More than 61 million Americans have no health insurance or carry very high deductibles, according to Census and industry data. Another 110 million don’t have dental coverage.
Yet, the healthcare system is not set up to help these patients. “I started realizing there was a void with the most vulnerable population, the uninsured,” said Alain Fernandez, who has spent nearly 25 years in the healthcare industry. “The self-paying patient didn’t have anybody fighting for them.”
A couple of years ago, the idea came to him. ValueDOC — a free health and wellness marketplace for cash patients — would serve up transparency and efficiency in a field that notoriously lacks them. Over the years, Fernandez had acquired intimate knowledge of the discounts secured between insurance companies and doctors, and he wanted to bring those same discounts to cash-paying patients. For this business plan, Fernandez, an alumnus of the Florida International University College of Business, won first place in the Business Plan Challenge FIU Track.
“Healthcare costs are soaring, and uninsured and under-insured patients have no insight into the cost or quality of healthcare so they avoid care altogether. Today’s patients want care fast, they do their homework, they want upfront estimates, and they listen to other patients,” said Fernandez, who has led departments at Miami Children’s, Cleveland Clinic, University of Miami Health System and other institutions in contract negotiations, physician relations, network development and other areas.
Today’s patients want care fast, they do their homework, they want upfront estimates, and they listen to other patients.
Alain Fernandez, ValueDOC
Here’s how ValueDOC would work: People who want to book an appointment for an ear infection, a mammogram or a dental cleaning, for instance, will be able to see what doctors and dentists in their areas would charge for the services. They will also be able to see the ratings by ValueDOC consumers on the doctors’ wait times, bedside manner and overall experience. Appointments are booked on the spot, with a credit card, generally for a significant discount from the standard fee schedules.
The doctors and dentists in return can set up a free profile and get exposure to this cash marketplace. Getting paid for the visit within two days of booking — maybe even before the service is rendered — is very appealing when many wait months for insurance payments. Many of them may have “lull times” when they could accept cash-paying patients. Other doctors are building their practices, so exposure to this marketplace could save them time and money on marketing.
“We knew the financial model had to be attractive to doctors as well as to patients,” Fernandez said. “ValueDOC fills a void between the doctor who is building his or her practice and the cash-paying patient who wants to get some kind of discount. We’ve embedded technology and ease of use into the process. We are offering full pricing transparency.” Like the Uber model, ValueDOC would take a portion of each booking.
Dr. Dulce Mascarinas, who is board-certified in family medicine and specializes in age management, liked the concept and signed up to participate on the platform. The Miami doctor said she sees the benefits of reaching patients that need it most, because many people without healthcare insurance won’t go to a doctor because of the cost and the difficulty of finding one.
Also, patients today are computer-savvy “and ValueDOC makes it easy to see directly what they are going to pay,” including for blood work, said Mascarinas, whose practice only accepts cash-paying patients and attracts a number of millennials. She plans to make some blocks of time available for ValueDOC patients and hopes ValueDOC will add telemedicine options as well, a fast-growing area of medicine that she offers.
Fernandez said his target market is millennials, now the largest population demographic. They are also the most likely to be uninsured or underinsured, and they are particularly used to booking services through apps and comparing prices and reviews. “They are a generation that want timely appointments, they want transparency, they want to see reviews. . . . They want an instant way to access services.”
Fernandez has been working on the concept on the side, including spending late nights on Skype with coders in India and taking the laptop to his kids’ events on weekends, as he is a managed care executive for UHealth. He has a small but dedicated ValueDOC team around him. His wife, Paola, manages day-to-day operations of ValueDOC, including vetting the doctors and dentists they bring on board, and other family members have chipped in. He hired a technology developer who oversaw an offshore team to build the website and hired a local user-experience designer for the site; https://doctors.valuedoc.com is the site in progress.
Currently nearly 40 doctors and dentists have signed up and are building their profiles.
Now ValueDOC is seeking to bring doctors onto the platform. Currently nearly 40 doctors and dentists have signed up and are building their profiles. They include primary care physicians, dentists, gastroenterologists and cardiologists, and ValueDOC plans to also offer acupuncture, massage therapy, chiropractic, dermatology and vision. Fernandez wants to have several hundred doctors and dentists before going live with the service in the fall.
The first market will be South Florida, and later other cities in the state, then Texas and California and beyond: “Our focus is on getting traction, so that we can then get angel investors involved who see the vision and opportunity and will want to help fuel this.”
So far, the venture has been funded by Fernandez and with $60,000 in friend and family investments. “I’ve pulled money out of retirement and everything else to make this work,” he said. “We’re all in on this one.”