E193 | What Happens When Patients Are Afraid of the Bill? | Brian Marsella

WEBVTT
Kind: captions
Language: en
00:00:11.120 --> 00:00:12.870
Hello and welcome back to the Advancing
00:00:12.880 --> 00:00:15.030
Healthcare Innovation Show. I am your
00:00:15.040 --> 00:00:16.790
host, Michael Staminos. And if you're
00:00:16.800 --> 00:00:19.029
new to us, welcome. We're super excited
00:00:19.039 --> 00:00:20.470
to have you here because we're really
00:00:20.480 --> 00:00:22.950
passionate about having curious
00:00:22.960 --> 00:00:24.950
conversations with leaders that are
00:00:24.960 --> 00:00:27.189
painstakingly reshaping the future of
00:00:27.199 --> 00:00:29.509
healthcare. And we're really passionate
00:00:29.519 --> 00:00:30.550
about a few different areas. We're
00:00:30.560 --> 00:00:31.990
passionate about healthcare innovation,
00:00:32.000 --> 00:00:33.910
access, leadership, and and the adoption
00:00:33.920 --> 00:00:35.910
of those innovations. And if it's your
00:00:35.920 --> 00:00:37.910
first time tuning in, let me just sort
00:00:37.920 --> 00:00:39.910
of take a quick step back to give you a
00:00:39.920 --> 00:00:41.910
little bit more on what we're trying to
00:00:41.920 --> 00:00:45.270
get done here. So, the ethos of the show
00:00:45.280 --> 00:00:47.350
is to bring real stories of innovation
00:00:47.360 --> 00:00:48.869
to life. Not just the stuff that you're
00:00:48.879 --> 00:00:50.549
reading in headlines, but like people
00:00:50.559 --> 00:00:51.910
that are in the trenches getting stuff
00:00:51.920 --> 00:00:55.430
done, sharing the wins, and also sharing
00:00:55.440 --> 00:00:58.310
some of those learnings. We've got an
00:00:58.320 --> 00:00:59.990
amazing action-packed here. If you
00:01:00.000 --> 00:01:01.349
haven't checked out any of our
00:01:01.359 --> 00:01:03.270
historical interviews, however you're
00:01:03.280 --> 00:01:04.869
consuming this, if you're watching this,
00:01:04.879 --> 00:01:07.109
if you're listening to this, please hit
00:01:07.119 --> 00:01:09.350
the subscribe button now so that any of
00:01:09.360 --> 00:01:13.990
the new interviews come directly to you.
00:01:14.000 --> 00:01:15.590
So, look, I've been doing the show for
00:01:15.600 --> 00:01:18.710
for a little while now, and there's a
00:01:18.720 --> 00:01:22.469
pattern that continues to emerge, and
00:01:22.479 --> 00:01:24.310
it's this. It's that the the clinical
00:01:24.320 --> 00:01:26.950
side of healthcare uh gets a lot of
00:01:26.960 --> 00:01:29.270
attention and there are certain parts of
00:01:29.280 --> 00:01:31.190
healthcare that everybody knows are
00:01:31.200 --> 00:01:34.310
broken but they just don't get talked
00:01:34.320 --> 00:01:38.789
about enough and money is one of them.
00:01:38.799 --> 00:01:41.429
And I'm not talking about like policy or
00:01:41.439 --> 00:01:43.830
you know reimbursement models. I'm
00:01:43.840 --> 00:01:46.310
talking about what does it actually feel
00:01:46.320 --> 00:01:51.830
like for a patient to pay for care and
00:01:51.840 --> 00:01:55.429
that part to me has been left alone. So
00:01:55.439 --> 00:01:59.109
today's guest has spent more than 30
00:01:59.119 --> 00:02:01.990
years inside of the ecosystem of
00:02:02.000 --> 00:02:04.469
healthcare and fundamentally is focusing
00:02:04.479 --> 00:02:06.630
in on that exact problem. So Brian
00:02:06.640 --> 00:02:10.469
Marcella is the president of HPS pay
00:02:10.479 --> 00:02:13.750
medics and tempo pay. So what the
00:02:13.760 --> 00:02:17.110
platform does is it's generally
00:02:17.120 --> 00:02:19.430
different. It guarantees payment to
00:02:19.440 --> 00:02:22.550
providers upfront. So it takes every
00:02:22.560 --> 00:02:25.430
bill that a patient owes and turns it
00:02:25.440 --> 00:02:28.470
into one clean monthly statement.
00:02:28.480 --> 00:02:29.670
Brian's going to go into a little bit
00:02:29.680 --> 00:02:31.270
more in this, but it but it gives every
00:02:31.280 --> 00:02:36.229
single patient um a path to pay because
00:02:36.239 --> 00:02:38.390
no one kind of gets turned away because
00:02:38.400 --> 00:02:41.270
their financial situation uh doesn't fit
00:02:41.280 --> 00:02:42.470
the model. So, like just think about
00:02:42.480 --> 00:02:44.550
that. Like, no one gets turned away. And
00:02:44.560 --> 00:02:46.150
and here's the number that really got me
00:02:46.160 --> 00:02:47.509
in kind of preparing for this
00:02:47.519 --> 00:02:50.949
conversation is that one in four people
00:02:50.959 --> 00:02:54.790
on the pay platform uh would fail a
00:02:54.800 --> 00:02:56.710
standard credit check. So, they would be
00:02:56.720 --> 00:03:00.070
denied financing anywhere else, but they
00:03:00.080 --> 00:03:02.710
still, you know, need care. So Brian's
00:03:02.720 --> 00:03:05.030
held I mean his CV is ridiculous but uh
00:03:05.040 --> 00:03:06.710
he's held senior leadership roles at
00:03:06.720 --> 00:03:10.470
Sigma and Etna and honestly he's been
00:03:10.480 --> 00:03:13.670
inside those rooms where you know risk
00:03:13.680 --> 00:03:15.589
gets priced and decisions get made at
00:03:15.599 --> 00:03:18.710
scale um and he knows exactly where the
00:03:18.720 --> 00:03:20.229
patient gets lost in the middle of it.
00:03:20.239 --> 00:03:22.550
So so in addition actually he also
00:03:22.560 --> 00:03:25.589
serves um as a board chair uh for the
00:03:25.599 --> 00:03:27.589
last what is it Brian 15 or 16 years
00:03:27.599 --> 00:03:29.670
it's it's it's been quite some time for
00:03:29.680 --> 00:03:31.670
Erie Family Health Center. So, this is a
00:03:31.680 --> 00:03:33.670
federally qualified health center in
00:03:33.680 --> 00:03:35.990
Chicago. And honestly, where the
00:03:36.000 --> 00:03:37.190
communities that are walking through
00:03:37.200 --> 00:03:39.430
that door, they don't have the luxury of
00:03:39.440 --> 00:03:42.149
of putting off care in many instances.
00:03:42.159 --> 00:03:44.949
And and honestly, a confusing bill is
00:03:44.959 --> 00:03:47.030
the difference between someone that's
00:03:47.040 --> 00:03:49.589
coming back uh and someone that actually
00:03:49.599 --> 00:03:52.070
disappears, you know, from that
00:03:52.080 --> 00:03:55.030
situation and system for entirely. So,
00:03:55.040 --> 00:03:57.990
Brian, it's great to see you. Welcome to
00:03:58.000 --> 00:03:59.270
the show.
00:03:59.280 --> 00:04:00.710
>> Thank you, Michael. appreciate being
00:04:00.720 --> 00:04:01.670
here.
00:04:01.680 --> 00:04:05.670
>> Yeah. So, listen, um I want to start off
00:04:05.680 --> 00:04:08.309
way back. Go all the way back. I think
00:04:08.319 --> 00:04:10.309
it was like 1992.
00:04:10.319 --> 00:04:12.869
Um you're young. You just started at
00:04:12.879 --> 00:04:17.270
Sigma. Uh what did you actually think
00:04:17.280 --> 00:04:20.310
you were walking into and what did
00:04:20.320 --> 00:04:23.189
reality look like?
00:04:23.199 --> 00:04:24.629
>> Yeah, boy. I you know, I'll tell you
00:04:24.639 --> 00:04:26.469
what. I took the job mainly because it
00:04:26.479 --> 00:04:28.070
was, you know, a couple hours from my
00:04:28.080 --> 00:04:29.670
house. It was a six-month training
00:04:29.680 --> 00:04:32.310
program and I felt like it was a good a
00:04:32.320 --> 00:04:34.150
good way to get engaged in uh in
00:04:34.160 --> 00:04:36.550
healthcare and uh you know to start a
00:04:36.560 --> 00:04:39.350
career and uh I just thought I was going
00:04:39.360 --> 00:04:42.390
to be helping people price how much it
00:04:42.400 --> 00:04:44.230
costs to have healthcare right I started
00:04:44.240 --> 00:04:45.430
my career
00:04:45.440 --> 00:04:47.590
>> financial under right
00:04:47.600 --> 00:04:50.070
>> and um it was one of the you was a great
00:04:50.080 --> 00:04:52.070
job um quite frankly I don't think I've
00:04:52.080 --> 00:04:53.670
been as good at anything as I was at the
00:04:53.680 --> 00:04:55.990
beginning of my my career at uh at
00:04:56.000 --> 00:04:58.390
pricing things but uh you It was
00:04:58.400 --> 00:04:59.590
interesting. We would sit down with
00:04:59.600 --> 00:05:01.350
employers and just tell them they had to
00:05:01.360 --> 00:05:02.629
continue to increase their deductibles
00:05:02.639 --> 00:05:04.550
in their out of pockets to bring the
00:05:04.560 --> 00:05:07.189
cost the cost down. And you know, we
00:05:07.199 --> 00:05:09.110
believed back then that, you know,
00:05:09.120 --> 00:05:12.150
everybody was going to overutilize care
00:05:12.160 --> 00:05:14.230
if we didn't make them financially
00:05:14.240 --> 00:05:16.790
responsible. And we also didn't have all
00:05:16.800 --> 00:05:18.790
these clinical programs to help keep the
00:05:18.800 --> 00:05:21.430
providers from, you know, right,
00:05:21.440 --> 00:05:23.430
>> basically, you know, you know, ordering
00:05:23.440 --> 00:05:25.029
on, you know, tests and everything. And
00:05:25.039 --> 00:05:28.150
this was back 34 years ago. the system
00:05:28.160 --> 00:05:31.749
is like, you know, 50fold more, you
00:05:31.759 --> 00:05:33.990
know, convoluted now than it ever was
00:05:34.000 --> 00:05:36.070
back then. Uh, you know, back then you
00:05:36.080 --> 00:05:37.909
would say a high deductible plan back
00:05:37.919 --> 00:05:40.469
then was a $1,000 deductible and a
00:05:40.479 --> 00:05:42.230
$3,000 out of pocket.
00:05:42.240 --> 00:05:43.670
>> So, very different. Like that's
00:05:43.680 --> 00:05:46.150
considered a rich plan today in today's
00:05:46.160 --> 00:05:48.310
world. Uh, but
00:05:48.320 --> 00:05:51.110
>> uh you know, I I just um it it was great
00:05:51.120 --> 00:05:52.469
start to my career. I actually went and
00:05:52.479 --> 00:05:54.310
got my MBA ostensibly to get out of
00:05:54.320 --> 00:05:56.390
healthcare. And when I got was getting
00:05:56.400 --> 00:05:58.070
my MBA, I realized that healthcare was
00:05:58.080 --> 00:06:01.029
20% of GDP. Why would I get out of it?
00:06:01.039 --> 00:06:01.830
>> That's right.
00:06:01.840 --> 00:06:04.390
>> And uh you know, so here I am another 25
00:06:04.400 --> 00:06:06.309
years later and uh you know, still
00:06:06.319 --> 00:06:08.390
involved and I've been involved in every
00:06:08.400 --> 00:06:09.990
aspect. I've been on the consulting
00:06:10.000 --> 00:06:12.870
side, the national carrier side, the as
00:06:12.880 --> 00:06:15.029
a I own a, you know, am I running a
00:06:15.039 --> 00:06:17.830
small business now, so purchasing our
00:06:17.840 --> 00:06:20.469
benefits and then, you know, also as my
00:06:20.479 --> 00:06:23.029
uh my my board chair position and I
00:06:23.039 --> 00:06:25.029
often time will go back to the Kellogg
00:06:25.039 --> 00:06:26.870
Healthcare School and tell them that
00:06:26.880 --> 00:06:28.870
nobody would build the system the way
00:06:28.880 --> 00:06:30.790
it's been built if they knew it what was
00:06:30.800 --> 00:06:32.469
happening today.
