Challenging the Industry to Improve the Medical Billing Process

Patients and families often find themselves concerned about the confusing nature of medical bills. This common complaint about the healthcare system led Secretary Sylvia M. Burwell of the U.S. Department of Health and Human Services (HHS) to call for new approaches to medical billing in 2016. To help draw national attention to this issue and stimulate innovation in the space, Health and Human Services and Mad*Pow collaborated to create the “A Bill You Can Understand” Design & Innovation Challenge. The challenge, sponsored by AARP, awarded cash prizes of $5,000 each for two winners: one for the innovator who designs the bill that is easiest to understand, and a second for the innovator who designs the best transformational approach for improving the patient’s experience of medical billing. The prizes were won by RadNet, a nation-wide owner and operator of outpatient imaging centers, for the easiest bill to understand, and Sequence for its transformational approach that extends a retail model of consumer behavior to medical billing. Mad*Pow was tasked with shaping the challenge, doing research and providing resources to serve as a foundation to challenge participants, and creating a web site to publicize the challenge and guide entrants. Read our final report: Pathways to ‘A Bill You Can Understand”: Lessons Learned from a Design and Innovation Challenge. We describe what we found while preparing these materials relate to pain points for patients associated with the current medical billing process and opportunities for improvements.

Project Highlights

  • Created collaborative environment with Health and Human Services, AARP and six health system and insurance company partners.
  • Ensured the voice of the patient influenced the challenge throughout, leveraging human-centered design methodology to rapidly develop insights and support materials to guide challenge participants.
  • Generated overwhelming response to the challenge, with nearly 400 competitors registering to participate.

Putting Patients at the Center of Their Own Care

Mad*Pow is passionate about fundamentally improving the experience of health for everyone, and our team started by conducting research that included a patient survey, as well as interviews with patients, the health care organizations involved in the challenge, and other stakeholders. We also worked with insurers and providers to understand the issues and opportunities associated with medical billing from their perspective. We used that research to understand the causes of confusion and frustration resulting from the medical billing experience as well as the opportunities present.

Designing the Challenge

Research findings and insights were compiled into a report, a patient journey map, ecosystem diagram and other resources to direct and jump start participating design teams. A set of core criteria was also developed, as well as criteria for both categories: Easiest Bill to Understand and Transformational Approach. Last, we developed a responsive web site to house all of this information and coordinated challenge activities with Health 2.0, who provided the platform for the challenge. Challenge winners were announced at the Health 2.0 fall conference on September 25-28th, 2016. 
To support challenge participants, Mad*Pow worked with Health and Human Services to engage a group of pilot partners to offer expertise and implement the winning design challenge concepts. 

Challenge Pilot Partners Include:

• Cambia Health Solutions (Portland, OR)
• Geisinger Health System (Danville, PA)
• INTEGRIS (Oklahoma City, OK)
• The MetroHealth System (Cleveland, OH)
• Providence Health & Services (Seattle, WA)
• University of Utah Health Care (Salt Lake City, UT)

Mad*Pow also collaborated with Health and Human Services to curate an advisory committee (which included two senior Mad*Pow health experience experts) and judging panel, which evaluated submissions based on understandability, creativity, and how well they addressed the challenges outlined by patients, providers, and payers. Specific details around evaluation criteria can be found on the challenge website.

Challenge Gains Traction

Mad*Pow announced the challenge at the HxRefactored conference in April 2016 and the challenge was launched by Secretary Sylvia Burwell at the DataPalooza conference in May of 2016. A webinar was hosted by Health and Human Services, AARP, Pilot Partners and Mad*Pow in June to answer participant questions and over 150 attendees joined. More than 100 teams entered the competition in the first week of the challenge — a number that has grown to nearly 400 in two months.

Everyone involved in the challenge — Mad*Pow, Health and Human Services, AARP, and the pilot partner healthcare systems — look forward to seeing ideas that can be immediately implemented and also make a major difference in the patient experience in the longer term. Winners will be announced in September 2016.

For more information on the challenge and the current experience of medical billing, please visit

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A Bill You Can Understand Design Challenge


A Bill You Can Understand
Amy Cueva Founder and Chief Experience Officer   Contact Amy
Paul Kahn Experience Design Director   Contact Paul
Dana Ortegón Senior Content Strategist   Contact Dana
Kim Dowd Experience Research Director
Rich Woodall Senior Visual Experience Designer & Illustrator   Contact Rich
Jennifer Smerdel Experience Strategist
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