SBIR-STTR Award

This SBIR Phase I project will develop a novel healthcare cost estimator and billing management mobileapplication to assist minority health and disparity populations in America find affordable healthcare andaccurately pay medical bills. America has the largest per capita health expenditure in the world, and Americansbear the significant burden of this with medical debt reaching US $81 billion in 2016 [1][2]. Over a quarter ofAmericans have challenges paying for medical care and this disproportionately impacts those minority healthand disparity populations, leading to disparities in access and ultimately health outcomes. For example,Blacks/African Americans are 25% more likely to have challenges paying for medical care than the averageAmerican, Hispanics/Latinos - 30% higher and socioeconomically disadvantaged populations - 60% higher forthose who earn less than $50,000 [3].To make fully informed decisions about their healthcare and be protected from surprise billing, patients mustknow the price and quality of a good or service in advance. Approximately 73% of inpatient care and 90% ofoutpatient care with the highest-spending are offered by multiple providers through the market, meaning ifpatients researched and compared these before making informed choices they could see significant savingsopportunities, with figures of up to 19% shown in literature [4]. However, the evidence for this is conflicting [5].On January 1st 2021, hospital pricing data for services and procedures became available for the first time, andwhile this data is accessible, powerful players in the healthcare market are incented to keep this commerciallysensitive data opaque to the public [4]. Access to intuitive tools that simplify the research and comparisonprocess would make the effort minimal and incentives high to find low-cost, high quality care. The ability tosave pricing information related to the providers and services a patient may need, and the out-of-pocket coststhey may incur will avoid surprise bills and allow for reconciliation when bills are received. This can help avoidexcessive charges and empowers patients to inquire about discrepancies.The scope of science proposed in this SBIR project is to develop a novel cost estimator search tool fed by anaggregated database of hospital pricing information combined with an automated billing reconciliation tool runon a smart device or laptop for a dynamic, user friendly experience completely free to the public.Digital products of this nature are available for businesses today and have been shown to improve employeeengagement with, and accessibility and affordability of, healthcare services. However, those unable to affordmedical care are 3.4 times more likely to be uninsured (28.9M Americans), and part of families with incomesbelow 400% of the poverty level (24.5M Americans) [6]. These individuals often don't have the support ofemployer-sponsored insurance and benefits, further widening the inequalities across the population.Approximately 70% of socioeconomically disadvantaged populations do, however, own a smart device [7]. Themobile health, cost estimator and billing management application developed through this project will offer forthe first time a direct-to-consumer solution agnostic of employer and health insurer, dedicated tosocioeconomically disadvantaged populations and their needs.The benefit of this pioneering work will be meaningful pricing information and billing tools becoming moreuniversally available, protecting patients, reducing the cost of care and ultimately bridging the gap inaccessibility and affordability of healthcare in America.In Phase 1, we will evaluate the technical feasibility and validity of the mobile application. In subsequentphases we will evaluate the usability and effectiveness through human subjects research, while building therequired partnerships and sales channels to develop a commercially viable product.

Public Health Relevance Statement:
Project Summary/Abstract This project has relevance to public health through its contribution to knowledge on the role of price transparency in improving access to affordable healthcare for socioeconomically disadvantaged populations. It will provide insight on how an automated billing reconciliation tool can generate savings or reduce the accrual of medical debt for patients, leading to increased engagement with healthcare service. It will also demonstrate how intuitive mobile applications can be used by underserved populations to break down barriers to accessing and affording healthcare.