00:06:32.479 --> 00:06:34.309
>> Yeah. But it's going to be very hard to
00:06:34.319 --> 00:06:36.550
unravel the system with, you know, the
00:06:36.560 --> 00:06:37.749
vast majority of the health care
00:06:37.759 --> 00:06:39.189
companies and the pharmaceutical
00:06:39.199 --> 00:06:41.830
companies being such a huge component of
00:06:41.840 --> 00:06:46.150
GDP and of of the the Dow Jones uh and
00:06:46.160 --> 00:06:48.790
all that that uh we got to find a way to
00:06:48.800 --> 00:06:51.350
actually solve it. And one of the ways
00:06:51.360 --> 00:06:52.870
is to help people become better
00:06:52.880 --> 00:06:55.110
consumers. And
00:06:55.120 --> 00:06:56.469
>> you know, we we we thought we were going
00:06:56.479 --> 00:06:59.029
to drive consumer-driven health plans 25
00:06:59.039 --> 00:07:01.350
years ago. We really haven't. We've
00:07:01.360 --> 00:07:03.189
gotten to the point where, as you said,
00:07:03.199 --> 00:07:05.189
a lot of people can't afford care. And
00:07:05.199 --> 00:07:06.309
so what's happening is they're just
00:07:06.319 --> 00:07:08.309
avoiding getting care. Kaiser Foundation
00:07:08.319 --> 00:07:10.870
says four and 10 people are not getting
00:07:10.880 --> 00:07:14.469
care because they can't afford it. So
00:07:14.479 --> 00:07:16.150
>> such a big number, man.
00:07:16.160 --> 00:07:17.270
>> You know, and you mentioned at the
00:07:17.280 --> 00:07:18.550
beginning, the clinical program, we
00:07:18.560 --> 00:07:19.830
focus in the clinical, well, you can
00:07:19.840 --> 00:07:22.309
never trigger a clinical program if you
00:07:22.319 --> 00:07:23.830
don't actually go get care in the first
00:07:23.840 --> 00:07:25.270
place.
00:07:25.280 --> 00:07:27.029
>> And so, you know, I mean, think about
00:07:27.039 --> 00:07:28.469
even just getting a preventive care.
00:07:28.479 --> 00:07:30.950
That's free for most Americans and most
00:07:30.960 --> 00:07:32.309
people still aren't getting it done
00:07:32.319 --> 00:07:33.589
because they're afraid there's going to
00:07:33.599 --> 00:07:35.589
be all sorts of costs that'll come out
00:07:35.599 --> 00:07:37.749
of that. They'll have to be on drugs or
00:07:37.759 --> 00:07:39.350
they'll need other procedures or they'll
00:07:39.360 --> 00:07:40.790
need testing or
00:07:40.800 --> 00:07:42.550
>> or you know maybe they actually get
00:07:42.560 --> 00:07:44.790
charged for the free care because they
00:07:44.800 --> 00:07:46.870
didn't somebody asked about hypertension
00:07:46.880 --> 00:07:49.189
and you know flagged and and and coded
00:07:49.199 --> 00:07:53.189
the wrong way. Well, it's amazing
00:07:53.199 --> 00:07:55.430
unintended consequences of the things we
00:07:55.440 --> 00:07:58.710
do have impact people's behavior.
00:07:58.720 --> 00:08:02.629
>> Exactly. Exactly. So, so seeing that um
00:08:02.639 --> 00:08:05.510
I'm just sort of curious like what what
00:08:05.520 --> 00:08:11.909
drew you to this fintech company? Um was
00:08:11.919 --> 00:08:13.589
it back in 22 or something like that? I
00:08:13.599 --> 00:08:15.670
mean, was it was it was it that problem
00:08:15.680 --> 00:08:17.270
in and of itself that you kind of looked
00:08:17.280 --> 00:08:18.869
in and you're like, "Wow, like this is
00:08:18.879 --> 00:08:20.469
actually super intriguing." And as you
00:08:20.479 --> 00:08:22.469
start kind of running the math and
00:08:22.479 --> 00:08:24.550
looking at numbers, I'm just sort of
00:08:24.560 --> 00:08:26.950
curious, what was it that really kind of
00:08:26.960 --> 00:08:29.670
brought you to that that decision?
00:08:29.680 --> 00:08:31.749
Obviously, I think, you know, look, you
00:08:31.759 --> 00:08:33.990
you spent over a decade at Etna. You you
00:08:34.000 --> 00:08:35.509
left for Mercer as a consultant, you
00:08:35.519 --> 00:08:37.670
know, then you went back to Sigma market
00:08:37.680 --> 00:08:39.029
president. I mean most people would call
00:08:39.039 --> 00:08:42.230
that a career but like you you shifted
00:08:42.240 --> 00:08:44.389
from that to go into this. What what's
00:08:44.399 --> 00:08:45.910
the thinking behind that?
00:08:45.920 --> 00:08:47.750
>> Yeah. You know when I when I left Sigma
00:08:47.760 --> 00:08:49.509
I started doing consulting for a number
00:08:49.519 --> 00:08:52.949
of uh uh what people might call it for
00:08:52.959 --> 00:08:54.790
for his point solutions. You're solving
00:08:54.800 --> 00:08:58.310
a specific issue in the industry
00:08:58.320 --> 00:09:01.030
>> fertility mental health centers of
00:09:01.040 --> 00:09:03.590
excellence diabetes reversal. I was
00:09:03.600 --> 00:09:04.870
talking to all those folks digital
00:09:04.880 --> 00:09:07.110
mental health. And what I was really
00:09:07.120 --> 00:09:08.630
intrigued by was unlike the big
00:09:08.640 --> 00:09:10.310
carriers, they could spin on a dime. You
00:09:10.320 --> 00:09:11.750
know, you could give them suggestions on
00:09:11.760 --> 00:09:14.470
their value proposition or on uh how to
00:09:14.480 --> 00:09:16.230
how to how to show their ROI differently
00:09:16.240 --> 00:09:17.750
or how to price things differently and
00:09:17.760 --> 00:09:19.190
they would make changes and move things
00:09:19.200 --> 00:09:21.670
forward. So that got me intrigued by
00:09:21.680 --> 00:09:25.430
getting out of the large, you know, um
00:09:25.440 --> 00:09:27.190
stable company world and saying, "Let me
00:09:27.200 --> 00:09:29.110
try something unique and different." And
00:09:29.120 --> 00:09:30.870
if an individual I had known from back
00:09:30.880 --> 00:09:32.630
to the beginning of my career, we both
00:09:32.640 --> 00:09:34.710
started underwriting together had come
00:09:34.720 --> 00:09:37.990
in as the CEO of of HBS Pamedics and
00:09:38.000 --> 00:09:39.670
really started throwing some statistics
00:09:39.680 --> 00:09:41.590
at me. You know, the four out of 10
00:09:41.600 --> 00:09:43.910
people are delaying care and 25% of
00:09:43.920 --> 00:09:46.630
prescriptions aren't picked up and that,
00:09:46.640 --> 00:09:48.870
you know, 50% of Americans can't afford
00:09:48.880 --> 00:09:53.030
a $500 bill. Um, and that, you know, you
00:09:53.040 --> 00:09:54.710
know, the average out of pocket, you
00:09:54.720 --> 00:09:56.630
know, at the time I think was like $800
00:09:56.640 --> 00:09:58.710
that people were paying. So those lines
00:09:58.720 --> 00:10:00.230
didn't cross, right?
00:10:00.240 --> 00:10:00.949
>> Yeah.
00:10:00.959 --> 00:10:02.389
>> I started thinking about what happened
00:10:02.399 --> 00:10:05.750
with COVID. With COVID, when people
00:10:05.760 --> 00:10:07.430
physically couldn't get in to see their
00:10:07.440 --> 00:10:09.509
doctor or they couldn't get into a
00:10:09.519 --> 00:10:11.750
hospital or they were afraid to go see
00:10:11.760 --> 00:10:13.110
that doctor, right?
00:10:13.120 --> 00:10:13.829
>> Yeah.
00:10:13.839 --> 00:10:16.230
>> So many people put off care just I mean
00:10:16.240 --> 00:10:17.829
people that had no problem getting care
00:10:17.839 --> 00:10:20.470
before put off care. And at the time I
00:10:20.480 --> 00:10:21.590
was still at Sigma, we were talking
00:10:21.600 --> 00:10:24.550
about the third wave of COVID, which was
00:10:24.560 --> 00:10:26.310
really the people that were showing up
00:10:26.320 --> 00:10:28.310
with stage two cancer instead of stage
00:10:28.320 --> 00:10:31.030
one. They were showing up diabetes
00:10:31.040 --> 00:10:33.030
instead of pre-diabetes. They were
00:10:33.040 --> 00:10:35.110
showing up with, you know, COPD that
00:10:35.120 --> 00:10:36.710
had, you know, or asthma that had gotten
00:10:36.720 --> 00:10:37.590
worse.
00:10:37.600 --> 00:10:40.150
>> Um, and it was all because they couldn't
00:10:40.160 --> 00:10:42.630
get care. Well, what this individual
00:10:42.640 --> 00:10:45.509
explained to me was, you know, for 50%
00:10:45.519 --> 00:10:47.590
of Americans, just not having access to
00:10:47.600 --> 00:10:50.630
cash is just like a door you can't get
00:10:50.640 --> 00:10:53.030
into or you're afraid to walk through.
00:10:53.040 --> 00:10:55.030
And those people are also having the
00:10:55.040 --> 00:10:56.870
same sort of situations happen where
00:10:56.880 --> 00:10:58.949
they enter the system in the wrong
00:10:58.959 --> 00:11:01.110
setting. they'll enter it at, you know,
00:11:01.120 --> 00:11:03.670
emergency room rather than uh, you know,
00:11:03.680 --> 00:11:06.389
the the primary care or they'll just
00:11:06.399 --> 00:11:07.750
enter it, you know, by the time they
00:11:07.760 --> 00:11:09.750
enter it, they're just sicker and you
00:11:09.760 --> 00:11:11.430
have a lot more work you have to do. If
00:11:11.440 --> 00:11:13.750
you think about not only the cost of
00:11:13.760 --> 00:11:15.829
stage two cancer versus stage one or
00:11:15.839 --> 00:11:16.870
stage zero,
00:11:16.880 --> 00:11:18.790
>> but it's also the mortality rates of
00:11:18.800 --> 00:11:19.910
those.
00:11:19.920 --> 00:11:21.990
>> It's dramatically different. So, be able
00:11:22.000 --> 00:11:23.910
to get people up front and I inherently
00:11:23.920 --> 00:11:25.590
knew that from my days of trying to
00:11:25.600 --> 00:11:28.069
drive people into clinical programs and
00:11:28.079 --> 00:11:30.550
get people into programs. But again, if
00:11:30.560 --> 00:11:32.150
you don't find that they have this
00:11:32.160 --> 00:11:35.110
issue, it's hard to ever, you know, deck
00:11:35.120 --> 00:11:37.430
up resources to help them get better.
