Rx for Pricing Transparency: MediXall has strategies to help consumers, employers, practitioners

Published by SFBW magazine: December 28, 2018
Author: Kevin Gale

There’s Amazon for shopping. There’s Airbnb for vacations. There’s Priceline, Expedia and Travelocity for trips. Wouldn’t it be nice if there were a similar easy-to-use experience for shopping health care?

That’s the need that MediXall.com of Fort Lauderdale is trying to address, says President Michael Swartz. The company allows consumers to use their smartphones, tablets or computers to check out health care providers and related service providers.

It’s ramping up by providing information about imaging centers. In South Florida, prices for MRIs, PET scans, CT scans, X-rays and other diagnostic imaging services can vary widely—without any real difference in the quality of outcomes as well, Swartz says. MRIs can range from $400 to more than $3,000 for the same imaging.

Patients are starting to get more savvy about shopping around rather than just going to a center a doctor recommends, especially when they have high deductibles, Swartz says. MediXall cites National Center for Health Statistics data that shows more than 48 percent of the state’s population between ages 18 and 64 were uninsured in 2017 or were struggling with a high-deductible insurance policy, leaving patients paying cash for medical imaging services that they cannot evaluate or comparison-shop, because of lack of available information.

For those lacking a health insurance provider who has a list of providers, finding a database of providers can be a challenge. That’s one of the roles MediXall wants to fill.

MediXall is looking at partnering with employers who have self-insurance programs. It could help employees manage costs before they hit their deductibles, Swartz says. That fits in a scenario with many employers who offer a combination of high-deductible plans and health savings accounts.

MediXall is all about pricing transparency in the health care field. The industry has had issues with gag clauses that inhibit pricing disclosure, which is starting to get legislative attention.

For example, President Donald Trump in October signed two bills that prohibit gag orders on pharmacists. The issue was contracts preventing pharmacists from disclosing that an equally effective but less-expensive drug option was available to patients.

Swartz, who was a co-founder of Viridian Capital Advisors and served as a senior analyst from 2013 to ’15, has tweaked his approach since MediXall had a soft launch in March. Initially, the approach was to target a broad array of health care providers. The company gained an insider’s view on how pricing works and became acquainted with CoreChoice, whose specialty networks include imaging.

Swartz realized he could tap into networks with thousands of providers instead of bringing in providers one by one. Providers also would already be fully credentialed, because health plans required that for reimbursements.

MediXall formed a strategic partnership with CoreChoice.
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