Choice is often a good thing.
But for the 55 million American senior citizens — those at least 65 years old — choice in healthcare can be a daunting task when it comes to picking the right Medicare plan.
In fact, 80 percent of those seniors, or roughly 44 million, are not in the most optimal Medicare plan for them. That translates to an extra $32 billion, or an average of $728 per senior per year in healthcare expenses they spend unnecessarily, said Scott Cadora, founder and CEO of Medicare Pathfinder, a healthcare analytics startup.
The Atlanta-based company, which is in the ATDC Accelerate portfolio of startups at Georgia Tech’s Advanced Technology Development Center, seeks to solve that problem.
Medicare Pathfinder’s technology uses data science and design to help seniors navigate the maze of Medicare plans, options and supplements so they can intuitively find the coverage that aligns to their individual medical needs and budget, said Cadora, who graduated from Tech with degrees in management and international affairs.
The catalyst for the startup, he said, came from helping his 99-year-old grandmother and speaking with other seniors about their frustrations with Medicare.
In metro Atlanta for example, seniors have 198 Medicare plans from which to choose. But they can select different features and other add-ons so metro Atlanta seniors end up with more than 1,252 different combinations of plans, he explained.
The three key factors that come into play are seniors’ health statuses, budgets, and critical decision factors such as choice of doctors, hospitals, and pharmacies.
“You want to find the health plan that works best for you and that gives you the highest coverage at the lowest cost,” Cadora said. Medicare Pathfinder’s technology takes those key elements into account to help seniors improve their healthcare choices.
“The primary end user is the senior but we also help health insurers because our analytics helps seniors make the best choices, and that, in turn, helps insurers improve their marketing efficiency,” Cadora said.
“We also have a third customer, which is the government itself because for them, we improve transparency and trust in the marketplace because this technology empowers seniors to make better choices using their own health data.”
Its business model help it win a “shark tank” startup competition at the seventh annual Health Datapalooza 2016 conference held in Washington, D.C. from May 8-11. The company bested two other finalists based on its business model, and the value created for the end user.
“We’re currently working with faculty at Georgia Tech to improve our data analytics and create a more powerful user experience for seniors. We expect to launch our service in selected markets later this summer.”