00:11:37.440 --> 00:11:38.949
And then I started thinking about my
00:11:38.959 --> 00:11:42.230
nonprofit and and my nonprofit has the
00:11:42.240 --> 00:11:44.150
highest quality statistics in all of
00:11:44.160 --> 00:11:46.870
Illinois and is the top 10% of the
00:11:46.880 --> 00:11:49.430
country. And in large part that I
00:11:49.440 --> 00:11:51.269
believe is because most of our folks are
00:11:51.279 --> 00:11:54.310
on Medicaid. And so we may have to work
00:11:54.320 --> 00:11:55.670
really hard to make sure they come in
00:11:55.680 --> 00:11:58.630
and get care. But once they're in,
00:11:58.640 --> 00:11:59.910
>> you know, we deal with them in a
00:11:59.920 --> 00:12:01.990
culturally competent manner. They don't
00:12:02.000 --> 00:12:04.389
have these bills they have to pay. And
00:12:04.399 --> 00:12:05.750
we, you know, we have to earn their
00:12:05.760 --> 00:12:07.990
trust to keep them in the system, but we
00:12:08.000 --> 00:12:10.310
do some amazing work. And I started
00:12:10.320 --> 00:12:12.310
thinking that the company I'm in now, if
00:12:12.320 --> 00:12:13.829
I we can help solve some of the
00:12:13.839 --> 00:12:16.470
financial issues with people that we can
00:12:16.480 --> 00:12:17.829
get them in the front door and we can
00:12:17.839 --> 00:12:19.750
actually take care of uh take care of
00:12:19.760 --> 00:12:21.190
them the way we would in in my
00:12:21.200 --> 00:12:23.829
nonprofit. And so that's where it really
00:12:23.839 --> 00:12:25.910
intrigued me. it it feels like a small
00:12:25.920 --> 00:12:29.509
sliver of the system. Um, you know, and
00:12:29.519 --> 00:12:31.509
there's that great quote, if you if you
00:12:31.519 --> 00:12:33.509
if you sub if you optimize all the
00:12:33.519 --> 00:12:35.509
subcomponents of a system, you're going
00:12:35.519 --> 00:12:37.750
to suboptimize the overall system,
00:12:37.760 --> 00:12:40.470
right? Well, you know, we we are trying
00:12:40.480 --> 00:12:42.629
to not trying to optimize that. We're
00:12:42.639 --> 00:12:44.150
trying to just make it easier for people
00:12:44.160 --> 00:12:46.470
to get in to get care
00:12:46.480 --> 00:12:48.790
>> to then be able to work through all of
00:12:48.800 --> 00:12:51.030
the other, you know, great solutions
00:12:51.040 --> 00:12:53.110
that their employer has has has put
00:12:53.120 --> 00:12:55.670
forth for them or that their provider is
00:12:55.680 --> 00:12:56.870
included.
00:12:56.880 --> 00:12:58.870
>> Um, and make sure they're getting care
00:12:58.880 --> 00:13:00.470
in the right setting. And we've seen
00:13:00.480 --> 00:13:03.030
good results. We've seen more care in
00:13:03.040 --> 00:13:04.949
the in the physician's office, in the
00:13:04.959 --> 00:13:07.110
outpatient than in the in the hospital.
00:13:07.120 --> 00:13:09.509
We've seen lower trend. And we actually
00:13:09.519 --> 00:13:11.829
see across all
00:13:11.839 --> 00:13:13.590
credit scores that people are accessing
00:13:13.600 --> 00:13:15.590
the system similarly. Not only the
00:13:15.600 --> 00:13:17.509
number of enter the system, but their
00:13:17.519 --> 00:13:19.590
dollar amount. We wear that with a badge
00:13:19.600 --> 00:13:21.430
of honor because I think you normally
00:13:21.440 --> 00:13:23.670
will see particularly lower f lower
00:13:23.680 --> 00:13:27.030
income folks or lower um credit score
00:13:27.040 --> 00:13:28.710
individuals accessing the system
00:13:28.720 --> 00:13:31.110
differently. Um you know this the stat I
00:13:31.120 --> 00:13:33.430
put earlier, 40% of all Americans are
00:13:33.440 --> 00:13:34.710
delaying care.
00:13:34.720 --> 00:13:36.629
>> Yeah. of Americans making less than
00:13:36.639 --> 00:13:40.790
$90,000 a year, 67% of them are avoiding
00:13:40.800 --> 00:13:42.150
or delaying care.
00:13:42.160 --> 00:13:44.629
>> So you see a rapid increase when
00:13:44.639 --> 00:13:47.350
>> 67% are delaying
00:13:47.360 --> 00:13:47.750
care
00:13:47.760 --> 00:13:50.550
>> or avoiding care. Yeah.
00:13:50.560 --> 00:13:53.110
Yeah. And then you start seeing people
00:13:53.120 --> 00:13:55.590
that are, you know, 5% of people are
00:13:55.600 --> 00:13:57.189
taking medical withdrawals from their
00:13:57.199 --> 00:14:00.150
401k to pay for care. you know, that's
00:14:00.160 --> 00:14:02.069
meant to be your, you know, that's meant
00:14:02.079 --> 00:14:04.389
to be there for your later in life and
00:14:04.399 --> 00:14:07.189
and your ability to retire and and a lot
00:14:07.199 --> 00:14:09.110
of people are having to to take money
00:14:09.120 --> 00:14:10.310
out of that just to pay for their
00:14:10.320 --> 00:14:12.389
medical care. So, if you you know, I
00:14:12.399 --> 00:14:14.470
could cite a million stats. They all
00:14:14.480 --> 00:14:17.590
fundamentally get to the point that
00:14:17.600 --> 00:14:20.949
Americans can't afford $1,000 bill,
00:14:20.959 --> 00:14:22.710
period.
00:14:22.720 --> 00:14:24.550
They're then going to delay it and, you
00:14:24.560 --> 00:14:26.949
know, put it off. And then the average
00:14:26.959 --> 00:14:28.550
right now that people are spending is
00:14:28.560 --> 00:14:32.389
1,100 per person. So a family of four,
00:14:32.399 --> 00:14:34.790
you know, 60% of those folks can't
00:14:34.800 --> 00:14:37.269
afford $1,000 and yet on average they're
00:14:37.279 --> 00:14:40.470
paying $4,400 in medical care. You know,
00:14:40.480 --> 00:14:42.870
it's just it's just logic and math that
00:14:42.880 --> 00:14:45.350
don't don't add up to having people
00:14:45.360 --> 00:14:47.189
access care in the right setting at the
00:14:47.199 --> 00:14:49.670
right time and feeling confident that
00:14:49.680 --> 00:14:52.069
they aren't going to go into worse
00:14:52.079 --> 00:14:54.470
medical debt that causes problems back
00:14:54.480 --> 00:14:55.350
end.
00:14:55.360 --> 00:14:57.110
um you know when that happens
00:14:57.120 --> 00:14:58.790
>> in in a sense do you feel like your
00:14:58.800 --> 00:15:00.790
board work at Erie Family Health Center
00:15:00.800 --> 00:15:03.030
has sort of humanized the problem for
00:15:03.040 --> 00:15:04.550
you to sort of see it? I mean, I guess
00:15:04.560 --> 00:15:06.870
maybe walk walk me through like are
00:15:06.880 --> 00:15:08.710
there any specific situations like a
00:15:08.720 --> 00:15:12.629
real story that you can share um that
00:15:12.639 --> 00:15:15.030
that kind of really made this
00:15:15.040 --> 00:15:16.550
crystallize this for you in terms of
00:15:16.560 --> 00:15:18.069
what you're what you're doing on the
00:15:18.079 --> 00:15:20.230
day-to-day, but obviously with your with
00:15:20.240 --> 00:15:22.550
your board work because I feel like
00:15:22.560 --> 00:15:25.670
those they cross paths for a reason. I
00:15:25.680 --> 00:15:26.949
just don't think that it just sort of
00:15:26.959 --> 00:15:28.629
happened by coincidence.
00:15:28.639 --> 00:15:30.069
>> Yeah. No, you're absolutely right. You
00:15:30.079 --> 00:15:32.310
know, so one of the interesting things
00:15:32.320 --> 00:15:33.670
about a federally qualified health
00:15:33.680 --> 00:15:36.790
center board is that 51% of the board
00:15:36.800 --> 00:15:39.269
members need to be patients.
00:15:39.279 --> 00:15:42.550
Okay. So we have 22 folks on our board.
00:15:42.560 --> 00:15:44.710
So I think I think right now 13 of them
00:15:44.720 --> 00:15:47.030
are patients and nine are you know
00:15:47.040 --> 00:15:49.350
non-patient business type people. Right.
00:15:49.360 --> 00:15:50.069
>> Right. Right.
00:15:50.079 --> 00:15:51.430
>> And then even in that world only a
00:15:51.440 --> 00:15:53.110
certain can generate their their income
00:15:53.120 --> 00:15:54.629
from the healthcare industry. So, it's
00:15:54.639 --> 00:15:56.790
very, you know, very highly highly
00:15:56.800 --> 00:15:59.829
reviewed in large part to make sure that
00:15:59.839 --> 00:16:01.430
the patients are the ones that are
00:16:01.440 --> 00:16:03.110
really helping to try and determine how
00:16:03.120 --> 00:16:04.870
the health center is going to operate.
00:16:04.880 --> 00:16:07.509
>> Yeah. And there's been many times when
00:16:07.519 --> 00:16:09.670
you know we when we look at the actual
00:16:09.680 --> 00:16:12.790
dollar dollars of running a a program of
00:16:12.800 --> 00:16:14.790
what you know whether it's a u you know
00:16:14.800 --> 00:16:16.310
some of our community based programs
00:16:16.320 --> 00:16:17.829
where we're doing life you know healthy
00:16:17.839 --> 00:16:20.230
cooking classes or you know some of our
00:16:20.240 --> 00:16:23.030
clinical oversight uh of you know people
00:16:23.040 --> 00:16:24.790
going into the home to to look at the
00:16:24.800 --> 00:16:26.470
home and making sure that you know
00:16:26.480 --> 00:16:28.230
people have access to things or all the
00:16:28.240 --> 00:16:31.350
work that we do outside of it. It costs
00:16:31.360 --> 00:16:33.430
us money times to do that.
00:16:33.440 --> 00:16:34.870
>> Yeah. That's right.
00:16:34.880 --> 00:16:36.710
>> But the patients will walk us through
00:16:36.720 --> 00:16:38.230
how much that helped them with their
00:16:38.240 --> 00:16:40.069
with their overall care
00:16:40.079 --> 00:16:41.670
>> and they'll say we can't look at this as
00:16:41.680 --> 00:16:43.829
a dollar and cents issue and that's
00:16:43.839 --> 00:16:45.990
unfortunately how most businesses look
00:16:46.000 --> 00:16:47.749
at things. We're going to say, you know,
00:16:47.759 --> 00:16:49.350
we have to look at this as what's the
00:16:49.360 --> 00:16:52.550
best overall health of the community.
00:16:52.560 --> 00:16:53.990
And then we're going to have to go find
00:16:54.000 --> 00:16:56.069
the resources potentially to make sure
00:16:56.079 --> 00:16:57.670
we can drive that. That could be
00:16:57.680 --> 00:17:01.269
fundraising dollars. it could be um you
00:17:01.279 --> 00:17:02.790
know a different different way to get
00:17:02.800 --> 00:17:05.829
people in for care um you know that that
00:17:05.839 --> 00:17:07.429
the kind of thing. So it really started
00:17:07.439 --> 00:17:11.429
helping me understand that we have to
00:17:11.439 --> 00:17:14.549
look at the overall issue
00:17:14.559 --> 00:17:16.390
and we need to really determine what's
00:17:16.400 --> 00:17:18.549
the best interest of the overall health.
00:17:18.559 --> 00:17:20.309
And so it's the same for an employer in
00:17:20.319 --> 00:17:22.230
my mind. You have to think about for
00:17:22.240 --> 00:17:24.390
that employer. I don't begrudge them for
00:17:24.400 --> 00:17:25.669
having to increase their deductible out
00:17:25.679 --> 00:17:28.630
of pockets, right? That's something that
00:17:28.640 --> 00:17:30.789
you they have to think about doing to
00:17:30.799 --> 00:17:32.870
make sure that the their sh their fair
00:17:32.880 --> 00:17:34.870
share of what is is people pay out of
00:17:34.880 --> 00:17:37.430
their paycheck is reasonable.
00:17:37.440 --> 00:17:39.830
>> Um but then they have to realize that if
00:17:39.840 --> 00:17:40.870
you when you're trying to build a
00:17:40.880 --> 00:17:43.029
one-sizefits-all for your employer base,
00:17:43.039 --> 00:17:44.390
you're going to have a subset that are
00:17:44.400 --> 00:17:46.230
going to be really suboptimized. So you
00:17:46.240 --> 00:17:47.909
have to find things you can bring to
00:17:47.919 --> 00:17:50.710
them that will help them if nothing
00:17:50.720 --> 00:17:52.630
else, you know, extend the time horizon
00:17:52.640 --> 00:17:54.070
of when they need they could pay back
00:17:54.080 --> 00:17:56.549
those bills, right? And so those kind of
00:17:56.559 --> 00:17:59.669
things really help me understand that
00:17:59.679 --> 00:18:01.990
you know again suboptimizing a piece of
00:18:02.000 --> 00:18:04.549
the equation can or you know or
00:18:04.559 --> 00:18:06.150
optimizing you know for a certain
00:18:06.160 --> 00:18:08.470
financial component can suboptimize the
00:18:08.480 --> 00:18:10.710
overall health and employers need to
00:18:10.720 --> 00:18:12.950
look at things their absenteeism their
00:18:12.960 --> 00:18:16.230
presentism their health care costs their
00:18:16.240 --> 00:18:18.150
you know other benefits and are people
00:18:18.160 --> 00:18:19.990
using those the way they want them to be
00:18:20.000 --> 00:18:22.630
used to really be able to think about
00:18:22.640 --> 00:18:23.990
you know are you delivering the right
00:18:24.000 --> 00:18:26.870
overall component to people.
