PNC and First Data see a benefit in tailoring the health care experience with a focus on the consumer, and are working to enable that process by funding a cloud-based IT company that digitizes medical office management.
"We think that consumerism of health care is a large macro trend," said Chris Ward, executive vice president and head of product for PNC Treasury Management.
PNC and First Data are among the companies that have made a $31 million investment in CareCloud, a Miami-based company that digitizes health care processes such as payments and records management. First Data would not comment and PNC did not disclose the size of its specific investment. CareCloud, which currently manages about $4 billion in health care accounts, integrates clinical and financial platforms in an attempt to make health care work like shopping or banking.
"The physician and the patient can interact online, they can make an appointment and a payment in the same place, either in the office or on an app," Ward said. "And all of this is happening in real time."
The digitizing of payments and provider processes in health care has suffered from the same challenges that afflicted other merchant categories, only in a more complex environment because health care payments usually involved a third party such as an insurance company. By creating a cloud-enabled layer between patients' payment types, the medical practice and insurer, Care Cloud hopes to allow booking, billing and payments in an omnichannel environment. This environment would also be "agnostic" to existing software and requires only an initial registration, Ward said.
PNC is also an active partner to CareCloud, managing claims submission and processing on behalf of health care providers.
"This is a bold step particularly for PNC, but also CareCloud in its growth partnering with two giants in the merchant business," said Michael Trilli, a senior analyst at Aite Group. "And it demonstrates PNC is thinking about this market correctly, which is more broadly than collecting a payment. Rather it is about providing different payment options prior to collections and how technology supports that process, and that is where PNC can hit a homerun with its product suite."
CareCloud will use the investment to add technology to accommodate the gradual shift toward consumer directed health care that has accelerated following the passage of the Affordable Care Act. More change is likely given the pending inauguration of Donald Trump as president. Trump campaigned on repealing the Affordable Care Act, but has since stated he may try to retain parts of it. House Speaker Paul Ryan recently introduced an alternative to the ACA that also keeps some elements of the original law, though it would dump other parts, particularly the individual mandate. All of these changes would impact how people manage health care costs and pay for treatment. "With the regulatory changes, people will be changing the way they are using health care payment cards," Ward said.
The regulatory uncertainty is proving attractive to technology companies that say their ERP, CRM and payments platforms can tame the chaotic health care market. CareCloud competes directly with PracticeSuite and Practice Fusion, companies that operate more on the record-keeping side of health care.
On the payments side, companies such as PatientPay, automate transactions; and Apple Pay contends it can streamline health care's paper-laden process by pairing it with other Apple technology that serves the health care industry. Simplee and Instamed also aim to simplify health care payments by automating paperwork.
But the overall momentum in the banking industry has waned, according to Trilli.
"I do not see this changing anything but it does give notice to banks that they need to think outside the clearinghouse box and engage in different types of relationships with software companies, which will only benefit their retail and wholesale products," Trilli said. "There is somewhat of a payments vacuum right now, so the timing of this is interesting and the evolution will be interesting to watch."