Co-founders Ahmed Marmoush, Ria Shah, and Karthik Palaniappan have combined their experience in digital health consulting and big tech to build a single source of truth for accessing healthcare pricing information. Their API has the ability to drive down costs by offering transparent price comparisons for employers and benefits brokers.
Healthcare has a cost transparency problem.
Imagine walking into a Best Buy and purchasing a TV with no knowledge of the cost, only later to receive a bill in the mail. Or what if you had to buy airline tickets without any visibility into sky high “airport facility fees”? As ridiculous as this sounds, it’s a fair picture of the US healthcare system in 2023.
Not only are healthcare expenses typically a surprise, they’re often exorbitant. Over the past 15 years, cost sharing has shifted to the consumer at a pace that has outstripped household income. In other words, the gap between income and healthcare costs is growing. One out of five families lack the savings needed to pay total out-of-pocket healthcare costs, so they either avoid necessary care or go into debt.
An answer to these two problems has come in the form of recent price transparency legislation like Transparency in Coverage. This law mandates that payers publish every single negotiated rate in a machine-readable format and give members an online tool to estimate out-of-pocket cost. Because of various new laws, every industry player including hospitals and insurance carriers must now publish their costs and provide the consumer with tools to shop.
These positive moves have created a new problem: data overload. More than 3000TB of healthcare pricing data is becoming available following the legislation, a volume and complexity virtually impossible to apply in real-world settings.
Pittsburgh-based Handl Health has stepped into the market to solve the problem, building a platform that powers an ecosystem of price transparency products by translating pricing data into actionable insights.
Ahmed Marmoush got his first real taste of the broken American healthcare system while working as a healthcare consultant at EY. Marmoush came from a family of pharmacists — who had immigrated to New Zealand from the Middle East — so he thought he knew what to expect from the healthcare system when he came to the US. But when he got an impossibly expensive surprise bill in the mail after a routine blood test, he was taken aback.
He showed the bill to his EY colleague and friend Ria Shah. Her response was telling. She said, in essence, “It is what it is.” As the child of Indian immigrants, Shah had learned to simply adapt to the broken system. But as Marmoush stood in front of her, shaking his head about his medical bill, something clicked. They both saw the underlying issue beneath the bill. A lack of pricing transparency was forcing millions of people to find workarounds in healthcare just to survive. But healthcare regulations were shifting dramatically in favor of greater price transparency. At EY, they’d each gained the industry knowledge necessary to forge a solution, so they decided to step out and try.
The idea was elegantly simple: make healthcare pricing data accessible and actionable. With Marmoush’s clinical background and experience designing value-based care models and cost containment strategies for health industries across the globe, and Shah’s extensive experience as a data strategist specializing in value-based contract design and big data management for major healthcare systems, they made a great team. Then they met Karthik Palaniappan and it took the team to a new level.
Palaniappan had put in years at Meta and Google Cloud as an engineer before he was introduced to Marmoush and Shah. He knew he wanted more than big tech could offer — specifically to work on a greenfield project that would be a part of shaping healthcare delivery and policy. That opportunity came in Handl Health.
Handl Health received an accelerant when it was accepted into Techstars Healthcare in Los Angeles. That opportunity gave the team exposure to the mentors and clients necessary to scale their platform. Following the completion of the program in June 2023, they are well positioned to make the dream of healthcare price transparency a reality.
Handl Health is a B2B platform focused on delivering accurate and actionable healthcare pricing data. It all comes down to one basic question: How much will a treatment or procedure cost?
“It might seem like a simple question,” says Marmoush, “but it’s incredibly complex to answer depending on who you are, what insurance you have, and what facility you use.”
The answer starts with data management. Handl Health has built better ways to ingest, aggregate, clean, and serve up healthcare pricing data. They’ve built algorithms that make sense of that data.
“Very few companies, even more than a year after this pricing data has come out, have successfully designed the right kind of pipeline to be able to use and deliver this data at scale,” says Shah.
That data can be personalized to the individual — “what will this procedure cost me today?” — and is also tuned to be used at an enterprise-level, such as by an employer or benefits consultant looking to develop and fine tune healthcare benefits and budgets.
Their vision is to become the central healthcare pricing data platform.
“The beauty of a platform play is that there are so many use cases that we can service,” says Marmoush. An employer helping employees figure out which provider to go to based on cost and quality information. The CFO trying to analyze their claims between two different networks in order to make a decision on which is aligned with their budget. Or a provider trying to improve collections by giving patients upfront cost estimates.
And having accurate pricing data isn’t just about getting a better deal on care. It’s about mitigating risks. Thanks to recent regulatory changes, large employers have started to ask questions about how much their insurers are charging and if those rates are aligned with the payers’ fiduciary responsibilities.
In terms of their go-to-market strategy, Handl delivers their platform capabilities through APIs and low-code/no-code tools, starting with two offerings in market today. The first is a dashboard to help corporations compare insurance networks. The tool includes pre-populated insurance data and easy-to-use dropdowns to compare costs across healthcare facilities and insurance carriers. The second is an API that supports cost estimation that can integrate with any user interface and calculates the cost of healthcare services and procedures for patients based on their insurance. These tools show just a few examples of the art of the possible with the data on Handl’s platform.
Imagine a world where healthcare prices were available at the click of a button, before care was delivered. Or where the concept of receiving a surprise bill was as antiquated as mailing a check. That’s the world being created by Handl Health.
Understanding healthcare pricing is fundamental to so many aspects of health, from lowering insurance premiums to increasing health equity. Thanks to recent price transparency regulatory changes, we’re at an inflection point for the American healthcare system, and Handl Health is positioned at the center to support and lead the evolution to cost transparency.
We’re also proud to support Handl Health because they’re doing the complex infrastructure work necessary to power an entire market, not merely one product. By using their data expertise to create a platform, Handl is powering a generation of healthcare pricing products. Their innovative approach is a catalyst for even more innovation, which has the potential to result in exponential growth. This is the kind of thinking we need in order to achieve health moonshots.
So far, the market response has been strong. As of this writing, Handl is on track to triple its 2022 distribution deals and provide coverage in 40 states by the end of the year.
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