00:18:26.880 --> 00:18:28.310
>> No, I've just been as you're mentioning
00:18:28.320 --> 00:18:30.310
this, I've just been thinking, man, you
00:18:30.320 --> 00:18:32.470
have
00:18:32.480 --> 00:18:34.950
so much experience on the payer side,
00:18:34.960 --> 00:18:37.029
you know, 30 plus years inside of the
00:18:37.039 --> 00:18:40.070
system. And a part of me, I guess I'll
00:18:40.080 --> 00:18:43.029
say the the inner cynic in me is like,
00:18:43.039 --> 00:18:45.190
well, you're inside of those systems
00:18:45.200 --> 00:18:48.470
that, you know, in essence birthed this
00:18:48.480 --> 00:18:52.070
opportunity for pays to to solve this
00:18:52.080 --> 00:18:56.870
issue. Does that does that feel like
00:18:56.880 --> 00:18:59.110
ironic to you or or do you think about
00:18:59.120 --> 00:19:00.710
it differently?
00:19:00.720 --> 00:19:02.549
>> You know, it feels a little bit ironic,
00:19:02.559 --> 00:19:04.630
but in all honesty, you know, some of
00:19:04.640 --> 00:19:08.630
these it it's such a big issue at a at a
00:19:08.640 --> 00:19:12.230
uh a macro level. You know, Medicaid and
00:19:12.240 --> 00:19:14.549
Medicare don't pay their fair share to
00:19:14.559 --> 00:19:16.230
the providers. So, they need to go get
00:19:16.240 --> 00:19:17.750
more of the money from the employers.
00:19:17.760 --> 00:19:19.750
Right now, we could have a lot of
00:19:19.760 --> 00:19:21.270
debates on whether the providers are
00:19:21.280 --> 00:19:23.830
using that money properly and we can
00:19:23.840 --> 00:19:25.110
have a lot of debates on, you know, when
00:19:25.120 --> 00:19:26.789
you see all the land grab that's have
00:19:26.799 --> 00:19:28.230
that's happening out there. In large
00:19:28.240 --> 00:19:30.950
part, consumers are demanding that
00:19:30.960 --> 00:19:32.789
>> you everybody's doing it for a reason,
00:19:32.799 --> 00:19:34.390
right? Um
00:19:34.400 --> 00:19:36.470
>> but uh you know, back in the day when we
00:19:36.480 --> 00:19:38.230
started consumerdriven health plans, we
00:19:38.240 --> 00:19:39.830
really believed that that was going to
00:19:39.840 --> 00:19:41.510
be the thing that allowed more employers
00:19:41.520 --> 00:19:44.230
to continue to offer care or to continue
00:19:44.240 --> 00:19:46.950
to subsidize care at the right level.
00:19:46.960 --> 00:19:49.029
And it worked for a little while. It
00:19:49.039 --> 00:19:51.029
really did. It brought trend down. It,
00:19:51.039 --> 00:19:53.510
you know, helped helped along the way.
00:19:53.520 --> 00:19:55.590
But then as costs have continued to go
00:19:55.600 --> 00:19:58.150
up, it's really gotten to a teeter, you
00:19:58.160 --> 00:19:59.990
know, the seessaw has gone too far in
00:20:00.000 --> 00:20:01.590
the other direction. And the unintended
00:20:01.600 --> 00:20:05.669
consequences of that have stepped. Um,
00:20:05.679 --> 00:20:07.190
there was even a recent study that
00:20:07.200 --> 00:20:09.190
showed, you know, people on that that
00:20:09.200 --> 00:20:11.590
that had cancer that were on a
00:20:11.600 --> 00:20:13.669
consumer-driven plan had worse outcomes
00:20:13.679 --> 00:20:14.789
than people that weren't on a
00:20:14.799 --> 00:20:17.190
consumer-driven plan. Interesting.
00:20:17.200 --> 00:20:18.950
>> They can't blame that on the
00:20:18.960 --> 00:20:21.029
consumer-driven plan. We all believe we
00:20:21.039 --> 00:20:22.789
were going to get people to be able to
00:20:22.799 --> 00:20:24.390
behave more rationally,
00:20:24.400 --> 00:20:24.710
>> right?
00:20:24.720 --> 00:20:27.029
>> The whole concept behind this was you do
00:20:27.039 --> 00:20:29.669
more research to buy a car than you do
00:20:29.679 --> 00:20:32.549
to go find your surgeon for a heart
00:20:32.559 --> 00:20:34.630
transplant, right? You do more.
00:20:34.640 --> 00:20:36.870
>> Isn't that interesting? This is this is
00:20:36.880 --> 00:20:39.350
mindboggling to me. And we really
00:20:39.360 --> 00:20:41.110
believed at the time in the health care
00:20:41.120 --> 00:20:43.029
world and I still some some people still
00:20:43.039 --> 00:20:45.830
believe it that you know if we make it
00:20:45.840 --> 00:20:47.750
you know people have the skin in the
00:20:47.760 --> 00:20:50.070
game that they're going to ultimately
00:20:50.080 --> 00:20:52.710
start doing more research and more care.
00:20:52.720 --> 00:20:54.710
Well some of it is the tools haven't
00:20:54.720 --> 00:20:57.750
progressed as fast as they should. Um
00:20:57.760 --> 00:20:59.430
some of it is pro you know providers
00:20:59.440 --> 00:21:01.430
they say it takes 19 years for a
00:21:01.440 --> 00:21:04.789
provider in a given subsp specialty
00:21:04.799 --> 00:21:06.549
>> to know for everyone in that subsp
00:21:06.559 --> 00:21:09.029
specialy to be delivering care at what
00:21:09.039 --> 00:21:11.750
that subsp specialy delivers to be the
00:21:11.760 --> 00:21:14.950
the most appropriate way to deliver care
00:21:14.960 --> 00:21:15.430
>> right
00:21:15.440 --> 00:21:17.669
>> so yeah you know carriers play a role in
00:21:17.679 --> 00:21:19.190
making sure that we you know that they
00:21:19.200 --> 00:21:21.029
they try to make sure that that doesn't
00:21:21.039 --> 00:21:23.029
happen right some of it is they're
00:21:23.039 --> 00:21:24.470
giving information to these providers
00:21:24.480 --> 00:21:26.149
that they can't get because people are
00:21:26.159 --> 00:21:29.350
going to multiple prov providers, right?
00:21:29.360 --> 00:21:31.110
>> So, there's really there's still value
00:21:31.120 --> 00:21:33.909
in what all of these groups do. It's
00:21:33.919 --> 00:21:36.630
just gotten to the point where, you
00:21:36.640 --> 00:21:38.549
know, increasing deductible out of
00:21:38.559 --> 00:21:41.350
pocket is is is making the system worse
00:21:41.360 --> 00:21:43.029
at this point in time. You know, the
00:21:43.039 --> 00:21:44.710
business group on health says that they
00:21:44.720 --> 00:21:46.630
believe increas
00:21:46.640 --> 00:21:49.190
costs are going up 9%.
00:21:49.200 --> 00:21:51.430
And employers are going to buy down
00:21:51.440 --> 00:21:53.669
about 1.4% 4% of that, you know, by
00:21:53.679 --> 00:21:55.510
increasing deductibles out of pockets or
00:21:55.520 --> 00:21:57.270
putting in other initiatives
00:21:57.280 --> 00:21:58.950
>> that will that will that will move more
00:21:58.960 --> 00:22:02.390
of that onus to the to the patient.
00:22:02.400 --> 00:22:04.149
You know, a lot, you know, employers
00:22:04.159 --> 00:22:06.390
can't, you know, asking them to to take
00:22:06.400 --> 00:22:08.950
even 7.6% is a lot. They're not able to
00:22:08.960 --> 00:22:10.710
get
00:22:10.720 --> 00:22:11.990
>> increase in all their good, you know,
00:22:12.000 --> 00:22:14.310
across all of their uh programs at
00:22:14.320 --> 00:22:16.870
times, right? So, you can't point to
00:22:16.880 --> 00:22:18.549
them and say they're the problem. You
00:22:18.559 --> 00:22:19.750
can't point to the carrier and say
00:22:19.760 --> 00:22:20.789
they're the problem. You can't point to
00:22:20.799 --> 00:22:22.870
the provider, but you have to point to
00:22:22.880 --> 00:22:24.310
everybody and say there's got to be some
00:22:24.320 --> 00:22:25.590
things that we can do differently. And
00:22:25.600 --> 00:22:27.270
I'm a big believer in driving people to
00:22:27.280 --> 00:22:29.909
high quality care, maybe even through,
00:22:29.919 --> 00:22:31.669
you know, lower co-pays, lower
00:22:31.679 --> 00:22:34.870
deductibles, or even free. Um, but
00:22:34.880 --> 00:22:36.230
ultimately, you know, skin in the game
00:22:36.240 --> 00:22:38.950
is valuable, but you got to actually
00:22:38.960 --> 00:22:41.029
then have some tools and resources for
00:22:41.039 --> 00:22:44.870
people to um, uh, to be able to afford
00:22:44.880 --> 00:22:46.710
that over time and give them a time
00:22:46.720 --> 00:22:49.029
horizon to pay that back like you would
00:22:49.039 --> 00:22:50.630
have them have a time horizon to pay for
00:22:50.640 --> 00:22:53.590
their car or their house or things like
00:22:53.600 --> 00:22:55.190
that. It's crazy that we have to think
00:22:55.200 --> 00:22:58.710
sometimes that healthcare is a,
00:22:58.720 --> 00:23:00.950
you know, a purchasing decision like a
00:23:00.960 --> 00:23:03.590
house or a car. But, you know, someone I
00:23:03.600 --> 00:23:05.190
was on a panel recently that said to
00:23:05.200 --> 00:23:07.350
somebody, you should let your employees
00:23:07.360 --> 00:23:10.230
know that on average you're buying them
00:23:10.240 --> 00:23:13.590
a Toyota every year. And I started
00:23:13.600 --> 00:23:15.909
thinking, what is this person saying?
00:23:15.919 --> 00:23:17.590
And if you think about it, the average
00:23:17.600 --> 00:23:19.669
now for, you know, per per employee is
00:23:19.679 --> 00:23:21.990
well over $25,000
00:23:22.000 --> 00:23:23.909
is the total cost per employee for
00:23:23.919 --> 00:23:27.270
healthcare, right? That's you can buy
00:23:27.280 --> 00:23:29.430
for $25,000. And you see you're buying
00:23:29.440 --> 00:23:31.750
them a new Toyota every year,
00:23:31.760 --> 00:23:33.909
>> right? Like we need people to understand
00:23:33.919 --> 00:23:35.029
that
00:23:35.039 --> 00:23:37.669
>> and we need employees in particular to
00:23:37.679 --> 00:23:39.110
understand that that's important. They
00:23:39.120 --> 00:23:41.590
need to get start paying more attention,
00:23:41.600 --> 00:23:43.430
right? But unfortunately, we've shut
00:23:43.440 --> 00:23:45.430
them off. We shut them off by thinking I
00:23:45.440 --> 00:23:47.270
can't even go get care
00:23:47.280 --> 00:23:49.110
>> or sometimes on the back end I can't
00:23:49.120 --> 00:23:51.270
have any understanding of what I owe,
00:23:51.280 --> 00:23:54.710
who I owe it to, when I owe it.
00:23:54.720 --> 00:23:56.549
>> There's rework of bills. There's all
00:23:56.559 --> 00:23:58.149
this stuff that happens and and
00:23:58.159 --> 00:23:59.669
unfortunately to some extent we've
00:23:59.679 --> 00:24:02.870
programmed people to ignore things. Um
00:24:02.880 --> 00:24:05.430
>> when I started my care at my at at my
00:24:05.440 --> 00:24:07.029
started getting my care at my nonprofit,
00:24:07.039 --> 00:24:08.549
I've been on the board for 19 years. I
00:24:08.559 --> 00:24:10.390
became the board chair 16 years ago.
