Fixing America’s Medical Debt Problem

An estimated 66.5% of all bankruptcies in the US are tied to medical bills. Meet 10 entrepreneurs on a mission to break this trend.

You might think that Americans’ collective $1.6 trillion in student loan debt is the №1 reason for them filing bankruptcy. But you’d be wrong. It’s medical bills.

When it comes to medical debt, the US takes home the cake. A recent academic study found that 66.5% of all bankruptcies in the US were tied to medical issues — either because of high costs for care or time out of work. The research, which was published in the American Journal of Public Health, revealed that an estimated 530,000 families turn to bankruptcy each year because of medical issues. While some other industrial nations have health insurers, most avoid five-figure medical bills as a result of how insurers and doctors are regulated.

More often than not, low- and moderate-income patients in the US face the common scenarios that become catalysts for medical debt. For instance, let’s say a woman goes to the emergency room to treat a particularly bad migraine. A doctor orders an MRI to rule out any major medical conditions. Later, she receives a bill from the radiologist who interpreted the scan at full cost. While the hospital was within her health insurance network, the radiologist was not.

Navigating the nuances of insurer coverage, and determining which financial resources will help can feel like a full time job. Fortunately, there are a handful of innovators that are working at the cross-section of healthcare and finance to help patients find their way out of debt, and avoid it all together. EmPower App provides employees liquidity to pay for medical events whenever they need coverage, lowering the cost of care. Vivor’s proprietary technology catalogues and keeps up-to-date over 1,000 financial assistance resources from hundreds of organizations. And Hoy Health has created a unique set of interconnected cash-pay products that are designed specifically for medically underserved markets. There are others. Each of these Health Transformers are tackling a unique angle of medical debt; all of them are working to achieve the same Health Moonshot: reduce the cost of care to zero.

Ian Manners and Ben Gagosian

Co-founders, Vivor

Manners and Gagosian are connecting patients with the financial assistance they deserve. Vivor is a cloud-based platform that reduces a patient’s financial responsibility (and stress) by maximizing the use of co-pay assistance programs. More than a catalog of over 1,000 financial assistance resources, Vivor also supports the process of enrolling a patient into programs and securing funds. With over 15 paying provider customers — including Yale-New Haven Health, Dignity Health/Dominican Hospital, and Oncology Hematology Care — the company manages over 100,000 active patient cases per year.

Message Ian Manners on StartUp Health HQ or email vivor@startuphealth.com.

Jo Schneier

Founder & CEO, Trusty.care

Schneier believes every consumer of health should be able to navigate government funded healthcare “without getting a degree in Medicare.” Trusty.care taps into rich data the government makes available and feeds it into their AI-driven system to create a “diagnostic” tool for users. The platform helps users maximize the financial benefits available to them while taking into consideration their individual health needs. Think TurboTax for choosing government-sponsored health insurance. Within six weeks of launching the platform, the company had 15,000 intents to purchase.

Message Jo Schneier on StartUp Health HQ or email trustycare@startuphealth.com.

Ron Weider and Jason Pyle

Co-founders, emPower App

Weider and Pyle are on a mission to universalize financial security by empowering patients to pay medical bills. For employers that offer high deductible plans, emPower provides employees liquidity to pay for medical events whenever they need coverage, lowering the cost of care, automating tax optimization, and reducing borrowing costs. The platform is part app, and part medical payment card, backed by a credit program. Unlike HSAs, emPower provides beneficiaries with low-interest loans to provide a safety net for them, and helps patients afford care when they most need it. The company developed its technology platform with a robust pipeline of early adopters including a proof-of-concept pilot with US HealthWorks. The company’s growing list of partnerships includes The Bancorp, Inc., MasterCard, and Echo.

Message Ron Weider on StartUp Health HQ or email empowerapp@startuphealth.com.

Justin Nicols

Founder & CEO, Sift Healthcare

Nicols is driving medical billing costs to zero. For health systems losing revenue due to revenue cycle inefficiencies such as unpaid bills, Sift Healthcare’s data platform applies predictive analytics and machine learning to all reimbursement and patient pay data streams to enable high-power denials management and propensity-to-pay modeling. In other words, Sift’s platform helps providers better understand patients and collect payments more efficiently by using root cause analysis of denials payer contract variances. Unlike typical data scrubbing and rules engines, Sift’s platform uses predictive analytics to reduce insurance claim denials, allowing for the normalization of very large billing datasets into a common platform and for granular payment insights not previously achievable. Sift Healthcare’s first pilot is underway with the country’s top revenue cycle management vendor for ambulatory services (2,000 physicians).

Message Justin Nicols on StartUp Health HQ or connect via email at siftmd@startuphealth.com.

Mario Anglada

Founder & CEO, Hoy Health

Anglada is building a future in which health consumers and their family — whether in the U.S. or abroad — can have their primary care needs met for $100 per month. Hoy Health has created a unique set of interconnected cash-pay products — HoyRX, HoyMEDS, HoyCCM, and HoyDOC — that are designed specifically for the Hispanic and medically underserved markets. All of the products are bilingual and can be accessed via a digital platform either domestically or by extended families abroad. With an established network of 62,000 pharmacy distribution points in the U.S. and Puerto Rico, and a formulary of 3,500 generics (80% of all generics), Hoy Health is giving users unprecedented medication access at low prices.

Message Mario Anglada on StartUp Health HQ or email hoyhealth@startuphealth.com.

Chris Sealey, Andrew Hopping and Andy Laken

Co-founders, CoverUS

Sealey, Hoppin and Laken are making healthcare affordable for everyone, everywhere. CoverUS financially rewards patients for capturing “real world” health data to complement their electronic health records. CoverUS empowers them to broker it securely and to be contacted with targeted adherence and research offers as a means to pay for their healthcare. The result is a medical industry with better, more timely consumer health data, and the ability to form direct patient relationships at scale.

Message Chris Sealey, Andrew Hopping and Andy Laken on StartUp Health HQ or email them at coverus@startuphealth.com.

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