Becker’s Hospital Review recently spoke with Jeremy Friese, MD, president of payer market at Olive, about the payer landscape and how technology can streamline healthcare for all stakeholders — most importantly, patients.
Question: You’ve been a practicing physician for over 20 years and now work with Olive on the payer side of healthcare. In your experience, what are some of the biggest friction points between payers and providers?
Dr. Jeremy Friese: I’ve had the great pleasure of practicing medicine at some of the world’s top healthcare institutions. Unfortunately no matter where you practice, at large or small organizations, anywhere across the country, the healthcare system is laden with friction. There are many different areas where you see this come to light. However, it’s especially evident in two major areas. The first is anytime information flows between providers and payers. The second is anytime finances flow between providers and payers.
The information and financial flow problems at both providers and payers are what we’ve set out to solve at Olive. We have a firm belief that when you connect, as we say, “both sides of the fax machine,” you can have a dramatic impact on the industry. As the president of our payer business, I have the pleasure of working with payers every day. I firmly believe that there’s an enormous opportunity on the payer side of the healthcare house to have a dramatic impact — especially when you look at areas like care management, utilization management, medical necessity and the way technology has exploded in just the last five years.
Q: How has the pandemic exacerbated these issues or made them more vital to address now?
JF: So much has changed in healthcare due to the pandemic. The problems I just highlighted were an issue even before COVID-19, however. It’s always been a never-ending game of “gotchas” between the two parties. This is even more true amid the pandemic. One of the main reasons is that healthcare has experienced 18 percent turnover in its workforce. When you think about the processes that have been primarily handled by humans — pushing papers, faxes, Post-It notes and manila folders from one desk to another — those were already a huge burden. Now add the fact that both providers and payers are experiencing a labor shortage. This situation has truly highlighted that technology needs to step in and solve some of these problems. Care management, utilization management, prior authorization and medical necessity aren’t going away because they play a critical role in our healthcare ecosystem. How can we handle them in a more frictionless manner? That’s the question that COVID-19 has made even more visible.
Q: What technologies or solutions are available now to mitigate or solve some of the administrative issues facing payers?
JF: There are areas in healthcare where technology has had a dramatic impact on the way we practice medicine. Unfortunately, the business of medicine is not at the same level from a technology standpoint as we see in other industries. Over the last five years, we’ve seen technologies used in banking, marketing, manufacturing and other industries being built in healthcare-specific ways, so we can solve the problems that we’ve been talking about, as well as many others that are starting to take shape. I’m excited to be part of the journey at Olive to take technologies like artificial intelligence, robotic process automation and computer vision, and to deploy them in healthcare in ways that have never been seen before.
Q: Do you have any bold predictions for 2022 when it comes to insurers or the payer side of healthcare? What role can Olive play?
JF: I predict health plans will start to adopt technologies to address infrastructure costs in ways they never imagined. Payers spend anywhere from 15 percent to 20 percent of every dollar to pay for the administrative burden. I envision a world where payers will dramatically change that percentage, so that $9 out of every $10 goes to pay for healthcare and only $1 out of every $10 goes to pay for the administrative burden. Olive is going to achieve those goals in partnership with health plans. It will be a long journey that won’t be finished in 2022. But, we’re going to start together and I’m excited to do that with innovative health plans.
It’s time for healthcare technology to lead other industries. We have a moral obligation to use these advances for the betterment of people. It’s not about just reducing costs, but also removing friction so patients get the care that they deserve. That, to me, is the reason that we do what we do every day at Olive.
To see more predictions from Dr. Friese and other thought leaders in healthcare, check out Olive’s Bold Predictions for Healthcare in 2022.
