’s a great question. And so we’ve actually done a number of things. The biggest is our combination with Kira, so I mentioned before Congress starts on the health system side and they’re gathering data from over 350,000 doctors across the country from from large health systems to smaller medical groups. And bringing that data in we found is a very powerful combination where you have clinically driven data. So a cardiologist is a cardiologist, but they’re the cardiologists do 100 things and as Dr. Smith might do, these five and her colleague might do something different. So understanding what they really do, versus what their specialty says, is one component which adds significant value for a member to understand who to go see To You mentioned like, like filters. So if you think about languages spoken, we had one health plan where we integrated this data, and we added languages to 49% of the profiles of the providers, the health plan did not have this information. So if I was a Spanish speaking or a Mandarin speaking person, in this case, in Philadelphia, Northeast Pennsylvania, I didn’t have access to providers, or at least I didn’t think I did. And then all of a sudden, we had 150 providers that speak those languages for members. And then on top of that, you think about philosophies of care, pictures and videos, some more personalized information. So taking a specialist, you’re gonna think about quality information and the outcome driven, I need something done that specific, but when I think about my primary care doctor, we think about it as more of a match. com, it’s a relationship. And the more I know about this provide, the more comfortable I am with this provider, the better the outcomes are going to be for me, so we look at it across it’s a kind of a continuum based on what you’re trying to accomplish as a patient, you know, am I looking for a one and done or am I looking for a relationship? But across that continuum, we add data points and elements that allow people to find the right provider? You know,
Nick van Terheyden
it’s interesting, you add the language, and it seems like an obvious thing, but it wasn’t. And, you know, I’m sure there was some guesswork going in based on physician names and so forth, that people tried to essentially reach that point. The other thing that tends to challenge is, the general population is the ability to comprehend the details. So you cited a great example cardiologist do all of these different things. How do I know which thing for me? And, you know, I look at it and I go, Oh, yeah, sure, I need X or Y. Having had the medical training, most people have not? Have you managed to bridge that divide? Or is that still one that’s out there?
Mark Menton
Yeah, I think it’s, it’s a continual work in progress. I mean, there are certain things where I need an MRI, you know, I need something specific that I know as a as a consumer patient, I can, I can kind of, I can search for that I can pick a provider and go. But then there’s things where it will never get to where a person is going to fully understand what they need. So it’s really about they trust their provider to refer them right. So I trust my doctor to tell me what I need. And so we talked about the data before we jumped on here, the data being available across multiple channels, we believe the data we have that help by members are looking to make decisions should be available at the doctor’s office to so that doctor knows, I’m going to refer you to Dr. Smith, because she does exactly what I need her to do. Versus I just have a list of cardiologists that can pick one and send it to you. So I think it’s making sure that the access for certain things, it’ll be very consumer focused. But other aspects of it, it’s going to be the providers are going to be referring you and making sure they have the right information as well. So making that that data available, wherever, wherever it needs to be access to make sure it’s accurate, consistent.
Nick van Terheyden
So I think that’s great. I mean, it’s obviously it’s a hill to climb and providing those on ramps for folks to be able to access it. You’ve obviously got lots of experience and data points with your community, the people that you serve, both, you know, from a corporate standpoint, but also ultimately, the final arbiter of that information, which you know, my perspective is the patient. It’s it. I know that the physicians and the other folks are involved, but they’re the ones looking for that. As you listen to your community, what are they telling you that they want out of this?
