October 29, 2024 Newswires

Study Shows PayMedix Lowers Costs and Improves Access to Healthcare for All Members

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Today PayMedix announced findings from a longitudinal analysis of member data that shows its zero-interest financing and healthcare payments solution successfully stems the rise in health insurance costs for its employer members by as much as 40% versus the national average. Further, its data revealed that subscribers are less likely to require in-patient hospital care and access care at similar rates across all credit score categories.

The findings, part of a review of 2023 data from more than 45,000 active members over a 12-month period, is the most comprehensive analysis of the long-term benefits of PayMedix’s innovative payments solution, first introduced more than 10 years ago.

Highlights from the study include:

Medical trend beats national benchmarks – according to Milliman’s 2023 study, the one-year and two-year annualized medical trend nationally were 6.4% and 5.4% respectively, in contrast to trend of just 4.0% (one-year) and 3.1% (two-year) for PayMedix member employers
- What it means: PayMedix member rates are rising at an annual rate that is approximately 40% lower than the national average. Employers who use PayMedix are saving money for themselves and their employees
Equitable access to care regardless of credit scores – the PayMedix analysis showed that in 2023, employee members with low credit scores (between 350 – 649) averaged the same number of annual claims as employee members with higher credit scores (between 650 – 850+)
- What it means: Employers who provide members access to zero-interest financing and flexible payment plans offered through PayMedix allow all employees to access care that fits their means and budgets
Lower inpatient utilization – on average, 22% of all insurance claims represent hospital inpatient care, according to Milliman’s 2023 benchmark, but only 14% of PayMedix members’ claims were for in-patient care during the same period *
- What it means: Lower inpatient utilization keeps costs down for everyone and illustrates how PayMedix contributes to better outcomes. In addition, when looking at claims involving professional care (e.g., visits to primary care, etc.), PayMedix outpaces national benchmarks by 10%, with 48% of all claims vs. 38% nationally. This suggests employees are going to the doctor and avoiding the need for emergent care. *

“Our data demonstrates what we have believed all along – together with employers and providers, PayMedix can break the cycle of out-of-control healthcare costs and fix our broken healthcare system by providing guaranteed zero-interest financing for employees and prompt full payments to providers,” said Tom Policelli, CEO, PayMedix. “We’ve shown that over time, PayMedix not only reduces costs, but improves equitable access to the healthcare system. Nearly 25% of PayMedix members would not qualify for commercial credit. We have proven that we can drive down cost for everyone when people can access care when they need it and not when they think they can afford it.”

PayMedix provides complete, uncapped financing for all in-network allowed charges that any employee may owe to providers. All employees are automatically enrolled, and PayMedix pays all participating providers in full. The employees each get a simplified consolidated statement (a SuperEOB) each month and can arrange to pay it on terms that fit their budgets. Participating providers, in turn, are simply paid the full employee balance due automatically and therefore have no consumer bill to collect.

“Our solution has allowed better access to healthcare for tens of thousands of employee subscribers by making it simpler, more affordable and more equitable,” said Brian Marsella, president of PayMedix. “Add to that the satisfaction and retention of our members, with a NPS score that is three times the industry average and we’re excited about the continued potential for PayMedix.”

* Reference: 2023 Milliman Medical Index (MMI) Study. Percentage noted excludes pharmacy claims.

About PayMedix

PayMedix, which began as the financing arm of Wisconsin-based HPS over a decade ago, is the only company solving the problem of high out-of-pocket costs for everyone – providers, patients, employers, and TPAs. PayMedix is changing how people access, use, and pay for healthcare by guaranteeing payments to providers and financing for all patients. PayMedix has processed more than $5 billion in medical payments for hospital systems and physician practices and can be implemented with any benefit plan that is using any PPO or HMO network.