Guest post by Levi Shapiro* The Affordable Care Act (“Obamacare”) represents the most systemic, transformative change in over 40 years to America’s largest economic sector: healthcare. This is a once-in-a-generation opportunity for mobile and digital startups to disrupt an inefficient industry. Even the government (CMMI- Centers for Medicare and Medicaid Services) predict health expenditures will continue to outpace economic growth, jumping 7.4% in 2014 to reach 20% of GDP by 2021. These recent regulatory changes create opportunities and challenges for mHealth and eHealth startups that are worth considering. A few basics about ACA:
- The insurance mandate will cover most Americans
- Individuals can purchase from state-based health insurance exchanges
- Insurance companies will bid to be included in exchanges
- Expansion of Medicaid (the federal-state program that provides health insurance to low-income Americans)
- Until ACA, an individual had to be both low-income and “categorically eligible”
- ACA will require states to cover all low-income Americans (earning up to 133% of the Federal Poverty Level) under the age of 65
- Insurance reforms
- Insurers can no longer deny coverage based on pre-existing conditions; no annual or lifetime limits on coverage
Good News for Healthcare IT Startups: Increased Government Funding & Partnerships Payers are incentivized to transition from volume-based payment (fee-for-service) to value-based payment. The Center for Medicare & Medicaid Innovation (CMMI) will evaluate and select programs that improve or maintain quality but reduce costs. Startups take note: CMMI and the Medicaid Waiver Authority are explicitly tasked with deploying new demonstration / pilot programs. In particular, the Affordable Care Act mandates vendor selection criteria to include Minimum Medical Loss Ratio (MLR):
- Early Sense (earlysense.com),
- Aerotel Medical Systems (http://www.aerotel.com),
- MobileOCT (www.mobileoct.com),
- MediSafe (www.medisafeproject.com),
- Treato (www.treato.com),
- Medivizor (https://medivizor.com),
- Zoeticx (zoeticx.com),
- Wellness Layers (http://www.wellnesslayers.com/default.aspx).
- TeleSofia (www.telesofia.com),
- Dario (www.mydario.com),
- American Well (http://americanwell.com),
- Biolert (www.biolertsys.com),
- Biogaming (www.biogaming.com),
- PhysioHome (http://www.physihome.com),
- Vaica Medical (vaicamedical.com),
- Healarium (www.healarium.com),
- KitCheck (http://kitcheck.com),
- MST- Medical Surgical Technologies (http://www.mst-sys.com),
- Kyma Medical (www. kyma-med.com),
- Kytera (www. kyteratech.com),
- Flometrica (www.flometrica.com),
- MedTrix (http://www.med-trix.com/index.php?module=News&pname=openArticle&articleID=56),
- Azure PCR (http://azurepcr.com),
- Sport Tracker (www. sportracker.com),
- LifeBEAM Technologies (www.life-beam.com),
- Hello Doctor (www. hello.do),
- SHL Telemedicine (www. shl-telemedicine.com),
- MedPal Health Solutions (www. medpalhs.com),
- iMDsoft (www. http://imd-soft.com/mobile-access),
- TeleMessage (www.telemessage.com),
- Ask Medic (http://www.myfemcard.com),
- Essence Group (http://essence-grp.com/home/artdetails.aspx?mCatID=60&artID=63),
- Medikal (https://www.medikal.ch/en),
- Nutrino (http://www.nutrino.co),
- LifeWatch (www.lifewatch.com), Tyto (www.tytocare.com),
- Mom Sense (http://momsenseltd.com),
- CountingApp (http://countingappmed.com),
- eWaveMD (http://ewavemd.com),
- Commwell Medical (www.commwellmedical.com),
- VG-Bio (http://www.vgbio.com),
- Fooducate (www.fooducate.com),
- Orpheus Medical (http://www.orpheus-medical.com/en/default.html),
- Surgical Theater (http://www.surgicaltheater.net),
- Webteb (www.webteb.net),
- FDNA Accessible Genetics (http://fdna.com),
- Totali (http://www.totallypregnant.com/?utm_source=totali.com),
- Sensible Medical (www.sensible-medical.com),
- Aliment Health (http://www.alimenthealth.com/#!),
- LifeMap Sciences (http://www.lifemapsc.com),
- Aspect Imaging (http://www.aspectimaging.com),
- Beercadia (http://www.beecardia.com),
- Sleep Rate (www.sleeprate.com),
- VoiceITT (www.voiceitt.com),
- Irody (www.irody.com),
- Emerald Medical Applications (https://dermacompare.com/pages/Login.aspx),
- Medintec (www. medintec.co.il),
- LogiTag (www. Logi-tag.com),
- Oxitone (www.oxitone.com),
- MirOculus (MirOculus.com),
- LB Sight (www.lbsight.com),
- Mon4t (http://mon4t.com),
- Ovuline (www.ovuline.com),
- Kanarit (http://www.kanarit.com),
- Prana Essentials (http://www.pranaessentials.com/Home/PranaInfo),
- enableteQ (www.enableteq.com),
- Natura Systems (http://www.naturasystems.com)
* Levi Shapiro is a Partner in the JIMMI Fund (www.jimmifund.com), working with global tech companies to invest in Israeli start-ups. Concurrently, Mr. Shapiro provides strategic advisory to global technology, media and telecom companies as a Senior Partner at TMT Strategic Advisors. Mr. Shapiro is also an Adjunct Professor in the Media Innovation Lab (http://milab.idc.ac.il) at IDC Herzliya, teaching Digital Media Entrepreneurship, Mobile Marketing and other entrepreneurial courses.
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