Mark Menton
Yeah, so I think we’ve done a couple of different studies. This past year, we do a consumer study every year. I think it consistently people want to understand how much is this going to cost me? Right? I mean, that we have those of us that have been in health care for a while we know that that’s been a, you know, the burden has been continually shift toward the patient to consumer verse at four out of pocket costs. So they absolutely want to understand what is this going to cost me before I go. And we see that as a as a big barrier for people actually not even receiving care. So whether it’s medical or RX, one great story I heard was with, with Walmart, when they introduced the $4 generic code for our generic drugs, right? People that there’s gonna be this big swell of new prescriptions being written. And what they found was, they call them glove box prescriptions as people that would get a prescription, and they didn’t know what was going to cost, they just shove it in their glove box and never get filled, because the last thing they want to do is be standing in line at a pharmacy. They get up to the pharmacist and they say that’s going to be $50 $75. I don’t have and so therefore, instead of risking that I just won’t get filled. But if I know it’s $4 I understand that and I get the care that I need. And we see that on the medical side to understand is this a $50 thing I’m looking for? Is it a $500 at 5000 at least have the context before I go in, and we do see people where they stay tell us If I don’t know what it costs, I’m not going to get it because it’s a, there’s an emotional and I’ll say a shame component to it, which we need to get out of healthcare altogether, right, being able to access affordable health care is a must. So making sure people have access to that information is a big deal. Finding providers like me, we talked about languages spoken, philosophy is a care if I can’t communicate with my provider, odds are I’m gonna, it’s not going to be a good outcome for me. And we saw in the study with equity and access that people that’s a fear and they fear that they’re going to not only not get a good outcome, they could ultimately be discriminated against, because the language they speak. So find any provider that speaks a language that I can communicate with, I think those are probably the two biggest things we see and hear loudly, or I need to find a doctor that I trust. And I need to understand what it’s going to cost me. And those are two things that we can solve today, for the vast majority of people and the vast majority of procedures, it’s just a matter of making that and making sure they understand that’s available to them and X accessible.
Nick van Terheyden
So you bring up transparency. And as a topic, I think, probably certainly in my mind one of the hottest both personally, but also professionally as an area that, you know, I would want to see. And I think your your experience shows that everybody else does. It’s not just me. Not that I’m surprised by that. Let’s be clear. But what I’ve seen today, his enormous resistance to that release of information. In fact, I’ve done a number of shows that even sort of focus in on that. Are you seeing transparency actually appearing is that a potential positive versus what it seems to be for most of these folks is a negative.
Mark Menton
So I can tell you it core to what house mark is, is we believe that people have a right to access this information. And it was part of our founding in 2012. And actually, even before that we were founded within a health plan that had that belief that the members had a right to access this information. It wasn’t something that should be held from them. So we’ve been fighting this battle for a long time. And we’ve had we’ve had a number of health plans have didn’t joined joined us in that in that quote, unquote, battle to really make this information available and bought into it. But I think the last year or two with the federal mandates, and no surprise Act, the transparency and Care Act, where the government mandating that it’s really unleashed an amount of investment that I’d say in the last 18 months, we’ve seen more investment and excitement in this area than we’ve seen the last 10 years combined. And we’re very excited about that. And that’s been our message to both our clients and to the market is the mandate is just it’s just a it’s a floor, it’s the bare minimum making information available is step one, creating a compelling experience on top of that to make it truly actionable. And like a navigation or guidance tool for help me number. That’s really the end goal. And our clients are really buying into that, Nick. And it’s I think that’s, that’s super exciting for me personally, and fighting this battle for 10 years, or 10 plus years. Is it now we have people that are really focused on thinking about it and not just talking about I mean, helplines have talked about the consumer and I put that in quotation marks the consumer for a number of years now, but they really haven’t understood how to create a compelling consumer experience because they’re selling to employer groups. Now they’re really truly not only thinking about it, but investing in these member experiences that are compelling, meaningful and actionable.
Nick van Terheyden
So for those of you just joining, I’m Dr. Nick the incrementalist and today I’m talking to Mark Menton, he is the general manager at Health spot. We were just talking about price transparency and the positive experiences, certainly in your realm. We’ve seen resistance I think we’ve also seen action on the part of the legislature that’s really tried to accelerate it. Is there a risk that you know, this then gets a little bit to be like gas stations where suddenly it’s all prices are out there and we start shot? You know, you’ve got Gas Buddy for health care? Do you think we’re going to go in that direction? Or is there more to it? What else are people looking for?
