Great question. A lot of early success for us has been through our fully automated and integrated billing approach and our ability to communicate a customized estimate for a patient pre-visit. Also, timing plays a huge roll in success. Never before has there been such an emphasis on creating a retail like experience in healthcare.
Agreed, insurance companies are typically a big cog in the wheel. We're starting to see things change as high deductible health plans have grown so rapidly. The consumerism of healthcare is starting to create change (i.e. price transparency executive order signed in June).
At this point the gamble is that Single Payer won't happen. There's a chance but we think it's slim. Our bet is that we're positioned well to take advantage of the recent Executive Order.
We are planning on integrating with multiple EMR's to make sure we're able to offer a fully automated, fully integrated approach to practices. I love the steps Epic is taking to open up API's. My hope is that more EMR's will follow suit. Healthcare is fun...and challenging :).