How do you handle the interaction with insurance plan information like accrued deductible? Certainly aims to guarantee the patient responsibility, right?
Love to see innovation in this space!
The challenge of not knowing what other services might end up being done seems daunting from a UX perspective. Hopefully you guys can find a solution.
(I was early on the Data team at Oscar Health, so have more than my fair share of experience with thorny health care pricing data.)
When patients enter their insurance, we have an API we use to retrieve their deductible remaining info, and then we use that to calculate their out of pocket cost that we show.
And yes, we guarantee the patient responsibility!
Definitely a challenge timing wise if a patient does other services with other doctors off platform between when we quote them and they see the doctor though.
Getting timely, accurate data from the insurance companies on this intuitively feels hard. What are the guarantees around those APIs? There are so many path-dependent factors, like outstanding claims, readjudication of old claims, or "revenue optimization" games on the backend.
> outstanding claims, readjudication of old claims
I was going to ask about these in particular. I am very curious how you can assign an accurate number to these so that you can guarantee an out-of-pocket number.
Sure! This is something we're still figuring out as we're quire early. Would say that the APIs don't guarantee a lot, so it's up to us to piece together the story for a patient and figure out these edge cases.
I say this not to discourage you, but what's being described here is far from an edge case. Providers have often up to ~90 days (when in network with the plan) to submit a claim. Then payers have time to process the claim and adjudicate it. If the claim is denied, providers have more time to appeal the claim, etc.
Again, this isn't intended to be discouraging at all. Just don't operate on the assumption that eligibility APIs showing out-of-date deductibles is normal and not an edge case!
You are actually largely in agreement with the author of the article. It just takes a a while to get there (and criticizes those conclusions from a slightly different angle).
> Today's market structure costs institutional investors (and by extension households) at least a trillion dollars annually (and Smart Markets hold the potential to eliminate that loss).
How does one get to this estimate? That is ~5% of US GDP. Everything else was easy to follow - this seemed high, at least intuitively.
It's a huge number that only makes context when looking at the absurd scale of capital markets globally. BlackRock has written on the cost of liquidity [1]. Unfortunately, much of the institutional research on this topic is in a walled garden, so we plan on publishing on this when we have our own data. Treating it as a Fermi problem, the market cap of US equities is ~50T and 140T notional of US equities traded in 2021. The global market cap is 125T (I don't have trading volumes there). FICC is much larger than equities.
Portfolio returns compound exponentially, so even small inefficiencies matter big time.
You can get to big numbers on global capital markets, for sure. I was wondering whether you a consulting/VC-style estimate given how specific the statements was: "Smart Markets hold the potential to eliminate that loss" of "at least a trillion dollars annually".
How do you think about it? Let's say we expect half the benefit to come from equities.
>> 0.5T / 125 T = 0.004
>> Smart Markets would need to raise portfolio returns by an average of .4% (net of trading costs) annually.
Don't know if this is accurate but the entire online stock brokerage industry revenue appears to be about $14B.
That seems like a significantly lower upper bound to the market size here.
That said, what seems interesting here is to come up in advance with many potential arbitrages, and load them in advance for fulfillment if they occur. Risky but interesting than having to roll your own complex tool for this.
To clarify, 1T isn't what we're claiming as our revenue opportunity; it's what traders are missing out on annually in the form of portfolio returns due to market friction and missed Pareto outcomes.
(FWIW and not that it's the market that we're going after per se—our strategy is mostly blue ocean—the market for US equities electronic execution services across the whole stack of technology, market data, broker algos, etc., is $18B/yr.)
Really anything that wants to pull all your data back into python is going to be horrible for analytics. What's really needed in this space is something that is smart enough to push most data-intensive operations down to the database and pull only the minimum amount of stuff back to python to do anything that's CPU intensive.
Stalin's military lacked in organization, tactics and strategy due to the purges and was surprised by Operation Barbarossa's timeline, but it was well armed and well equipped. Case in point being the Soviet tank forces, which were much more numerous and advanced than German intelligence had suspected.
