Let’s think about healthcare networks, specifically the Blue Cross, United, Cigna, and Aetna networks. Let’s say there are a million or so entities in America billing for medical services. These are individual physicians, hospitals, surgical centers, imaging centers, pharmacies labs, etc. This number is getting smaller due to consolidation. Every year, ~$3T flows between the providers and the payors. Essentially, this is a completely opaque marketplace connecting patients with providers.
Marketplaces are fascinating to me because we’ve seen a huge disruption in traditional business models in the last few decades. Ebay, Amazon, Etsy, Airbnb, Facebook, Alibaba, etc. They’ve built transparent marketplaces rooted in 21st Century tech and principles. For example, Facebook is a marketplace connecting advertisers with 2 billion people. How much does it cost to build and maintain this worldwide network? A tiny fraction of the cost of one year of American healthcare. This can and will be done in healthcare, but it’s not going to come out of the BUCAs. It’ll come from left field and powered by entities that see the writing on the wall.