Turquoise Health Unveils PATIENTS Framework to Streamline U.S. Healthcare Transactions
Healthcare pricing platform Turquoise Health today announced the launch of the PATIENTS Framework, a new open-source initiative aimed at standardizing healthcare transactions in the United States. The framework seeks to address the complexity and fragmentation of the current system by establishing a simplified, transparent, and patient-centered approach to administrative processes.
PATIENTS is an acronym for Publicly Accountable, Transparent, Interoperable, Efficient, Nonproprietary Transaction Standard. The initiative is designed to overhaul outdated administrative structures and provide patients with clear, upfront information about the cost and quality of their care—before appointments or procedures take place.
“Patients deserve better,” said Chris Severn, CEO of Turquoise Health. “They deserve to know what their care will cost and what quality to expect—upfront and without the confusion that’s defined the U.S. healthcare experience for too long.”
According to Severn, nearly 30% of all U.S. healthcare spending is wasted on administrative costs, making it the largest contributor to excess spending in the system. He said that reducing this waste will require replacing the patchwork of proprietary systems between payers, providers, and intermediaries with a unified standard focused on patient outcomes.
The framework’s core principles include:
-
Prioritizing patient needs and simplicity
-
Enabling integrated payer-provider transactions
-
Ensuring backward compatibility with current payment systems
-
Promoting open-licensed, interoperable standards
-
Making documentation transparent and universally understandable
The PATIENTS Framework seeks to replace the industry’s current “Revenue Cycle”—a 10-step process often spanning several months—with a streamlined transaction model completed mostly before care is delivered. Key components of the new framework include:
-
A Standard Modular Contract between providers and group purchasers
-
An Open Payment, Grouping and Pricing System
-
A Universal Clinical Coverage Library
-
Standard Plan Design and Benefits Mapping
-
Open and Patient-Facing Transaction Rails
Severn pointed to successful models in other industries and countries, such as banking clearinghouses and Germany’s standardized healthcare system, as evidence that large-scale administrative reform is possible.
“We’re inviting forward-thinking leaders across healthcare to help rebuild this system into something that truly serves patients,” Severn said.
Turquoise Health has published full documentation of the PATIENTS Framework, which is available at https://turquoise.health. Healthcare stakeholders can reach out directly via patients@turquoise.health to get involved.