00:24:10.400 --> 00:24:11.830
When I became the board chair, I said, I
00:24:11.840 --> 00:24:14.230
should get my care here.
00:24:14.240 --> 00:24:15.750
So, I started getting my care there.
00:24:15.760 --> 00:24:17.110
Quite frankly, it's the best care I've
00:24:17.120 --> 00:24:18.710
ever gotten. And I used to get care at
00:24:18.720 --> 00:24:20.710
some of the most prestigious, you know,
00:24:20.720 --> 00:24:22.070
facilities.
00:24:22.080 --> 00:24:24.149
>> Um,
00:24:24.159 --> 00:24:26.870
>> I wasn't paying I wasn't paying my bill
00:24:26.880 --> 00:24:30.149
until I got a red final due notice.
00:24:30.159 --> 00:24:32.789
>> You know, be like 180 days later, you're
00:24:32.799 --> 00:24:34.390
finally getting a bill that says final
00:24:34.400 --> 00:24:36.230
due. And sometimes it was, you know,
00:24:36.240 --> 00:24:40.789
$150 that I owe. I could afford it, but
00:24:40.799 --> 00:24:43.430
I had been pre-programmed to say, "I'm
00:24:43.440 --> 00:24:46.950
not paying Northwestern Healthcare until
00:24:46.960 --> 00:24:48.870
I get my red final due because I'm not
00:24:48.880 --> 00:24:50.789
sure if it's been paid, if there's been
00:24:50.799 --> 00:24:52.549
everything's been paid for
00:24:52.559 --> 00:24:54.149
>> and do I owe?" And then I would go and I
00:24:54.159 --> 00:24:55.510
would look when I got that red final
00:24:55.520 --> 00:24:57.350
due, I'd go look and say, "Do I owe the
00:24:57.360 --> 00:24:59.350
money?" Right?
00:24:59.360 --> 00:25:01.430
>> Well, the reality is my CF the CFO at
00:25:01.440 --> 00:25:03.190
the the nonprofit said, "You know, is
00:25:03.200 --> 00:25:04.310
there something we can do better in
00:25:04.320 --> 00:25:05.909
billing?" I'm like, "No, it's great. You
00:25:05.919 --> 00:25:07.990
guys do a great job." said, 'Well, this
00:25:08.000 --> 00:25:09.269
is kind of embarrassing for me to ask
00:25:09.279 --> 00:25:12.470
you, but why aren't you paying us in 30
00:25:12.480 --> 00:25:14.470
days like we'd like you to? And I said,
00:25:14.480 --> 00:25:17.029
'Oh my goodness, this is I've been
00:25:17.039 --> 00:25:18.710
pre-programmed to not pay attention to
00:25:18.720 --> 00:25:21.510
any bill until I got red final due.
00:25:21.520 --> 00:25:21.750
>> Yeah.
00:25:21.760 --> 00:25:23.750
>> And so, I didn't realize how much I was
00:25:23.760 --> 00:25:25.750
harming them. In essence, they were
00:25:25.760 --> 00:25:27.750
giving me a loan for 180 days for that
00:25:27.760 --> 00:25:29.029
$150.
00:25:29.039 --> 00:25:29.750
>> That's right.
00:25:29.760 --> 00:25:31.350
>> Nonprofit didn't have the money to do
00:25:31.360 --> 00:25:32.310
that. You know, they don't they're
00:25:32.320 --> 00:25:32.710
nonprofit.
00:25:32.720 --> 00:25:33.990
>> They got they got to float it, right? So
00:25:34.000 --> 00:25:35.750
it's like you you magnify that by
00:25:35.760 --> 00:25:37.269
however many thousand patients are on
00:25:37.279 --> 00:25:38.950
the panel, right? So it's like that that
00:25:38.960 --> 00:25:41.510
adds up. And if Northwestern I owed them
00:25:41.520 --> 00:25:43.430
3,000, they were giving me six months to
00:25:43.440 --> 00:25:45.430
pay for it too. That's bad for them,
00:25:45.440 --> 00:25:46.870
right? They should be, you know, they
00:25:46.880 --> 00:25:48.390
shouldn't be floating that money to
00:25:48.400 --> 00:25:50.230
people. They should be putting that into
00:25:50.240 --> 00:25:52.789
providing the best doctors and the best,
00:25:52.799 --> 00:25:54.789
you know, call centers and all that sort
00:25:54.799 --> 00:25:56.549
of thing, right? And so, you know,
00:25:56.559 --> 00:25:58.390
here's me in the industry. You know,
00:25:58.400 --> 00:26:00.470
back then I'd been in for 24 years or
00:26:00.480 --> 00:26:03.750
whatever. 20 30 almost 30 is not
00:26:03.760 --> 00:26:04.950
understanding the unintended
00:26:04.960 --> 00:26:06.870
consequences of my actions. Right.
00:26:06.880 --> 00:26:07.750
>> Yeah.
00:26:07.760 --> 00:26:09.590
>> And that's what happens with a lot of
00:26:09.600 --> 00:26:11.190
things in this industry. It's people
00:26:11.200 --> 00:26:12.310
don't understand the unintended
00:26:12.320 --> 00:26:14.630
consequence of whatever you do is going
00:26:14.640 --> 00:26:16.630
to come back ultimately in the back end.
00:26:16.640 --> 00:26:18.149
It's going to hurt your provider. It's
00:26:18.159 --> 00:26:19.350
going to hurt your employer. It's going
00:26:19.360 --> 00:26:21.909
to hurt your you as an employee. And you
00:26:21.919 --> 00:26:23.190
know, we got to find a way to help
00:26:23.200 --> 00:26:26.230
people make better decisions overall. um
00:26:26.240 --> 00:26:28.630
you know and and and and see the picture
00:26:28.640 --> 00:26:31.110
the whole picture of the system. Um I
00:26:31.120 --> 00:26:33.669
don't have an elixir for that but in our
00:26:33.679 --> 00:26:35.750
but what we try to do in our small way
00:26:35.760 --> 00:26:38.630
here is give people a time horizon to
00:26:38.640 --> 00:26:41.190
pay their money back that they owe so
00:26:41.200 --> 00:26:43.190
they feel more confident in getting the
00:26:43.200 --> 00:26:45.190
care at the right time in the right
00:26:45.200 --> 00:26:46.470
setting.
00:26:46.480 --> 00:26:47.110
>> Um
00:26:47.120 --> 00:26:48.390
>> so wait a second. So walk me through
00:26:48.400 --> 00:26:50.630
this. So, so walk me through like this
00:26:50.640 --> 00:26:52.470
this this super EOP like like I'm a
00:26:52.480 --> 00:26:54.549
patient who who just saw the doctor you
00:26:54.559 --> 00:26:56.710
know for like the first time like what
00:26:56.720 --> 00:26:58.789
used to happen is that what you
00:26:58.799 --> 00:27:00.230
described about you know getting care
00:27:00.240 --> 00:27:01.830
then getting that bill final bill is
00:27:01.840 --> 00:27:03.350
that what used to happen like versus
00:27:03.360 --> 00:27:06.470
what happens now now that you know pay
00:27:06.480 --> 00:27:09.269
medics uh temple pay like that now that
00:27:09.279 --> 00:27:11.510
you've sort of infused yourself into
00:27:11.520 --> 00:27:12.789
that scenario.
00:27:12.799 --> 00:27:14.549
>> Yeah. So we've got two distinctly
00:27:14.559 --> 00:27:16.149
different products, but the main product
00:27:16.159 --> 00:27:17.830
which we've been doing for 20 years is
00:27:17.840 --> 00:27:20.230
HBS Pay Medics. We're actually a network
00:27:20.240 --> 00:27:22.630
of providers that all of them have
00:27:22.640 --> 00:27:25.029
agreed to not ask the patient for any
00:27:25.039 --> 00:27:26.789
money upfront,
00:27:26.799 --> 00:27:29.510
right? And right now nowadays 43% of
00:27:29.520 --> 00:27:31.190
hospitals are asking for a form of
00:27:31.200 --> 00:27:32.630
payment before they'll give an elective
00:27:32.640 --> 00:27:33.990
s, you know, anything elective
00:27:34.000 --> 00:27:36.070
procedure, right? I literally was
00:27:36.080 --> 00:27:38.950
talking to a buddy of mine last week who
00:27:38.960 --> 00:27:41.190
was scheduled to go in for a procedure
00:27:41.200 --> 00:27:44.549
at a surgery center and and literally he
00:27:44.559 --> 00:27:46.230
was like
00:27:46.240 --> 00:27:49.029
they had to move the surgery because
00:27:49.039 --> 00:27:53.350
they wanted him to pay like it was I
00:27:53.360 --> 00:27:55.110
think it was like 10 grand or it was not
00:27:55.120 --> 00:27:56.070
a small number.
00:27:56.080 --> 00:27:56.310
>> Yeah.
00:27:56.320 --> 00:27:57.430
>> And he's like
00:27:57.440 --> 00:27:58.710
>> I wish they would have told me that
00:27:58.720 --> 00:27:59.669
beforehand,
00:27:59.679 --> 00:28:00.070
>> right?
00:28:00.080 --> 00:28:02.389
>> Like because and he had the money to pay
00:28:02.399 --> 00:28:04.070
it but he delayed it anyway. But that's
00:28:04.080 --> 00:28:05.750
besides the point. But he's like, "I
00:28:05.760 --> 00:28:07.750
just I just wasn't ready to pay that."
00:28:07.760 --> 00:28:09.430
Like right there. He's like, "I was
00:28:09.440 --> 00:28:10.870
getting ready to go in." He's like,
00:28:10.880 --> 00:28:12.070
"They couldn't have told me that maybe
00:28:12.080 --> 00:28:13.750
like a day or two ago for me to like
00:28:13.760 --> 00:28:15.430
mentally process this."
00:28:15.440 --> 00:28:16.630
>> No.
00:28:16.640 --> 00:28:18.149
>> Well, and that's the reality that the
00:28:18.159 --> 00:28:21.110
standard system is you have no idea what
00:28:21.120 --> 00:28:22.549
you're going to pay because you don't
00:28:22.559 --> 00:28:23.510
really know where you are in your
00:28:23.520 --> 00:28:24.870
deductible or out of pocket or what the
00:28:24.880 --> 00:28:26.870
actual procedure is going to cost. They
00:28:26.880 --> 00:28:28.470
ask you to put a, you know, many of them
00:28:28.480 --> 00:28:30.950
will ask you to put money down upfront.
00:28:30.960 --> 00:28:33.830
>> Yeah. um or at least a form of payment.
00:28:33.840 --> 00:28:35.350
So, that's going to also, you know,
00:28:35.360 --> 00:28:38.070
exacerbate my my desire to go in. Then,
00:28:38.080 --> 00:28:39.029
I'm going to go in and have the
00:28:39.039 --> 00:28:42.070
procedure done. I'm gonna get a bill.
00:28:42.080 --> 00:28:44.230
I'm typically going to get a bill from
00:28:44.240 --> 00:28:46.389
the provider before anything's been done
00:28:46.399 --> 00:28:47.990
by the carrier.
00:28:48.000 --> 00:28:49.669
>> So, it might say, you know, you owe
00:28:49.679 --> 00:28:53.350
$2,2500 for this. I'm going to ignore
00:28:53.360 --> 00:28:55.269
that. And I should ignore that because
00:28:55.279 --> 00:28:57.029
it doesn't, you know, the provider, the
00:28:57.039 --> 00:28:58.230
carrier hasn't determined what my
00:28:58.240 --> 00:28:59.909
deductible was, what my co- insurance
00:28:59.919 --> 00:29:02.389
was, were some of the pieces on the bill
00:29:02.399 --> 00:29:05.510
actually not legit. And so then they're
00:29:05.520 --> 00:29:07.669
going to process a bill. Then they're
00:29:07.679 --> 00:29:08.870
going to send me an explanation of
00:29:08.880 --> 00:29:10.549
benefits or most time now it's going to
00:29:10.559 --> 00:29:12.870
be you have to go online and look for it
00:29:12.880 --> 00:29:13.990
online.
