There are no money-back guarantees in healthcare. At least not yet.
Regi Schindler learned about this issue when a woman came to him seeking help after she donated a kidney to her sister. The donor had suffered life-threatening, debilitating complications from the transplant procedure. As a result, was no longer able to work and became destitute.
Schindler, a healthcare risk manager in practice for 25 years, says he was deeply affected by this woman’s story.
“My focus was on trying to create a solution that creates wins for everybody, because so often what you see in healthcare is winners and losers,” Schindler says. “It’s OK to have winners and losers in technology and energy. But when you’re talking about healthcare, you shouldn’t have losers.”
The job to be done was mitigating the financial risk facing both surgeons and patients when complications from known risks of the procedure develop after a surgical procedure. In response, Schindler created BLISCare — an innovative insurance program offered only to high-quality surgeons that protects their patient from any medical costs that may arise from specific surgery complications.
BLIS is an acronym for Bundled Loan and Indemnity Solution. By removing that threat of financial loss from unexpected medical problems, BLIS is transforming the doctor-patient relationship by putting them both on the same page before the procedure, during the procedure and after the procedure — no matter what happens.
BLIS aligns provider, insurer and patient incentives to promote high-quality care at low financial risk to all involved, Schindler says.
“The core value proposition at BLIS is about identifying and selecting the very best surgeons in their specialty and then helping them perform as many cases as they want by enabling the BLIS solution for protection and financing,” he says.
Manageable Risk for High-Risk Surgical Patients
For one patient, BLIS was a true life-saver. A severely obese, uninsured patient in his mid-20s scraped together enough money from his job delivering pizzas — and with help from friends and family — to pay for bariatric surgery. Unfortunately, he was one of about 5% of bariatric surgery patients who develop life-threatening complications, extending his hospital stay to two weeks. The patient’s mother was distraught not only because of her son’s health but also because of the cost of treatment.
Fortunately, the surgeon who performed the operation had BLIS coverage, and the surgeon was able to tell the patient’s mother that the family wouldn’t have to pay any of the additional expenses related to the complications. The patient’s mother, a devout woman, dropped to her knees and thanked God for this miracle.
Schindler says stories like these keep him focused.
“It’s a humbling kind of environment for us because we’re just insurance people trying to help solve a problem,” he says. “The human side of what goes on every day in healthcare touches us.”
Launched in 2005, Portland, Ore.-based BLIS today has approved more than 500 surgeons in 43 states, thus far protecting more than 10,000 surgery patients from unexpected financial loss. To date, no surgeon has left the program on his or her own accord. Only surgeons who have outcomes that fall outside of an acceptable range are asked to leave the program.
BLIS provides financial coverage for complications arising from bariatric, plastic and orthopedic surgeries. Policies cover surgeons through an entire cycle of patients’ post-acute care for up to 30 months.
“It’s a true outcomes-based company,” Schindler says.
Now, BLIS is developing a surgeon registry where participating doctors can review case data and share best practices with fellow surgeons. “Surgeons learn from each other. Our unique dataset will help facilitate this process,” Schindler says. “As a professional risk manager, my training is all about using data to develop processes designed to create continuous improvement.”