The population's ability to bear sacrifices and Stalin's willingness - matched by Hitler's - to sacrifice millions of civilians alongside the soldiers were instrumental, but it certainly was the military - rather than civilian resistance - that ultimately broke the German war machine.
Your ordering is off. Their initial tanks were old and ineffective. It was after the sieges that tank production in the east ramped up with T34's. If the civilians had not taken the brunt and fought back, there wouldn't have been enough time to produce any tanks on the other side of the country. The Soviet tank forces of 39-40 couldn't hold a candle to the later version.
I guess the scale of the war and whether it deserves the moniker of a World War depends on your geo-political perspective. Both U.S. and Russia, are involved in military operations all over the world, and it's a little silly to call that a "desirable state of affairs" just because they're not fighting each other.
Make no mistake, I'm not carrying water for Teller in this thread or defending Jane Fonda. I do think Teller was sort of a nutcase, and Fonda was definitely a traitor. Frankly we're all lucky to be alive after some of the crap that was done in the name of "strategic defense," and it's indeed tragic that countless victims of the superpowers' proxy wars can't say the same.
But deterring a third world war is not one of those things that's subject to moral relativism. You seriously need to spend some time talking with WWII vets, while we still have them with us.
We are currently living in the most peaceful time in human history. That's an objective fact based on annual deaths from warfare, not a subjective opinion or perspective.
As much as I would like it to be different, we are still at least one or two decades away from an effective European deterrent against Russian aggression. If only because of our inability to coordinate decisive responses and our unwillingness to pool military resources in a European army, rather than split them into national militaries with incredibly amounts of redundancy and ineffectiveness.
Yes, but these hurdles to overcome are political, not technological or financial. And for that period, the biggest deterrent against Russia is Russia itself, because they are militarily, as a former german Chancellor once said "The Republic of Upper Volta with nuclear Warheads"
According to Wikipedia (http://en.wikipedia.org/wiki/List_of_United_States_Army_inst...) US has 35 existing bases in Germany and has closed 207 (!) bases in the past. Some of the most important (strategic importance and size) are in Germany. To think that such a huge military presence has "exactly zero to do" with how freely German government can make decisions which would be contrary to the US interests is an illusion.
Its a financial risk. Germany could today tell the US to be out of the country by a set date and what could the US do? Likely at most point to contracts and treaty agreements and request negotiation. Does anyone really think the US could say no and get away with it?
Germany wants the money the bases bring and likely the perceived protection they present. If they didn't see the latter then the money point is key. How much does the US spend to maintain those bases and do they pay fees beyond that to have them?
As a Libertarian I would be more than happy seeing us out of every country that is peaceful. We have no real need to be there in this day and age with the ease at which power can be projected. I won't go into the question of being in certain other countries because of disagreements which led to war, declared or not.
West Germany is still occupied by US troops. The 2+4 treaty is !NOT! a peace treaty. Russians just withdraw their troops from east Germany. Take a look in the 2+4 contract, neither US troops nor US atom rockets are allowed in east Germany.
Each Chancellor has to sign a paper called Kanzlerakte, that he agrees, to give up sovereignty at lot of cases, e.e. intelligence, military.
There were plenty of shenanigans going on between the U.S. and German politicians in the early BRD days. But the scanned document everyone's been passing around purporting to refer to the so-called Kanzlerakte is obviously a fake.
I don't comment on the Kanzlerakte, it's obvious fake.
US barracks are not extraterritoriality zones, please cite your claim.
"US soldiers are not under German jurisdiction", this is only partly true. It's part of the "NATO-Truppenstatut". With Art. 19 Abs. 3 Satz 1 ZA (Zusatzabkommen) the foreign soldiers are part of German jurisdiction.
Love to see innovation in this space!
The challenge of not knowing what other services might end up being done seems daunting from a UX perspective. Hopefully you guys can find a solution.
(I was early on the Data team at Oscar Health, so have more than my fair share of experience with thorny health care pricing data.)