00:29:14.000 --> 00:29:15.350
>> I'm going to look at that and I'm going
00:29:15.360 --> 00:29:19.269
to be able to say, "Okay, I was build
00:29:19.279 --> 00:29:20.630
this just happened. My daughter had an
00:29:20.640 --> 00:29:23.669
appendecttomy. We were build $52,000 for
00:29:23.679 --> 00:29:27.110
the for the bill. There was a $20,000
00:29:27.120 --> 00:29:29.990
reduction for cost. Most of the rest of
00:29:30.000 --> 00:29:31.990
it went out of I owed I think I owed
00:29:32.000 --> 00:29:34.789
$1,800 for my you deductible and out of
00:29:34.799 --> 00:29:35.590
pocket. Right.
00:29:35.600 --> 00:29:36.470
>> Yeah.
00:29:36.480 --> 00:29:38.870
>> So now I will wait till I get a bill
00:29:38.880 --> 00:29:41.110
from the provider that says there's
00:29:41.120 --> 00:29:42.950
$1,800 owed.
00:29:42.960 --> 00:29:43.750
>> Yeah.
00:29:43.760 --> 00:29:45.830
>> And then I will determine how long it is
00:29:45.840 --> 00:29:47.830
before I have to pay that bill because I
00:29:47.840 --> 00:29:49.669
would like to not pay it until I have
00:29:49.679 --> 00:29:51.590
to. Right.
00:29:51.600 --> 00:29:53.669
>> And that's how a standard system works.
00:29:53.679 --> 00:29:54.070
Okay.
00:29:54.080 --> 00:29:54.870
>> Yeah.
00:29:54.880 --> 00:29:56.630
>> In our world, it's very different. You
00:29:56.640 --> 00:29:58.149
never ask for money upfront by the
00:29:58.159 --> 00:30:00.789
provider. You shouldn't be. Right.
00:30:00.799 --> 00:30:03.510
>> The provider sends the sends it into us.
00:30:03.520 --> 00:30:05.510
We repric it to whatever discounts look
00:30:05.520 --> 00:30:07.350
like. We send it to the the third party
00:30:07.360 --> 00:30:08.950
administrator.
00:30:08.960 --> 00:30:11.750
They adjudicate the bill and then they
00:30:11.760 --> 00:30:14.789
send it back to us.
00:30:14.799 --> 00:30:17.750
We then pay the provider
00:30:17.760 --> 00:30:19.990
both what the employer owed the provider
00:30:20.000 --> 00:30:22.389
and what the employee owed,
00:30:22.399 --> 00:30:22.630
>> right?
00:30:22.640 --> 00:30:24.470
>> And so the provider gets that and checks
00:30:24.480 --> 00:30:26.870
it off and will stop sending you a bill
00:30:26.880 --> 00:30:29.430
every two weeks, you know, while while
00:30:29.440 --> 00:30:30.870
you haven't paid it. You maybe you've
00:30:30.880 --> 00:30:31.990
been waiting, you know, been waiting to
00:30:32.000 --> 00:30:33.990
see what happened in the old world. They
00:30:34.000 --> 00:30:35.269
just they're, you know, they're paid in
00:30:35.279 --> 00:30:37.510
full, so they stop billing you.
00:30:37.520 --> 00:30:38.310
>> Yeah.
00:30:38.320 --> 00:30:40.789
>> We take that, we aggregate it with any
00:30:40.799 --> 00:30:42.549
other other claims that you had that
00:30:42.559 --> 00:30:43.510
month.
00:30:43.520 --> 00:30:44.950
and we'll send you out a statement that
00:30:44.960 --> 00:30:48.070
is both a bill and an explanation of
00:30:48.080 --> 00:30:50.950
benefits. And it will say, Michael, for
00:30:50.960 --> 00:30:52.630
you and your family, there were six
00:30:52.640 --> 00:30:56.070
claims this this month.
00:30:56.080 --> 00:30:58.230
>> You know, after all was said and done,
00:30:58.240 --> 00:31:01.430
you know, you owed of that $10,000 in
00:31:01.440 --> 00:31:04.950
claims, you owed uh $2,200.
00:31:04.960 --> 00:31:06.950
>> How would you like to pay that? Would
00:31:06.960 --> 00:31:09.190
you like to pay that in full right now?
00:31:09.200 --> 00:31:11.110
Would you like to pay that with your uh
00:31:11.120 --> 00:31:12.549
with a credit card, with your bank
00:31:12.559 --> 00:31:14.389
account, with an HSA account, with an
00:31:14.399 --> 00:31:16.789
FSA account, or would you like to take
00:31:16.799 --> 00:31:20.070
out a not an interest free uh fee free
00:31:20.080 --> 00:31:21.590
loan?
00:31:21.600 --> 00:31:23.590
And you, Michael, you have good credit,
00:31:23.600 --> 00:31:26.470
so you you you may decide I don't, you
00:31:26.480 --> 00:31:27.669
know, I can pay it off right now. Or you
00:31:27.679 --> 00:31:30.230
may decide, yeah, I'll take that. No, I
00:31:30.240 --> 00:31:31.750
if I'm going to buy a refrigerator, I
00:31:31.760 --> 00:31:33.029
might want to and I they're going to
00:31:33.039 --> 00:31:34.630
give me zero interest and I can pay it
00:31:34.640 --> 00:31:37.430
off. I'm going to take that. Mhm.
00:31:37.440 --> 00:31:39.190
>> Um, so you have the option to decide
00:31:39.200 --> 00:31:41.750
what you want to do and you pay us once
00:31:41.760 --> 00:31:43.269
instead of paying those six different
00:31:43.279 --> 00:31:44.310
providers.
00:31:44.320 --> 00:31:45.350
>> That's right.
00:31:45.360 --> 00:31:47.430
>> So you also save some money and time and
00:31:47.440 --> 00:31:48.950
energy, you know, matching up the bills
00:31:48.960 --> 00:31:50.870
and everything like that. If you take a
00:31:50.880 --> 00:31:53.269
loan out, again, it doesn't matter,
00:31:53.279 --> 00:31:54.630
Michael, you may have somebody else at
00:31:54.640 --> 00:31:57.110
your company that is making low dollars,
00:31:57.120 --> 00:31:59.509
has a very low credit score. That person
00:31:59.519 --> 00:32:02.149
with us still has qualified to have
00:32:02.159 --> 00:32:03.750
credit up to whatever their out of
00:32:03.760 --> 00:32:06.310
pocket limit is. So we look at an entire
00:32:06.320 --> 00:32:08.389
group of uh you know entire population
00:32:08.399 --> 00:32:11.110
of employees. So you we you know you you
00:32:11.120 --> 00:32:13.830
you've got that person has credit also
00:32:13.840 --> 00:32:15.669
and they'll they'll do term terms with
00:32:15.679 --> 00:32:18.549
us. Right now our average payment plan
00:32:18.559 --> 00:32:18.870
>> Yeah.
00:32:18.880 --> 00:32:21.750
>> people $3,900 and it's taking that 22
00:32:21.760 --> 00:32:24.549
months to pass back.
00:32:24.559 --> 00:32:27.269
>> So when you go back I talked about
00:32:27.279 --> 00:32:28.230
earlier.
00:32:28.240 --> 00:32:28.870
>> Yeah.
00:32:28.880 --> 00:32:30.470
>> You know that most people don't have
00:32:30.480 --> 00:32:32.070
$1,000,
00:32:32.080 --> 00:32:34.549
right? So, you know, it's no wonder
00:32:34.559 --> 00:32:35.830
that, you know, a lot of folks are going
00:32:35.840 --> 00:32:37.909
to need a lot of time to pay that back.
00:32:37.919 --> 00:32:39.590
And what we'll do is, you know, new
00:32:39.600 --> 00:32:42.470
claims come in, we can't automatically
00:32:42.480 --> 00:32:44.149
add them to your payment plan. We still
00:32:44.159 --> 00:32:45.509
have to have a conversation with you to
00:32:45.519 --> 00:32:47.110
add them to plan, but we can add them to
00:32:47.120 --> 00:32:48.310
that plan.
00:32:48.320 --> 00:32:50.870
>> And for us, long as people are paying us
00:32:50.880 --> 00:32:52.710
a reasonable amount of money
00:32:52.720 --> 00:32:54.549
>> and we might ask, you know, Michael, if
00:32:54.559 --> 00:32:56.230
you call up and say, "Look, I'd like to
00:32:56.240 --> 00:32:57.990
take this thousand dollars and you know,
00:32:58.000 --> 00:33:00.789
how what can you do to to uh give me
00:33:00.799 --> 00:33:02.149
credit for that?" We might look at you.
00:33:02.159 --> 00:33:03.430
we know a lot about you and we're going
00:33:03.440 --> 00:33:05.830
to say, "Hey, how about if you paid $250
00:33:05.840 --> 00:33:07.909
over the next four payments?" And you
00:33:07.919 --> 00:33:09.909
might say, "That's totally fine." We
00:33:09.919 --> 00:33:11.190
might look at that same, you know,
00:33:11.200 --> 00:33:13.269
somebody else that has the same thousand
00:33:13.279 --> 00:33:17.029
that's making $40,000 a year. Um, and we
00:33:17.039 --> 00:33:19.269
might say, "How about if you pay us $50
00:33:19.279 --> 00:33:21.590
for the next 20 payments,
00:33:21.600 --> 00:33:23.590
>> right?" So, we'll start off with a
00:33:23.600 --> 00:33:23.909
payment.
00:33:23.919 --> 00:33:25.350
>> So, it's like it's like a give and take
00:33:25.360 --> 00:33:27.269
there because, you know, because, you
00:33:27.279 --> 00:33:28.470
know, when I read the stat that there
00:33:28.480 --> 00:33:29.909
was like, you know, one in four of your
00:33:29.919 --> 00:33:31.350
members would fail a standard credit
00:33:31.360 --> 00:33:33.269
check. I'm like, "Wait a second. You
00:33:33.279 --> 00:33:35.110
serve them anyway, which is great,
00:33:35.120 --> 00:33:36.389
right? But every other financial
00:33:36.399 --> 00:33:38.149
product, at least to my knowledge, in
00:33:38.159 --> 00:33:40.070
America, they would turn those people
00:33:40.080 --> 00:33:40.870
away."
00:33:40.880 --> 00:33:41.190
>> Yeah.
00:33:41.200 --> 00:33:43.669
>> And and yet, you know, you've kind of
00:33:43.679 --> 00:33:46.630
gone against conventional logic and
00:33:46.640 --> 00:33:48.149
you've made it work. But it sounds like
00:33:48.159 --> 00:33:50.389
what you're doing is it's like you have
00:33:50.399 --> 00:33:52.070
like a relationship with the patient and
00:33:52.080 --> 00:33:54.310
you have an understanding with them and
00:33:54.320 --> 00:33:57.190
and and as a result of level setting, it
00:33:57.200 --> 00:33:59.590
just it it doesn't become transactional.
00:33:59.600 --> 00:34:00.870
It's like, "All right, man. like I hear
00:34:00.880 --> 00:34:03.590
what's going on, you know, do this. So,
00:34:03.600 --> 00:34:05.990
some sort of like a live negotiation.
00:34:06.000 --> 00:34:07.350
>> Is that meant to be like that?
00:34:07.360 --> 00:34:08.710
>> Yeah, it really is. I mean, because
00:34:08.720 --> 00:34:11.190
again, what we are here for is to make
00:34:11.200 --> 00:34:13.030
sure people get care.
00:34:13.040 --> 00:34:14.550
>> That's the bottom line. And to help
00:34:14.560 --> 00:34:16.310
simplify them, right?
00:34:16.320 --> 00:34:18.550
>> The providers actually pay us something
00:34:18.560 --> 00:34:21.109
to do this because they're no longer
00:34:21.119 --> 00:34:22.629
having to build. They're no longer
00:34:22.639 --> 00:34:23.990
having to collect and they no longer
00:34:24.000 --> 00:34:25.589
have any bad debt. We take on all the
00:34:25.599 --> 00:34:28.230
bad debt. And then the employers may at
00:34:28.240 --> 00:34:30.470
times pay us something depending on, you
00:34:30.480 --> 00:34:33.190
know, their plan design and their um uh
00:34:33.200 --> 00:34:34.950
and and the industry that they're in.
00:34:34.960 --> 00:34:37.030
But at the end of the day, we always
00:34:37.040 --> 00:34:39.109
never ask the patient for for any
00:34:39.119 --> 00:34:41.669
interest or any uh you know on their on
00:34:41.679 --> 00:34:43.349
their on their dollars because what
00:34:43.359 --> 00:34:45.030
we're here to is to make sure that they
00:34:45.040 --> 00:34:47.349
get care. Ultimately for the employer,
00:34:47.359 --> 00:34:49.510
it's going to be a good thing, right?
