“Individuals can drive change by forcing healthcare to adapt to their changing consumer preferences. Each of us has a choice in where we go for care (in most cases) and the feedback we give our healthcare providers must be considered. Reviews and star-ratings aren’t just for restaurants these days. We can proactively research and shop for care providers, then follow up with reviews just like we would with other purchases.”

As a part of my interview series with leaders in healthcare, I had the pleasure to interview Florian Otto, a health technology entrepreneur and thought leader recognized across the national healthcare and technology spaces. As co-founder and CEO of Cedar, a patient payment and engagement platform, Florian is committed to simplifying and humanizing the healthcare experience — across all administrative aspects of the process. Since launching in late 2017, Cedar has quickly become a disruptive player in the patient payment and experience space under Florian’s steadfast leadership. The company’s flagship product, Cedar Pay, combines data science and advanced technology to make the patient billing process resemble other day-to-day transactions, like ordering a Starbucks coffee or shopping on Amazon. Prior to founding Cedar, Florian was an executive at Zocdoc where he drove the commercial adoption of the platform by health systems. Previously, Florian founded a daily deal company in Brazil (ClubeUrbano) that was sold to Groupon. After the acquisition, he became CEO of Groupon Brazil. He has also worked at McKinsey & Company within their healthcare practice. Florian holds an M.D., D.D.S. and Ph.D. from the University of Freiburg, Germany.

Thank you so much for joining us! Can you tell us a story about what brought you to this specific career path?

My fiancé had a terrible billing experience after a short ER visit in a Manhattan hospital that caused her to lose trust in our healthcare system. The two-hour visit resulted in three separate bills that were very difficult to understand. One of the bills even ended up going into collections after being sent to the wrong address. I thought, “if a first-tier hospital in Manhattan has such an antiquated billing technology, the entire industry must be broken.”

At Cedar, we’re trying to fix this experience for both patients and providers. By leveraging technology and data sources, we’re simplifying the healthcare experience by reaching patients in the way they want to be reached.

What do you think makes your company stand out? Can you share a story?

At Cedar, we’re focused on optimizing the patient experience across the entire healthcare journey. We believe this starts with true personalization. Our platform, powered by machine learning, leverages millions of data points, including provider data as well as external data sources, to develop a complete picture of patient communication and payment preferences.

A few examples of this in action include:

● Identifying which communications channel (paper, text, email, or IVR), and at what point in time, will result in the highest likelihood of patient engagement. If a patient prefers to receive their healthcare bill via text, we can communicate with them via text. No more bills lost in the mail. We’re reaching patients in the manner they want to be reached, which in turn increases engagement.

● Personalize each patient message, as well as the frequency that we reach out to patients. If a patient doesn’t understand their bill, how can they be expected to pay it? By personalizing bills per patient and making them easy to understand, we can enable patients to feel more informed and empowered throughout their healthcare journey.

● Provide customized payment plans for patients, based on payment history, demographic data, and level of engagement. High healthcare bills typically come in the wake of a serious accident or health problem. When this occurs, the last thing a patient should have to worry about while on the road to recovery is how to pay their healthcare bill. We can work with patients on payment plans or guide them to assistance programs depending on each unique circumstance.

Additionally, we have built a consumer-like patient application that is easy to navigate, uses modern communication methods and allows for 1:1 chat. Our application is accessible on mobile devices as well as desktop computers, and boasts engagement rates above 70%. We’ve interacted with more than 490,000 patients nationwide on behalf of clients and received a 95% overall patient satisfaction rate. And, more than 20% of our users are 65 and over. We recently heard from a 91-year-old patient who said: “It was a great process, nice and easy. I didn’t have to go searching for my password or username. The entire process took less than a minute. And, no searching for a stamp!” That really sums up the experience we think every recipient of healthcare should have. Though, this is just the beginning.

Lastly, our platform offers providers a patient customer relationship management (CRM) system and dashboards to help providers track all patient questions and interactions, monitor patient engagement and satisfaction in real-time, and better optimize outreach efforts.

What advice would you give to other healthcare leaders to help their team to thrive?

Healthcare touches everyone. It’s hard to think of another industry more in need of different thinking and approaches that hold the potential to inspire change. In order to change healthcare, leaders in the space need to embrace diverse perspectives. We must promote a workplace environment that embraces differences in opinion, culture, lifestyle and more to help teams thrive.

