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Reboot Healthcare’s New Health Plan


Crowdfunding Campaign

Goal: $75,000

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Goal: $75,000

Funds Raised: $0

Countdown to Launch:

Hours
Minutes

The business part of healthcare is broken.
We're going to Reboot Healthcare and you can help (yes, you!)

Our new health plan will deliver efficient, accessible, and affordable healthcare through our advanced network and apps
for patients and physicians.

Our offer

Patient Care + Patient and Physician Friendly Technology
= Peace of Mind

Our smart technology ensures patient safety and privacy, and tools for physicians that ensure the best care pathways and outcomes for their patients.

For Patients 

  • Accurate real-time information about healthcare plans and options 
  • Reduced premium costs
  • Real time access to telespecialists

For Physicians & Providers

  • 72 hour payment using Healthcare Cash Register ©
  • Real time eligibility accuracy
  • Contracts renewed automatically at market rate or above

What it
looks like

For Patients

ForCurrent SystemOur Startup
Specialty care approvals:3-28 daysSame day
Request to add your physician:90-120 days30 day Concierge Model
Health Plan Satisfaction:25% people change plans each yearLess than 5% leave our plan each year
Health Plan Premiums:Varies20% less than average
Claim Denial Rates:Rose 23% since 2016Less than 5% -- advance health service reservation
Returned Call Rates:Industry average ~ 78.1%Target: 100%

Physicians and Other Providers

ForCurrent SystemOur Startup
Treatment decision making:LImited treatment decisions allowedClinical autonomy /
discretion
Payment / Settlement:12.4 days average72 hours
Referral processing:By law: 3-5 days. In practice: 8-10 daysOn-demand same day*
Credentialing /
Re-credentialing:
Send "snail" mail and email requestsConcierge approach and provider-specific online document vault.

Allows CMEs to be uploaded as they are earned.
Patient financial responsibility:Patient’s out of pocket is an estimate.

Deductible accumulator can be up to 6 months out of date.
Patient responsibility is accurate based on provider contract
Maximize payment terms:Pay lower of billed or contracted ratePay contracted rate
Contracts:Discourage contract updates -- rates are generally much lower than market rateRenewed automatically at market rate or higher

* If provider uses Healthcare Cash Register ©

How we
will do it

The co-founders, and the healthcare veterans in our network, are committed to the radical simplification of business processes and delivery of user-friendly tools at the center of healthcare: Patients, Physicians, and other Medical Professionals.

Our founders’ have extensive knowledge of the full range of existing systems for every aspect of the healthcare delivery system, e.g. EHRs, claims processing, provider directory, plan member benefits, facility contracting tools, lab information systems, and more.

Our experience in solving the combined technology and operational problems  includes solo physicians, small groups, large groups, integrated delivery networks, small community hospitals, large hospital networks, small health plans, large multi-state health plans, skilled nursing facilities, and others.

Root Cause Analysis tells us three things:

  • Nearly all failures are due to legacy information systems that were designed for traditional health insurance — which started dying out over 30 years ago. Member Benefit and Claims Processing systems just were not built for the modern world.
  • Physician and other provider contracts are too complex
  • Payment settlements are conflated with provider documentation. This results in both processes failing, as well as outrageous and excessive management costs

 The advantage of a startup is that it does not have legacy data, and we are free to implement all of the solutions we were paid to design for the legacy health plans and providers we have worked for over the years. This fresh start allows the Reboot Healthcare co-founders to implement the technology they were asked to design by those legacy health plans and the providers who desperately need relief from the burden of always increasing administrative complexity. 

After years of meetings with health plan executives and the government regulators, Reboot Healthcare is being launched to take advantage of what has been described as “revolutionary” and “massively simplified business processes.”

It’s a practical three point plan:

  1.  Member benefits are coded to the medical services provided by physicians and other providers
  2. Our health plan data and the tools that are fed by them is designed for today’s payment arrangements
  3. We maintain a clear separation between the Payment Settlement process from the Due Diligence process

Only a startup with employees and advisors that is outside of the existing industry influences can make a bold play like this.