Mark Menton
I think we always thought of healthcare as it’s a unique beast and it’s a highly complex and regulated market. I think getting this data and freeing the data is a good step. But you have to layer on top of that. Your benefits the person it has to be a personalized experience right and to build a truly personalized experience. It’s hard for Gas Buddy to know what car I drive what you know, like, what, how do I drive my car? Where did I go the last four times I filled up my gas tank. Your health plan knows that about you and create can truly create a personalized experience. I think us working with our plans, creating that member experience with the data they have that a third party is not going to have. That’s a differentiator where you can publish prices all day long. But it doesn’t really matter. What matters to me is how much is it gonna cost me out of pocket? Right? So it might be $1,000. But if I’m not $100 into my deductible, I only have to pay $75. Those things matter. And if you don’t have that layer on top of the mandated information, I think you’re missing a component that’s going to truly unlock the value.
Nick van Terheyden
So that’s interesting. I mean, I think great, you know, follow through on the analogy, I mean, knowing and understanding the individual applying the appropriate elements to that. What else is driving these decisions for the patients relatives? What other things have you seen as part of that?
Mark Menton
Yes, I mean, obviously, the one thing we haven’t solved is a national quality metric. That’s one thing we hear over and over again, from our, our users and our health plans alike, as what can we do from a quality perspective? Now, there are a number of quality metrics out there. But we have not found one. And there’s not one that you can go to an average American and say, do you trust this quality metric? So I think that that’s another ongoing thing that we really have to solve for? Because I think that’s, that’s the really missing component, we can create these personalized things around price transparency. But what does that mean from a quality perspective, and that those two, in many cases are are equal, right, and a consumers decision? So I think that’s one thing we have to solve for. And then I think the other thing is just getting engagement. We know that people want these tools, or they say they want the tools. But how do we make them available and accessible where they need them? Right? So it’s not just I don’t always remember to go to my health plans website, or my health plans mobile app to make a decision, I might go to Google, I might ask my doctor. And again, so we want to make that this data and experience available wherever you’re looking for it because it shouldn’t be tied. It’s to your point earlier, it’s my data as an individual, it’s not the health plans data. It’s not my doctor’s data. It’s not Google’s data. So this data, if, if I’m looking for it, why is it available, wherever I’m looking for it versus having to find a specific, you know, application or specific website that I have to go hunt down, remember, log in and find out, we have to democratize information to get it to people’s hands where they need it.
Nick van Terheyden
You know, I think that’s exactly right. The The other thing that sort of occurs to me as part of this is that they’ve got to give up information. So there has to be some element of trust in providing that because, you know, I want you to know more about me, so that you can give me more customized, but at the same time, what we’ve seen in other places, and I’ll pick on, you know, the the general sort of web based influencing that has not been entirely transparent. How are you addressing that to make sure that you continue with a trusting relationship with all of the parties involved.
Mark Menton
So we talk every day about the creepiness factor, and how we don’t cross that line, right, there’s that there is a line between, I understand what you’re looking for, and I’m here to help you versus I got access to information you didn’t know I had, and I’m here to help you. And I do that kind of I’m from the government, and I’m here to help. So it’s really about a getting consent and by and so having the user the member understand, we’re here like a we are here to help and here’s the information you can set to let us use to help guide you and make choices. And I think the other thing is, it’s we’re not narrowing it down to saying you should go see Dr. Smith, it’s based on what we know about you, here’s three or four options that we think are right. And then you can pick and choose based on what’s more important to you. I think it’s really a combination of making sure that user understands what we’re doing. And they consent to it’s a act of consent. And then, again, not saying this is what to do, but more here are your options that we think are appropriate. And then you can make a decision based on that as an individual. I think you balance those two, then you’re much more likely to get somebody to buy into it and take action on information versus feel used or steered.
