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 muchcredit; 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 yearshe 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’shealthcare summit. Thus all the things that drive the banking and financial services engine rely on healthy individuals and communitiesand 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 anarticle 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 findhealthcare using the rails of our banking complex to finally realize the national dream of realtime 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 ofthe future, where banks join with fellow healthcare stakeholders todevelop common solutions to help the uninsured and unbanked, tosocialize better tools and information that families can use for theirmedical treatments, to help individuals get real time access to theirhealthcare records through online banking used by 55 million householdsin America and growing, and to enable community centers that PresidentObama is investing in with eligibility, funds and data transferplatforms that support far greater coordination of the finitehealthcare assets in the community. Oh yes, we have a vital ingredientand a critical role in the national dialogue and don’t let anyone tellyou otherwise.

Banks and financial services firms are teaming with healthtechnology companies and others to create a new paradigm, starting withvastly improved administrative processes and moving up the valueparadigm in phase 1, to automating workflows that remove the paperchase, leveraging the unique market position of the bank to process andcapture payment data that improves revenue cycle decisioning throughdenial management or contract management routines that take up so muchtime in the business office, and finally moving to the top of thepyramid of value, to address the enterprise needs of the healthcarecommunity. Different banks are evolving at different rates along thispyramid. As you do, know that the top contenders have found compellingprospects for profitability. As success stories come in, medicalbanking groups are following this strategic pathway, creating one ofthe nation’s most compelling “Green Tech” engines – another tie intothe goals of the Obama Administration. Yes, we have a criticalingredient for the national dialogue to improve healthcare.

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

In phase 2, banks are embracing the power of their marketposition, reving up eHealth strategy, creating real time gateways withhealth IT partners, specializing card platforms to automate paymentprocessing across stakeholders, leveraging online banking to supportsingle-sign on for the consumer, giving families private access tohealth-wealth tools, and although Track 1 is a primary focus for manytoday, the recipes of the future belong to Track 2: innovations inmedical consumerism.

So we ask you to apply yourselves diligently to the task ofexploring how financial systems can align with the national process toimprove healthcare; and this moves us to phase 3, examining howgovernance models, like the Federal Reserve, can spearhead commonstandards banks can use to empower business and consumers withmission-critical and family-critical tools…tools that hospitals can useto automate the routines in Phase 1, tools that health plans can use toreduce disbursement costs, tools that community care centers can use toaccess healthcare assets in real time, tools that will allow you and Ito use a “healthcare ATM” just like we use the regular ATM, so if wetravel abroad as a medical tourist or just across the country and weget ill, we have secure and private on demand access to our healthcarerecords and our financing resources at the swipe of a card. We can getthis done!

Building an electronic medical banking community, the theme ofour event, moves the President’s “Green Tech” agenda forward.Rationalizing the extreme paper chase in healthcare is core tomodernizing our healthcare system. We’ve done good work digitizing thefront door, sending the claim from the provider to the payor but theback door was left wide open and today, whenever you visit a caregiver, a steady stream of paper follows you – almost all paymentrelated. This mountain of paper invadesour healthcare system, creating enormousbarriers to efficiency, siloing data that needs to be securelyliberated to improve healthcare at every point along the process andespecially at point of service, where adverse drug events causeavoidable pain and loss.

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

Sometimes when agonizing over problems you wake up to findsolutions right under your nose. I want to suggest to you today thatthe medical banking build-out is inevitable. As banks linked withairline systems removed layers of inefficiency, enabling consumers withonline tools, so medical banking is following a similar pathway,pushing paper out of the system, liberating data, fueling revenuecycles and decisioning; helping banks and their healthcare clients togain a better view of the intrinsic value of the fundamental financialunit in healthcare, so taxed with myriad codes, and potentiallyunleashing $200 billion in credit from receivables that are wastingaway on the books and records of our nation’s healthcare systems. Otherindustries have liquidated this asset. This is a mainstream practiceexcept for healthcare, where the value of receivables is too oftenlocked in a deep freeze. This will change in the new medical bankingparadigm.