Our
Co-Founders

Laura Landry 

Health Operations & Information Technology 

I have been been at the intersection of healthcare operations and health technology innovation since 2000 when I designed and implemented projects for the County of Los Angeles Department of Health Services and later the City of Long Beach Department of Health and Human Services. I led a team in addressing the complex business process, privacy, security, and systems integration required to demonstrate health data liquidity could be accomplished at scale. We were one of nine federal contract awardees  of the Nationwide Health Information Network project.

I am passionate about taking care of the people in healthcare who take care of the patients.

My focused purpose is to deliver affordable peace of mind — which is the declared purpose of health insurance but has not been the fact of it for decades.

Patients, physicians, nurses, and all the other people in and around healthcare deserve business processes and technology systems that are as user-friendly and accurate as  online banking or on-demand product purchasing.

It’s time to radically simplify the business aspect of healthcare.

S. Bre Jackson

Market Development & Physician Strategist

Healthcare is a people driven market.  Every patient deserves the best of care.  I call that True Care.  True Care is optimizing the healthcare continuum with the physicians and specialists synchronously coordinating care with the patient at the center receiving the best timely care.  Timeliness is a critical concern that we all agree is the definitive value of medicine.   

As a health plan veteran, I work to build the best physician networks that are regional and area of care specific.  Physician strategy is helping physicians identify the best tools and resources to ensure quality of care and deliver the best of care outcomes for their patients.   

Whether I am launching a new campus for specialized care or working with physicians’ services, my sole goal is to ensure patients have access to high-quality health care.   

There is a nirvana-like ecosystem where information, technology and care converge to ensure patient have better outcomes and care is measurable and affordable.   

The business of healthcare is solvable, and I am advocating for True Care for everyone. 

Where we
are now

This venture is just starting! The pivot we made away from being a service provider to healthcare organizations introduced the first real opportunity to transform healthcare we have seen in the past 20 years.

Starting a health plan is nothing new — there are several of them that are less than a decade old. Starting a health plan to radically simplify the 1970s legacy business processes has not been done before.

We have:

  • Identified our legal, actuarial, and operations teams
  • Drafted our business plan
  • Dusted off every one of our breakthrough technology wireframes
Next up: Raise funds that will allow us to hire the resources and prepare the documents required to register for California’s Department of Managed Health Care approval to operate.

Our goal

We are raising Development Funds of $75,000

With as little as $1.50, you can help us to develop the operating plan for a breakthrough innovation in health insurance focused on providing you (whether you are a consumer or a provider) with affordable and understandable services that are fiscally responsible and supported by modern technologies. 

If you are not able to contribute financially at this time, the second most important thing is for this Crowdfunding campaign to go viral! Please spread the word — share on Facebook, Instagram, Twitter, and LinkedIn!

It will come as no surprise that starting a health plan comes with massive amounts of paperwork and regulatory review.

Your contribution will get us started on, for example:

  1.  Specialized Staff & Consultants
    • Prepare actuarial documents
    • Prepare underwriting documents
    • Prepare CA Dept of Managed Health Care application
  2. Legal
    • Review all plans for compliance with law and regulations
    • Attend meetings with regulators
  3. Government and Other Fees
    • Application submission
    • Other fees, regulation required memberships, etc.
  4. Industry Specific Software
    • Financial modeling
    • Operations modeling

Risks & Challenges

  1. To gain regulatory approval for a health plan is a complex process
  2. Specific staff and contract resources are needed to complete the task.
  3. Required resources have been identified but are not yet under contract.
  4. In the event the crowdfunding campaign does not meet its goal, regulatory filing may be delayed.

Rewards

These will appear at Launch Time

Spread the
word

Let’s take this Crowdfunding campaign viral!

Please spread the word — share on Facebook, Instagram, Twitter, and LinkedIn!

The more people who see this campaign, the more people can support this. The faster we raise money, the sooner the new health plan will be available at lower premium prices with respectful practices for our members, physicians, and all providers.

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