At Cedar, we strongly believe that diversity is critical for success and we’ve made it a priority since day one. From diversity groups to company-wide trainings, we’re committed to promoting diverse people and thinking — and I’d urge other leaders to do the same.

Ok, thank you for that. Let’s jump to the main focus of our interview. According to this study cited by Newsweek, the US healthcare system is ranked as the worst among high income nations. This seems shocking. Can you share with us 3–5 reasons why you think the US is ranked so poorly?

Healthcare costs continue to rise and as an industry we must look for opportunities to learn from consumer experiences and tap into technology and data sources to address these challenges.

One reason the US healthcare system is ranked so low is due to the lack of ease and transparency across the board. It’s no secret that today’s healthcare system is difficult to navigate. From connecting with the appropriate provider, to understanding treatment options and insurance policies, healthcare can be an extremely complex and stressful experience. Unfortunately, the stress caused by outdated medical billing and communication methods can sap healthcare recovery, prolonging the recovery process and seriously affecting patient outcomes.

Second, the U.S. spends approximately $3.5 trillion on healthcare, and patients are being asked to spend more money on healthcare than ever before. Since 2011, patient cost-sharing has increased 66% and deductibles have increased by 230%. This has led to serious financial impacts on patients as they are now being asked to spend more money out of pocket. According to Consumer Reports, nearly 3 in 10 insured Americans had an unpaid medical debt sent to collections. Of those, 24% didn’t realize the bill was owed and 13% said they’d never received the bill in the first place. The research suggests that Americans are actually getting caught in medical debt not solely because of their inability to pay, but also because they are simply baffled by their bill.

Third, consumer expectations are shifting. As a result of the changing patient payment landscape, today’s patients want and expect more from their healthcare experience than ever before. However, what healthcare currently offers is still far from that expectation. While the industry continues to focus on the consumer experience, there is a critical need for technology to support and empower patients throughout their entire healthcare journey.

And fourth, we’re not personalizing the patient experience. Think about shopping on Amazon. It is such a seamless experience. We need to look to replicate this experience across healthcare. Patients can’t access and navigate healthcare how, when and where they want to and this remains a major problem and opportunity.

You are a “healthcare insider.” If you had the power to make a change, can you share 5 changes that need to be made to improve the overall US healthcare system? Please share a story or example for each.

Make consumer engagement #1 — At the core of value-based care is the idea that we want to keep people healthy with a holistic, empowered approach that engages them as a central figure in their care plan. By emulating the approach that Apple and other big tech companies have established around consumer engagement, we can better provide patients with an experience that caters to their personal preferences and needs as a consumer.

Learn from leading industries like retail — Imagine a world where you can pay your medical bill with the same ease as buying your morning coffee or shopping on Amazon, all guided by your personal preferences. We need to make that consumer-focused experience a reality for today’s patients.

Look to and leverage technology — Technology enables us to deliver insights that provide a complete picture of patient preferences. This will allow us to enhance the patient experiences that are highly painful today — like paying a healthcare bill. With technology, we can make the act of paying a healthcare bill highly personalized and customized — a win for patients and providers.

Focus on transparency — Healthcare is difficult to navigate, and patient bills especially are filled with codes and jargon that are indecipherable for the everyday person. We need to remove the jargon and help patients understand what they received care for, how much they owe and why and how to pay it. Also, we must make it easier for patients to understand their expected costs ahead of time. We rarely will order a meal at a restaurant or buy a piece of clothing without knowing how much it costs. Why isn’t this the case in healthcare?

Extend personalization throughout the entire healthcare process — Personalized medicine, or treating each patient as a unique individual, is top of mind in clinical care. But the administrative process is still “one size fits all.” Administrative processes, like billing or checking in for an appointment, seem so inhumane in comparison because they are not customized per patient. Not only do we need personalized medicine, but we also need a personalized administrative process within healthcare.

Ok, it’s very nice to suggest changes, but what concrete steps would have to be done to actually manifest these changes? What can a) individuals, b) corporations, c) communities and d) leaders do to help?

Individuals can drive change by forcing healthcare to adapt to their changing consumer preferences. Each of us has a choice in where we go for care (in most cases) and the feedback we give our healthcare providers must be considered. Reviews and star-ratings aren’t just for restaurants these days. We can proactively research and shop for care providers, then follow up with reviews just like we would with other purchases.