Project Terms:
Algorithms ; Ambulatory Care ; Outpatient Care ; outpatient treatment ; Americas ; Back ; Dorsum ; Ursidae Family ; Bears ; Ursidae ; bear ; Charge ; Conflict (Psychology) ; Conflict ; Decision Making ; Health Expenditures ; health care expenditure ; healthcare expenditure ; Family ; Future ; Goals ; Health ; Health Personnel ; Health Care Providers ; Healthcare Providers ; Healthcare worker ; health care personnel ; health care worker ; health provider ; health workforce ; healthcare personnel ; medical personnel ; treatment provider ; Hospital Shops ; Hospitals ; Incentives ; Income ; Economic Income ; Economical Income ; Insurance Benefits ; Insurance Carriers ; Insurers ; Health Insurance ; health insurance plan ; Language ; Literature ; Natural Language Processing ; natural language understanding ; Outpatients ; Out-patients ; Patients ; Poverty ; Impoverished ; Public Health ; Publishing ; Research ; Role ; social role ; Running ; Sales ; Savings ; Science ; Time ; Translating ; Work ; Price ; pricing ; Health Care Costs ; Health Costs ; Healthcare Costs ; African American ; Afro American ; Afroamerican ; Black Populations ; black American ; Businesses ; Healthcare ; health care ; Hispanics ; Hispanic Populations ; Latino Population ; Spanish Origin ; hispanic community ; Latino ; Uninsured ; Caring ; base ; Label ; improved ; Procedures ; Phase ; Medical ; Ensure ; insight ; Intuition ; Visual ; Individual ; Databases ; Data Bases ; data base ; Inequality ; tool ; Nature ; Knowledge ; Complex ; Health Care Markets ; Healthcare Market ; Services ; American ; experience ; success ; laptop ; novel ; Devices ; Modeling ; QOC ; Quality of Care ; CPT Codes ; Current Procedural Terminology Codes ; Provider ; disparity in health ; health disparity ; Effectiveness ; Legal ; Address ; Data ; Human Subject Research ; Improve Access ; Small Business Innovation Research Grant ; SBIR ; Small Business Innovation Research ; Process ; Grouping ; groupings ; Development ; developmental ; minority health ; cost ; inpatient service ; inpatient care ; digital ; Underserved Population ; under served group ; under served people ; under served population ; underserved group ; underserved people ; design ; designing ; Outcome ; Population ; user-friendly ; user centered design ; usability ; mHealth ; m-Health ; mobile health ; mobile application ; mobile app ; mobile device application ; socioeconomic disadvantage ; Socioeconomically disadvantaged ; socio-economic disadvantage ; socio-economically disadvantaged ; socio-economically underprivileged ; socioeconomically underprivileged ; database query ; data base query ; Employee Engagement ; disparity reduction ; reduce disparity ; disadvantaged population ; health care service ; healthcare service ; health care availability ; access to health care ; access to healthcare ; accessibility of health care ; accessibility to health care ; accessibility to healthcare ; health care access ; health care service access ; health care service availability ; healthcare access ; healthcare accessibility ; healthcare availability ; healthcare service access ; healthcare service availability ; care costs ; barrier to care ; barrier to health care ; barrier to healthcare ; barrier to treatment ; obstacle to care ; obstacle to healthcare ; referral services ; health management ; health care management ; healthcare management ; data harmonization ; harmonized data ; cost estimate ; cost estimation ; effectiveness evaluation ; assess effectiveness ; determine effectiveness ; effectiveness assessment ; evaluate effectiveness ; health disparity populations ; health disparate populations ; searchable database ; searchable data base ;

This SBIR Phase I project will develop a novel healthcare cost estimator and billing management mobileapplication to assist minority health and disparity populations in America find affordable healthcare andaccurately pay medical bills. America has the largest per capita health expenditure in the world, and Americansbear the significant burden of this with medical debt reaching US $81 billion in 2016 [1][2]. Over a quarter ofAmericans have challenges paying for medical care and this disproportionately impacts those minority healthand disparity populations, leading to disparities in access and ultimately health outcomes. For example,Blacks/African Americans are 25% more likely to have challenges paying for medical care than the averageAmerican, Hispanics/Latinos - 30% higher and socioeconomically disadvantaged populations - 60% higher forthose who earn less than $50,000 [3].To make fully informed decisions about their healthcare and be protected from surprise billing, patients mustknow the price and quality of a good or service in advance. Approximately 73% of inpatient care and 90% ofoutpatient care with the highest-spending are offered by multiple providers through the market, meaning ifpatients researched and compared these before making informed choices they could see significant savingsopportunities, with figures of up to 19% shown in literature [4]. However, the evidence for this is conflicting [5].On January 1st 2021, hospital pricing data for services and procedures became available for the first time, andwhile this data is accessible, powerful players in the healthcare market are incented to keep this commerciallysensitive data opaque to the public [4]. Access to intuitive tools that simplify the research and comparisonprocess would make the effort minimal and incentives high to find low-cost, high quality care. The ability tosave pricing information related to the providers and services a patient may need, and the out-of-pocket coststhey may incur will avoid surprise bills and allow for reconciliation when bills are received. This can help avoidexcessive charges and empowers patients to inquire about discrepancies.The scope of science proposed in this SBIR project is to develop a novel cost estimator search tool fed by anaggregated database of hospital pricing information combined with an automated billing reconciliation tool runon a smart device or laptop for a dynamic, user friendly experience completely free to the public.Digital products of this nature are available for businesses today and have been shown to improve employeeengagement with, and accessibility and affordability of, healthcare services. However, those unable to affordmedical care are 3.4 times more likely to be uninsured (28.9M Americans), and part of families with incomesbelow 400% of the poverty level (24.5M Americans) [6]. These individuals often don't have the support ofemployer-sponsored insurance and benefits, further widening the inequalities across the population.Approximately 70% of socioeconomically disadvantaged populations do, however, own a smart device [7]. Themobile health, cost estimator and billing management application developed through this project will offer forthe first time a direct-to-consumer solution agnostic of employer and health insurer, dedicated tosocioeconomically disadvantaged populations and their needs.The benefit of this pioneering work will be meaningful pricing information and billing tools becoming moreuniversally available, protecting patients, reducing the cost of care and ultimately bridging the gap inaccessibility and affordability of healthcare in America.In Phase 1, we will evaluate the technical feasibility and validity of the mobile application. In subsequentphases we will evaluate the usability and effectiveness through human subjects research, while building therequired partnerships and sales channels to develop a commercially viable product.

Public Health Relevance Statement:
Project Summary/Abstract This project has relevance to public health through its contribution to knowledge on the role of price transparency in improving access to affordable healthcare for socioeconomically disadvantaged populations. It will provide insight on how an automated billing reconciliation tool can generate savings or reduce the accrual of medical debt for patients, leading to increased engagement with healthcare service. It will also demonstrate how intuitive mobile applications can be used by underserved populations to break down barriers to accessing and affording healthcare.

Project Terms: