Breaking the Cycle of Inefficiency
Boe Hartman, CTO of Nomi Health, draws on nearly three decades of international banking expertise to address one of the U.S. healthcare system’s most pressing issues: inefficiency. Nomi Health’s approach to transforming healthcare payments revolves around real-time systems designed to reduce costs for employers, employees, and providers alike.
Nomi Health: A Four-Pillar Strategy
Hartman explains how Nomi Health’s operations span four key areas:
- Pharmacy Management: Delivering pharmaceuticals at reduced costs to self-insured employers, saving clients an average of 8%.
- Analytics: Providing actionable insights from claims data in near real-time to help organizations optimize healthcare spending.
- Provider Network: Creating cost-efficient networks by offering providers direct, real-time payments.
- Financial Services: Streamlining healthcare transactions with banking tools that simplify and secure payments.
Exposing Systemic Vulnerabilities
Hartman sheds light on systemic flaws that calcify the healthcare payment market, as demonstrated by the Change Healthcare hack. This breach, orchestrated by a foreign actor, halted $4.5 trillion in U.S. healthcare payments, exposing the lack of alternative routes in a monopolistic system.
He draws parallels to banking, emphasizing the need for healthcare payments to adopt rigorous accountability and risk management practices similar to those in finance.
Banking Insights for Healthcare Payments
Drawing from his tenure at institutions like Capital One and Goldman Sachs, Hartman outlines how healthcare can emulate banking’s resilience. He advocates for frameworks like the UK’s "Dear Chairman" letters, which hold organizations accountable for infrastructure investments and risk controls.
Innovating Healthcare Payments in Real-Time
Nomi Health is setting new standards for the healthcare industry:
- Real-Time Data: Empowering employers to make immediate, informed decisions on healthcare benefits.
- Direct Payments to Providers: Ensuring providers receive fair, timely compensation.
- Stop-Loss Innovations: Introducing credit lines to replace traditional stop-loss premiums, further optimizing costs.
A Call for Policy Action
Hartman underscores the importance of treating healthcare payments as critical infrastructure. He advocates for public-private partnerships to bring accountability and modernization to a system that constitutes 20% of the U.S. GDP.
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