00:34:49.520 --> 00:34:51.510
Our trend is significantly lower in the
00:34:51.520 --> 00:34:54.069
market average every year and the
00:34:54.079 --> 00:34:55.669
utilization of the hospitals is
00:34:55.679 --> 00:34:58.069
significantly lower in our market every
00:34:58.079 --> 00:35:00.710
year when we do our studies. And so the
00:35:00.720 --> 00:35:02.230
you know there's very few things in this
00:35:02.240 --> 00:35:03.910
in life in my mind that the provider
00:35:03.920 --> 00:35:06.710
gets the provider is is gets a positive
00:35:06.720 --> 00:35:09.589
outcome, the employer gets a positive
00:35:09.599 --> 00:35:12.230
outcome and the employee gets a positive
00:35:12.240 --> 00:35:14.390
outcome and we do it by looking at a
00:35:14.400 --> 00:35:16.390
groupbased product. You know, there are
00:35:16.400 --> 00:35:18.870
some great solutions out there that, you
00:35:18.880 --> 00:35:20.630
know, you can get at the provider. You
00:35:20.640 --> 00:35:23.270
know, if you owe $5,000, you you know,
00:35:23.280 --> 00:35:24.950
they'll actually have people at your
00:35:24.960 --> 00:35:27.270
bedside asking you if you want to get a
00:35:27.280 --> 00:35:30.230
medical credit card, right? Which could
00:35:30.240 --> 00:35:32.310
be zero interest, but two things. One is
00:35:32.320 --> 00:35:33.990
you'll only qualify for what you qualify
00:35:34.000 --> 00:35:35.990
for. So, you might only qualify 2,000
00:35:36.000 --> 00:35:38.630
that 5,000 or a thousand of it. The
00:35:38.640 --> 00:35:40.710
other is if you miss a payment
00:35:40.720 --> 00:35:42.710
>> I mean they kill you on the interest
00:35:42.720 --> 00:35:45.109
>> 23% interest back to the beginning you
00:35:45.119 --> 00:35:47.829
know of the you know the group consumer
00:35:47.839 --> 00:35:49.510
financial protection board was really
00:35:49.520 --> 00:35:51.510
looking at that a few years ago and was
00:35:51.520 --> 00:35:52.870
trying to find ways to make sure that
00:35:52.880 --> 00:35:54.390
stuff didn't happen.
00:35:54.400 --> 00:35:56.710
>> Ours when you look at a group basis we
00:35:56.720 --> 00:35:58.710
can we can handle that. We have another
00:35:58.720 --> 00:35:59.990
product that's really more of a credit
00:36:00.000 --> 00:36:02.870
card solution. And basically an employer
00:36:02.880 --> 00:36:05.670
can say, "I'd like to or a health plan,
00:36:05.680 --> 00:36:07.430
you know, we we sell to different folks.
00:36:07.440 --> 00:36:09.109
They could say, I'd like to extend
00:36:09.119 --> 00:36:13.589
$2,500 or $1,500 to all of my employees,
00:36:13.599 --> 00:36:15.510
>> no matter what their credit score is."
00:36:15.520 --> 00:36:18.230
And and I'd like that to cover medical,
00:36:18.240 --> 00:36:21.589
pharmacy, dental, vision, maybe even vet
00:36:21.599 --> 00:36:23.430
care, right? So, I'm gonna extend
00:36:23.440 --> 00:36:25.349
everyone a level of credit that maybe,
00:36:25.359 --> 00:36:27.190
you know, again, your high paid people
00:36:27.200 --> 00:36:28.710
probably didn't need that,
00:36:28.720 --> 00:36:30.390
>> but your low paid people did, and you're
00:36:30.400 --> 00:36:31.589
trying to offer something across the
00:36:31.599 --> 00:36:32.790
board, so it's really going to be
00:36:32.800 --> 00:36:34.950
valuable to your lower paid folks.
00:36:34.960 --> 00:36:36.630
>> And that doesn't have, you know, that
00:36:36.640 --> 00:36:39.910
can go nationwide, and that can be very
00:36:39.920 --> 00:36:42.310
simply set up. And the employer actually
00:36:42.320 --> 00:36:45.030
pays us to do that. They pay us per
00:36:45.040 --> 00:36:45.829
month,
00:36:45.839 --> 00:36:47.670
>> um, you know, to cover our loan and to
00:36:47.680 --> 00:36:49.270
cover our bad debt and to cover the
00:36:49.280 --> 00:36:51.349
administrative costs. but they can then
00:36:51.359 --> 00:36:53.190
offer this very, you know, good benefit
00:36:53.200 --> 00:36:55.510
across the board um to everybody in
00:36:55.520 --> 00:36:58.230
their population. And it's it it builds
00:36:58.240 --> 00:37:00.710
health equity into their plan, you know,
00:37:00.720 --> 00:37:01.430
because
00:37:01.440 --> 00:37:02.630
>> the two people I was talking about
00:37:02.640 --> 00:37:03.990
earlier when I said they might have
00:37:04.000 --> 00:37:06.790
different needs on the loan,
00:37:06.800 --> 00:37:09.030
>> they have the same plan design,
00:37:09.040 --> 00:37:11.750
>> right? And so $1,000 means something
00:37:11.760 --> 00:37:13.750
very different to somebody making 40,000
00:37:13.760 --> 00:37:16.069
than somebody making 400,000. Yet, you
00:37:16.079 --> 00:37:17.670
know, typically you have the same plan
00:37:17.680 --> 00:37:20.390
design across the board. Well, our our
00:37:20.400 --> 00:37:22.550
plan becomes so much more valuable to
00:37:22.560 --> 00:37:25.109
that person making 40,000 that had that
00:37:25.119 --> 00:37:26.710
same thousand dollar bill. So, we're
00:37:26.720 --> 00:37:27.990
bringing health equity into the
00:37:28.000 --> 00:37:31.589
equation. Again, try our mission really
00:37:31.599 --> 00:37:34.310
is to simplify health care through, you
00:37:34.320 --> 00:37:36.310
know, easier statements as well as
00:37:36.320 --> 00:37:38.150
providing financing to get people to get
00:37:38.160 --> 00:37:38.870
care.
00:37:38.880 --> 00:37:40.310
>> And listen, you're creating more access,
00:37:40.320 --> 00:37:41.829
right? So, I mean, I'm all about that. I
00:37:41.839 --> 00:37:45.030
mean, who's resistant to this? Because I
00:37:45.040 --> 00:37:47.430
mean, it's it sounds elegant, right? I
00:37:47.440 --> 00:37:50.630
mean the data is strong. There's a few
00:37:50.640 --> 00:37:53.190
things that I read that was like I don't
00:37:53.200 --> 00:37:54.550
know I think you guys had just released
00:37:54.560 --> 00:37:57.829
data that your your employer groups are
00:37:57.839 --> 00:38:00.630
are are growing healthcare costs at 4
00:38:00.640 --> 00:38:01.990
and a half% compared to like the
00:38:02.000 --> 00:38:03.430
national benchmark which I think was
00:38:03.440 --> 00:38:05.510
like almost 9%.
00:38:05.520 --> 00:38:06.150
>> Right.
00:38:06.160 --> 00:38:09.190
>> I'm just wondering who's who's pushing
00:38:09.200 --> 00:38:12.470
back like why why are they pushing back?
00:38:12.480 --> 00:38:14.069
>> Yeah. I mean, one of the issues we have
00:38:14.079 --> 00:38:15.670
today is we're really, you know, here in
00:38:15.680 --> 00:38:17.510
Wisconsin mainly. We've got a few other,
00:38:17.520 --> 00:38:19.270
you know, locations, but, you know, a
00:38:19.280 --> 00:38:20.630
lot of employers want a consistent
00:38:20.640 --> 00:38:22.790
program across the board and they're not
00:38:22.800 --> 00:38:24.390
saying, I'm gonna I'm gonna optimize my
00:38:24.400 --> 00:38:27.190
regional solution, right? Um, so that
00:38:27.200 --> 00:38:28.710
could be could be some of it. Some just
00:38:28.720 --> 00:38:30.630
don't know about it. As much as we're
00:38:30.640 --> 00:38:32.310
out in front of brokers, consultants,
00:38:32.320 --> 00:38:33.510
we're trying to put things out there,
00:38:33.520 --> 00:38:35.190
they a lot of them don't know about it,
00:38:35.200 --> 00:38:39.109
right? Um, and uh some think maybe it's
00:38:39.119 --> 00:38:41.430
too good to be true at times, right? Um,
00:38:41.440 --> 00:38:43.190
you know, underwriter in me has always
00:38:43.200 --> 00:38:45.109
said, you know, increased deductibles
00:38:45.119 --> 00:38:46.790
out of pockets drives lower utilization
00:38:46.800 --> 00:38:48.710
which allows a lower cost,
00:38:48.720 --> 00:38:50.390
>> right? A lot of people have a trouble
00:38:50.400 --> 00:38:52.470
flipping that that you know, actually
00:38:52.480 --> 00:38:54.630
some utilization is really important and
00:38:54.640 --> 00:38:57.109
is good utilization, right?
00:38:57.119 --> 00:38:59.030
>> And you know, and the way we do it where
00:38:59.040 --> 00:39:00.550
people will have to pay it back, they're
00:39:00.560 --> 00:39:02.069
just giving them a time horizon to do
00:39:02.079 --> 00:39:04.470
that really should it really should only
00:39:04.480 --> 00:39:06.790
help that good utilization. it shouldn't
00:39:06.800 --> 00:39:09.430
promulgate, you know, utilization that's
00:39:09.440 --> 00:39:12.710
frivolous, right? So, um, so there's a
00:39:12.720 --> 00:39:14.470
still a lot that we needed to get to get
00:39:14.480 --> 00:39:16.390
the message out there. And then our
00:39:16.400 --> 00:39:18.230
other program is, you know, again, it's
00:39:18.240 --> 00:39:20.230
nationwide. We're we're pretty new. We
00:39:20.240 --> 00:39:21.430
just bought that company about a year
00:39:21.440 --> 00:39:22.550
and a half ago.
00:39:22.560 --> 00:39:24.230
>> Um, so we're out there getting the
00:39:24.240 --> 00:39:26.150
message out. And again, it's really,
00:39:26.160 --> 00:39:27.829
>> you know, do people understand this
00:39:27.839 --> 00:39:31.109
issue that has is the unintended
00:39:31.119 --> 00:39:33.670
consequence of your plan design choice
00:39:33.680 --> 00:39:35.349
that's come into play? And do they even
00:39:35.359 --> 00:39:36.630
know that there's a solution out there
00:39:36.640 --> 00:39:39.750
that can that can impact it? And then
00:39:39.760 --> 00:39:41.430
how you know then they have and how can
00:39:41.440 --> 00:39:43.510
that fit into the myriad of solutions
00:39:43.520 --> 00:39:45.190
they put on the table.
00:39:45.200 --> 00:39:46.790
>> Some are just reluctant to add anything
00:39:46.800 --> 00:39:49.430
else. You know at this conference I was
00:39:49.440 --> 00:39:51.190
at last week. You know that one of the
00:39:51.200 --> 00:39:52.230
biggest things they were talking about
00:39:52.240 --> 00:39:53.430
was
00:39:53.440 --> 00:39:55.510
>> we've overrotated to all of these
00:39:55.520 --> 00:39:56.870
solutions that you're implementing
00:39:56.880 --> 00:39:58.390
because the system isn't working
00:39:58.400 --> 00:39:59.910
properly today
00:39:59.920 --> 00:40:03.829
>> with any music. And you know that is you
00:40:03.839 --> 00:40:05.510
know you only add value when people are
00:40:05.520 --> 00:40:07.430
using them
00:40:07.440 --> 00:40:09.910
about diabetes. There are so many
00:40:09.920 --> 00:40:11.750
companies are doing amazing work in
00:40:11.760 --> 00:40:15.030
diabetes right and we have all these DLP
00:40:15.040 --> 00:40:16.150
ones that are also helping with
00:40:16.160 --> 00:40:18.470
diabetes. You would think diabetes
00:40:18.480 --> 00:40:19.750
should be gone when you look at
00:40:19.760 --> 00:40:22.550
everybody's results but diabetes
00:40:22.560 --> 00:40:24.150
continues to grow because you just don't
00:40:24.160 --> 00:40:26.230
have enough people accessing those great
00:40:26.240 --> 00:40:29.510
programs and those great initiatives. um
00:40:29.520 --> 00:40:31.990
or they're never being diagnosed upfront
00:40:32.000 --> 00:40:33.510
the way they should or you know they're
00:40:33.520 --> 00:40:34.870
diagnosed too late because they never
00:40:34.880 --> 00:40:36.870
went and got their care because they
00:40:36.880 --> 00:40:38.230
were afraid to go see that doctor
00:40:38.240 --> 00:40:39.670
because of the financial implications
00:40:39.680 --> 00:40:42.390
that could come into play.