Now, do you remember how when growing up, Mom made you eat thepeas? Some of you still don’t like peas because of that. Value shoulddrive progress not legislative fiat. It may make sense to engage alegislative agenda at some point, but for now we’ve chosen to take ourideas to the marketplace and let the market decide. And they have. The1100 employer strong Automotive Industry Action Group embraced medicalbanking as a strategy, helping us to create a new Tool Kit forEmployers to diffuse medical banking practices in the marketplace, andwe’re excited that LeapFrog and others are taking notice of ourefforts. MBProject just aligned with NCPDP, the only group that isdoing real time processing on a general basis, to cross-pollinate ideaswith our banking members. The HFMA is here, a powerful healthcaregroup, and this is testimony to the power of our ideas. I look forwardto hearing Bob Broadway tell us how we can help hospitals navigate oneof the toughest times in the history of healthcare. As Obama said,we’re at that Thelma and Louise flashpoint in healthcare, where the carcould go over the cliff. The medical banking community will not standby 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, founderof Consumers for Health Care Choices, will share his ideas and I’mgoing to listen to him carefully. We need to listen to consumers,because our quest to build platforms that serve business willultimately find critical mass in service to families. Banks know thepower of scaling services for the masses, which they do everyday. As wecollectively fine tune the vision in medical banking, new concepts willemerge of how to marry online banking, credit terminals, ATMs, branchsystems, to personalized healthcare platforms that promote betterlifestyles and better healthcare. Not only will this improve customerretention but banks may add three times more to the bottom line bycreating a health-wealth portal, linked to online banking, based on anextrapolation of research done by Dr. Paul Whitman, here fromCalifornia Lutheran University in Simi Valley.

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

Healthcare and banking groups are sharing ingredients, theyare finding common ground to improve healthcare in increasinglypowerful ways. When I first started talking about this in 1996, I wasmet with a field of bank stares. Yet convergence is vital to thenational dialogue to improve healthcare. The Medical Banking Projecthas pioneered new ground; we’ve thrown ourselves into the healthcaredialogue with a critical ingredient and with our members, we are makinggreat strides. All of you, top executives in your domains, must knowthat you are an integral part of the process, not a bystander. Youshould not accept the fact that everyone in healthcare is sittingaround a table and leaving you out. You must be in the process, youmust, if necessary, throw yourself into the process to fuel anelectronic medical banking community that provides powerful andrelevant services for our ailing healthcare system.

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

To help you, MBProject has created new tools:

Our Gold Seal program, is the essential underpinning of ourmovement. Its not just a technology platform that we need; we mustbuild a platform of trust for business and consumers and bankers knowthat all too well. One slip up, and 58% of your customers will changebanks. 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 bathwater. Banks will continue to provide a central driving force in theevolution of healthcare solutions.

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

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

Our International Journal of Medical Banking, as Maureendiscussed, provides a peer reviewed tool that helps to get the mentaljuices flowing to spur creative strategies linking banking andhealthcare systems.

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

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

In closing, I want to emphasize again that necessity is themother of invention. What if one of the most important and criticalingredients for fixing our banking and healthcare crisis was to findcommon ways to help each other? What if two broken, elephantinesystems, prodded by a dancing mouse, discovered new ways to healthemselves? Cleary, a healthy community supports a productive workforcethat ultimately results in healthy deposits. Healthcare and bankingleaders truly have much in common. There is good reason to invest inhealthcare to energize the bottom line, and get the economy movingforward again. I believe we have an historic opportunity to influencethe progress of our nation by throw ourselves into the creation of anelectronic medical banking community. Towards this end, we offer thisInstitute to inform the national process, so that we can collectivelybuild a healthy-wealthy future for our families and communities.Thank-you.

Presentation of awards

Medical Banking Project is driven by a mission: to convertdigital savings into charitable resources. We do this by optimizingbanking resources for healthcare. What gives life to our mission arethe executives that have come into our process as members and leadersof our workgroups and councils. We want to acknowledge each of theseleaders for their hard work. Each year, one or two people rise to thesurface.