Nick van Terheyden
Yeah, I think that’s a great way. And you know, trust is essential in all of this because ultimately, if you don’t have that people will not engage and we need that engagement. We also need the transparency so that the patients can make those informed decisions, not just monetarily, but also I think rightly you know, quality and other elements that all contribute to a decision that you know can be life changing in many cases. As you think about the future, in a lot of this hinges on data, and it hinges on digital enablement. Tell us a little bit about where you see this going, what what what you’re excited about.
Mark Menton
Um, so I think there’s a couple of things that I’m excited about, what is you’re seeing increased adoption, the tools and one, we have a very low hanging fruit on the I love the incrementalist mindset, right where you don’t have to transform something, you can make small steps. So when we look at user patterns on our platform, from a five to one perspective, we see people searching just for a doctor versus understanding what my cost is. So think about that we’d like five, for every five people that have come to our platform for looking for a doctor to perform a procedure or service and one 1% are actually looking for cost. So what we’ve done is we’re breaking down the barrier between those two searches and melding them. So it’s the same experience. And whether you’re looking for cost or provider, we know that you’re really probably looking for both, you just don’t know it yet. Right. So presenting the information to them without them even having to go seek it or understand it that’s available. I think that’s, that’s a near term thing that we’re doing that I think will dramatically increase engagement and utilization of transparency tools. And then I think second, and that we’ve, I’ve hit on this a couple of times, but making sure that this information is available, wherever the person is looking for it. If we expect people to go to their web, their health plans app, it’s just not going to happen. They go to that we don’t I mean, they do go their health plan app. So we have that that does check the box, we’ve got that covered. But we also know a lot of people start at their providers website or talk to their provider, if the doctor doesn’t have access to the same information the health plan does, we’re gonna have a confused member, confused patient. So I think making sure that that data is available, I think that’s really the next big incremental step where people no matter where they’re looking, they have access to this information. Once they have access, then all sudden, they understand the value of it, and they can start making decisions based on that.
Nick van Terheyden
You know, it’s interesting, you bring that up, it’s sort of the the truth of a single source of data and trust that you know, that verified and appropriately shared. I know people have so many entry points into the healthcare system, we have to make sure that that’s a consistent experience. Otherwise, all you create is essentially confusion, probably think we’re doing a good job in the digital enablement of all of us.
Mark Menton
I think we’re making efforts I don’t know for how good the effort has been to date, I think there’s still a lot of pride of ownership of both the experience and the data that we have to move beyond and say, Who are we ultimately serving? And who, who has a right to access that information. And when we when we get past that it’s not my data or your data, it’s the patient’s data. I think that takes us to a new paradigm where it’s both from a data perspective and a digital experience perspective. We’re well beyond where we are today. But I think until we get past the pride of ownership. That’s kind of right, that to me, that’s the last thing really holding us back as people still trying to protect that data, protect the experience versus freeing the information and let people find it where they need it.
Nick van Terheyden
You know, it’s interesting, interesting, you finish on that sort of, you know, data is key, it’s sort of economics separation for some organizations, allowing that open access is still competitive, because you compete on different things. And I think that’s what folks are really looking for, ultimately, in the healthcare system. Exciting times, I think, you know, great opportunities, especially around transparency. I know there’s huge demand for that. It’s interesting, you talk about the five to one, I was a little bit surprised that more people were searching just for a doctor, but I guess you know, lack of information, but I’m sure that’s going to tilt as people feel more of that individualistic aspect. But you know, delighted to hear that you’re on this great journey. You brought all of this and you know, bringing a trusting relationship to serving that. Unfortunately, as usual, we’ve run out of time, so it just remains for me to thank you for joining me on the show. It’s been a great pleasure, Mark. Thanks for joining me.
Mark Menton
Thanks, Dave. Glad glad to be here and I look forward to talking again.
