First health system to pilot scanning health insurance card QR codes for easy patient check-in
During a digital health symposium this week, Christopher Longhurst, MD, with UC San Diego Health, pulled up a QR code from his phone's digital wallet, scanned it at a check-in kiosk and instantly displayed how his medical insurance information was retrieved and verified in real time, including copay amounts.
The UC San Diego Health digital health symposium was the first demonstration of the SMART health QR codes for health insurance cards initiative — a new model for digitally standardizing and modernizing health insurance cards, streamlining patient check-ins and reducing billing errors. UC San Diego Health is the first health system in the nation to pilot this innovative new approach.
“There are more than 1,000 health insurance companies in the United States, each with their own insurance card format,” said Longhurst, chief medical officer and chief digital officer at UC San Diego Health. “It takes weeks to train new staff members to decipher all those different card formats, and there are often typos, which can lead to rejected insurance claims. Having a common QR code format to scan will streamline the process, reduce errors and simplify insurance documentation for our patients and staff.”
Although many health plans have recently launched their own digital member identification cards, there has not been a common standard that allowed providers to easily scan or ingest that information — until now.
The new SMART Health Insurance Card is based on the SMART Health Card QR code standard that was adopted for verifiable vaccination records during the COVID-19 pandemic by most of the U.S. health care and technology ecosystems, including: most U.S. states, national pharmacy chains, health providers and insurers and mobile and technology platforms.
The new SMART Health Insurance Card initiative garnered support from the Healthcare Financial Management Association (HFMA) in April, a nonpartisan professional practice organization that represents 100,000 health care financial management professionals nationwide.
“We urge our health care system colleagues, payer partners and electronic health record practice management system vendors to actively participate in the SMART Health Insurance Cards initiative and embrace the SMART Health Card standard for health insurance cards,” said Richard L. Gundling, senior vice president, professional practice at HFMA. “We believe that adopting this standard will enhance the efficiency and effectiveness of health care services, and thereby benefit patients and providers alike.”
“This is an exciting step forward in our work to make health care simpler for those we serve,” said Glen Stettin, MD, chief innovation officer for Evernorth Health Services. “SMART insurance cards have the potential to help patients get faster access to needed care, and help doctors get reimbursed more efficiently. Any organization interested in removing friction in health care should consider them.”
Following today’s demonstration, UC San Diego Health, UC Irvine Health, UCLA Health, UCSF Health, UCR Health and UC Davis Health will conduct further pilots of the model.
HFMA is also forming a working group of large health systems nationwide to collaborate with their payer and electronic health record vendor partners to pilot the model in coming months. After the pilots, the participants will assess the outcomes and strive for the widespread implementation of the standard and the model during the upcoming benefit year starting in January 2024.
Public Benefit Corporations: A Third Option For Health Care Delivery?
Soleil Shah, Jimmy J. Qian, Amol S. Navathe, Nirav R. Shah
MARCH 23, 2021
Corporate structure is central to the mission of any corporation. This is especially true in health care. By providing different internal incentives, corporate structures influence an organization’s ability to deliver high-value care to patients. For US hospitals, two primary types of private corporate structures exist: for-profit and nonprofit. Each has social value, but both possess features that may constrain their ability to offer high-value patient care, while limiting their accountability toward achieving this goal. A relatively new and lesser-known corporate structure—public benefit corporations (PBCs)—offers a promising alternative. In health care, PBCs may simultaneously improve individual patient outcomes and collective benefit without sacrificing institutions’ financial stability. Patients, providers, and policy makers should understand the incentives driving decision making in for-profit and nonprofit hospitals, as well as the advantages and drawbacks of adopting PBCs in health care delivery.