Corporations can listen to consumers and invest in technologies and resources that will deliver more personalized care throughout the entire patient journey, from check-in to billing, with a clear ROI. As new technology platforms continue to emerge there is an ability to leverage data in new ways to help reduce costs, improve outcomes and increase both patient and physician experiences. For example, technology and data sources can help identify when, where and how a patient wants to be reached based on their individual preferences. Instead of being the exception, we must make this the norm.

Communities can partner with corporations and individuals who are committed to improving healthcare access and delivering better care. By partnering with the healthcare stakeholders who are at the cutting edge of technology, patient offerings and holistic care, we can more effectively manifest real change. Host community sessions that highlight these organizations or provide community members with critical healthcare access information and look to technology to help bring these activations to life.

Regardless of industry or product, change must start with leadership. I encourage leaders to communicate their passion and work with their team to extend that passion throughout their organization. As I mentioned earlier, I have a background in healthcare but became passionate about improving the patient experience after my fiancée’s horrible billing experience. Almost everyone at Cedar has had a similar experience, either with themselves or with a family member. As a leader, I encourage team members to be vocal about these headaches and work together as a team to fix these problems across healthcare.

Are you working on any exciting new projects now? How do you think that will help people?

We’re excited about the momentum we’ve had thus far but realize that healthcare headaches go beyond just billing. Most often, the first touch point for consumers and the healthcare system is planning for an appointment — whether it be addressing symptoms associated with a chronic condition or an annual checkup. To optimize the experience for patients, providers need to consider what happens before the patient even walks in the door. We’re excited to continue leveraging our platform and technology resources to further optimize and personalize the entire experience for patients, from checking in for their appointment to paying their bill — and beyond.

What are your favorite books, podcasts, or resources that inspire you to be a better healthcare leader? Can you explain why you like them?

To be an effective healthcare leader, you must be well-versed in topics beyond just healthcare. This means taking inspiration from other industries, such as retail or tech, to help empower you to have a more holistic outlook. Some of my favorite resources inside and outside the industry, include:

● Catastrophic Care by David Goldhill

● Made In America by Sam Walton

● Entrepreneurial Thought Leaders Podcast by Stanford eCorner

● Stay Tuned with Preet with Preet Bharara

● McKinsey Podcast

How can our readers follow you on social media?

I can be followed on Twitter at @flottobrasil or on LinkedIn. You can also follow Cedar to learn more about company initiatives and happenings on both Twitter and LinkedIn or visit our website https://www.cedar.com/.

About the Author:

Originally from Israel, Limor Weinstein has been anorexic and bulimic, a “nanny spy” to the rich and famous and a Commander in the Israeli Army. Her personal recovery from an eating disorder led her to commit herself to a life of helping others, and along the way she picked up two Master’s Degrees in Psychology from Columbia University and City College as well as a Post-Graduate Certificate in Eating Disorder Treatment from the Institute for Contemporary Psychotherapy.

Upon settling in New York, Limor quickly became known as the “go to” person for families struggling with mental health issues, in part because her openness about her own mental health challenges paved the way for open exchanges. She understood the difficulties many have in finding the right treatment, as well as the stigma that remains so prevalent towards those who are struggling with mental health issues. She realized that most families are quietly struggling with a problem they’re not comfortable talking about, and that discomfort makes it much less likely that they will get the help they need for their loved ones. She discovered that being open and honest about her own mental health challenges took the fear out of the conversations. Her mission became to research and guide those families to the highest-quality treatment available. Helping others became part of her DNA, as has a commitment to supporting and assisting organizations that perform research and treatment in the mental health arena.

After years of helping families by helping connect them to the right treatment and wellness services, Limor realized that the only way to ensure that they are receiving appropriate, coordinated and evidence-based care would be to stay in control of the entire treatment process. That realization led her to create Bespoke Wellness Partners, which employs over 100 of the best clinicians and wellness providers in New York and provides confidential treatment and wellness services throughout the city. Bespoke has built its reputation on strong relationships, personalized, confidential service and a commitment to ensuring that all clients find the right treatment for their particular issues.

In addition to her role at Bespoke Wellness Partners, Limor is the Co-Chair of the Academy of Eating Disorders. She lives with her husband, three daughters and their dog Rex in Manhattan.

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