00:40:42.400 --> 00:40:44.790
>> What do you think most
00:40:44.800 --> 00:40:47.510
financial executives
00:40:47.520 --> 00:40:50.230
fundamentally misunderstand about like
00:40:50.240 --> 00:40:54.710
the patient financial experience?
00:40:54.720 --> 00:40:56.870
Um,
00:40:56.880 --> 00:40:59.589
I think there are some that don't feel
00:40:59.599 --> 00:41:01.190
that anything they do is going to change
00:41:01.200 --> 00:41:03.910
the way people consume care. And that
00:41:03.920 --> 00:41:06.550
may not be wrong. We have to find a way.
00:41:06.560 --> 00:41:07.990
I mean, part of this is, you know,
00:41:08.000 --> 00:41:10.630
people have to start engaging, right?
00:41:10.640 --> 00:41:12.870
Um, I look at myself. I've lost 94
00:41:12.880 --> 00:41:14.309
pounds since the beginning of last year
00:41:14.319 --> 00:41:18.309
without using any medication. I I feel
00:41:18.319 --> 00:41:20.870
better. I'm I'm gonna have le I all my
00:41:20.880 --> 00:41:24.069
numbers are now in line, right? I had to
00:41:24.079 --> 00:41:25.750
make a conscious effort to do that. I
00:41:25.760 --> 00:41:28.230
had to think more like a uh you know,
00:41:28.240 --> 00:41:30.630
somebody that was thinking about my care
00:41:30.640 --> 00:41:32.550
versus somebody that just thought, well,
00:41:32.560 --> 00:41:34.630
I'll wait till the system covers me when
00:41:34.640 --> 00:41:37.349
I have something that happens later on.
00:41:37.359 --> 00:41:37.829
Right.
00:41:37.839 --> 00:41:38.230
>> Yeah.
00:41:38.240 --> 00:41:40.790
>> And don't have to always get care, you
00:41:40.800 --> 00:41:43.109
know, at the at the Cadillac of
00:41:43.119 --> 00:41:45.030
locations. you can go to an urgent care
00:41:45.040 --> 00:41:47.190
facility and get as good a care or go
00:41:47.200 --> 00:41:48.630
see your primary care when you need to.
00:41:48.640 --> 00:41:50.150
Like you have to change the mindset of
00:41:50.160 --> 00:41:51.430
members and they have to be held
00:41:51.440 --> 00:41:55.910
accountable. Um but
00:41:55.920 --> 00:41:57.430
but you can't always just do that
00:41:57.440 --> 00:41:59.190
through benefit plan design which is the
00:41:59.200 --> 00:42:00.550
easiest thing to do because it could be
00:42:00.560 --> 00:42:03.349
consistent across the board. It can be
00:42:03.359 --> 00:42:05.190
you know you can help try and think make
00:42:05.200 --> 00:42:07.670
people make right decisions. So you know
00:42:07.680 --> 00:42:09.910
you really have to think about it from a
00:42:09.920 --> 00:42:12.069
holistic perspective.
00:42:12.079 --> 00:42:16.390
what can I do to, you know, help as many
00:42:16.400 --> 00:42:18.710
people access the most the care at the
00:42:18.720 --> 00:42:22.309
right cost in the right setting? Um, and
00:42:22.319 --> 00:42:23.990
I and that may have to be different
00:42:24.000 --> 00:42:26.390
solutions in different areas. Um, you
00:42:26.400 --> 00:42:28.069
know, I feel bad for employers that, you
00:42:28.079 --> 00:42:30.230
know, you look at a Walmart, it's got
00:42:30.240 --> 00:42:32.630
500,000 people that they're trying to
00:42:32.640 --> 00:42:35.510
set a plan design for in, you know, 50
00:42:35.520 --> 00:42:37.109
different states and well, you know,
00:42:37.119 --> 00:42:39.430
even globally, right? Right. They're
00:42:39.440 --> 00:42:41.670
trying to make decisions, you know, that
00:42:41.680 --> 00:42:43.829
that that that that optimizes. And I've
00:42:43.839 --> 00:42:45.190
never worked with Walmart, so I'm not
00:42:45.200 --> 00:42:47.670
using them as an example of anybody
00:42:47.680 --> 00:42:49.589
right or wrong, but if you think about
00:42:49.599 --> 00:42:51.750
their, you know, their, you know, the
00:42:51.760 --> 00:42:53.670
decisions that they have to make,
00:42:53.680 --> 00:42:56.309
they're difficult. And how do you how do
00:42:56.319 --> 00:42:57.829
you how do you offset what people pay
00:42:57.839 --> 00:42:59.190
out of their paycheck versus what they
00:42:59.200 --> 00:43:01.750
pay at point of care? How do you offset,
00:43:01.760 --> 00:43:03.109
you know, how do you try and find ways
00:43:03.119 --> 00:43:05.910
to get people to to do things? Well, one
00:43:05.920 --> 00:43:07.910
thing is just, you know, find ways to
00:43:07.920 --> 00:43:10.309
help them be accountable for the
00:43:10.319 --> 00:43:13.030
dollars, but not accountable immediately
00:43:13.040 --> 00:43:14.710
to have to pay those dollars. It's a
00:43:14.720 --> 00:43:16.710
small component that I think has a big
00:43:16.720 --> 00:43:20.230
impact on how people consume care. So
00:43:20.240 --> 00:43:23.510
then if let's just say fast forward 10
00:43:23.520 --> 00:43:27.910
years from now if pays tempo pay HPS if
00:43:27.920 --> 00:43:30.470
they're working at the scale that you
00:43:30.480 --> 00:43:33.670
believe they can be working
00:43:33.680 --> 00:43:37.430
what does healthcare look like in that
00:43:37.440 --> 00:43:39.910
future like paint paint the picture for
00:43:39.920 --> 00:43:40.950
me.
00:43:40.960 --> 00:43:43.430
>> Yeah I mean quite frankly we'd love it
00:43:43.440 --> 00:43:45.430
to be over all networks. We don't really
00:43:45.440 --> 00:43:47.109
have a desire to build new networks. We
00:43:47.119 --> 00:43:49.030
want to have our financial solution
00:43:49.040 --> 00:43:50.950
that's baked in Wisconsin and and a few
00:43:50.960 --> 00:43:53.190
other places included um you know with
00:43:53.200 --> 00:43:55.670
the providers I with the carriers. I
00:43:55.680 --> 00:43:57.430
think the carrier provider relationship
00:43:57.440 --> 00:43:59.349
would be better. I think the member
00:43:59.359 --> 00:44:01.510
provider relationship would be better.
00:44:01.520 --> 00:44:03.349
You'd have people getting care at the
00:44:03.359 --> 00:44:05.510
right setting which ultimately will
00:44:05.520 --> 00:44:07.829
start to lower costs. I mean there's so
00:44:07.839 --> 00:44:09.349
much more that needs to be done to lower
00:44:09.359 --> 00:44:11.190
costs. I mean as you know 2% of people
00:44:11.200 --> 00:44:13.670
are typically driving 60% of the overall
00:44:13.680 --> 00:44:17.190
care. Um but you know finding way to you
00:44:17.200 --> 00:44:18.870
know to help make sure people are are
00:44:18.880 --> 00:44:21.270
doing the right decisions. Um the more
00:44:21.280 --> 00:44:24.550
you can take friction out of the system
00:44:24.560 --> 00:44:26.390
without just simply making everything
00:44:26.400 --> 00:44:28.470
free because that's some people's deci,
00:44:28.480 --> 00:44:30.309
you know, way to take friction out is
00:44:30.319 --> 00:44:32.309
we'll make everything free. Um when you
00:44:32.319 --> 00:44:33.829
can take some of that friction out, you
00:44:33.839 --> 00:44:35.589
can do it in a way that helps all three
00:44:35.599 --> 00:44:37.430
stakeholders, the employer, the
00:44:37.440 --> 00:44:39.589
provider, and the member. You can start
00:44:39.599 --> 00:44:41.589
to rein in costs. you can start to have
00:44:41.599 --> 00:44:42.950
a more health, you know, equitably
00:44:42.960 --> 00:44:44.550
health, you know, a health plan that's
00:44:44.560 --> 00:44:47.109
more equitable and, you know, hopefully
00:44:47.119 --> 00:44:50.150
we can start really making an impact on
00:44:50.160 --> 00:44:52.630
this trend because it's unsustainable.
00:44:52.640 --> 00:44:55.190
It's unsustainable the way it is to now.
00:44:55.200 --> 00:44:57.430
I mean employers again, how do you know
00:44:57.440 --> 00:45:00.470
how if you can only get 2% co you know a
00:45:00.480 --> 00:45:03.829
cost increase from your your your your
00:45:03.839 --> 00:45:06.150
consumers your your customers you know
00:45:06.160 --> 00:45:09.270
and you're getting a dime 10 15 30% from
00:45:09.280 --> 00:45:11.030
your health care which is one piece of
00:45:11.040 --> 00:45:13.109
your cost
00:45:13.119 --> 00:45:15.270
you know how do you how do you stay
00:45:15.280 --> 00:45:17.990
afloat and you know the the employer
00:45:18.000 --> 00:45:19.430
health care system a lot of people are
00:45:19.440 --> 00:45:21.829
thinking about you know we're hearing
00:45:21.839 --> 00:45:23.190
more and more about people trying to get
00:45:23.200 --> 00:45:25.510
out of the health care system, but the
00:45:25.520 --> 00:45:27.109
problem with that is there's not a great
00:45:27.119 --> 00:45:28.870
individual
00:45:28.880 --> 00:45:30.950
plan to put people towards. And so you
00:45:30.960 --> 00:45:33.109
and then you lose control of any of that
00:45:33.119 --> 00:45:34.390
that you know to help think about
00:45:34.400 --> 00:45:37.109
presentism and absenteeism. So you know
00:45:37.119 --> 00:45:38.550
find a way to bring a health an
00:45:38.560 --> 00:45:40.790
equitably uh you know an equitable
00:45:40.800 --> 00:45:43.190
health plan to your customers. Find a
00:45:43.200 --> 00:45:45.030
way to partner more with providers. Some
00:45:45.040 --> 00:45:46.630
of it may be off you know there may be
00:45:46.640 --> 00:45:48.550
some subsegment direct contracting with
00:45:48.560 --> 00:45:51.030
providers and we become a conduit to
00:45:51.040 --> 00:45:53.510
help with that. Um, that's that's how
00:45:53.520 --> 00:45:54.870
we're going to change the system. I
00:45:54.880 --> 00:45:56.710
think, you know, we're we're a piece of
00:45:56.720 --> 00:45:57.990
the equation, but I think we're an
00:45:58.000 --> 00:45:59.670
important piece.
00:45:59.680 --> 00:46:02.150
>> And before I let you go, just share
00:46:02.160 --> 00:46:04.550
with, you know, with the audience what
00:46:04.560 --> 00:46:06.069
what's the best way for people to follow
00:46:06.079 --> 00:46:07.510
you and the work that you and the team
00:46:07.520 --> 00:46:09.030
are doing. So, kind of give us like a
00:46:09.040 --> 00:46:11.030
like a commercial before we before we
00:46:11.040 --> 00:46:12.150
wrap.
00:46:12.160 --> 00:46:13.829
>> Yeah. Know, we'd love people to connect
00:46:13.839 --> 00:46:16.710
with us. Uh, you know, our our payix.com
00:46:16.720 --> 00:46:18.870
or hps.mmd
00:46:18.880 --> 00:46:23.670
are our websites. we follow me. We put
00:46:23.680 --> 00:46:25.510
out a lot of thought leadership pieces.
00:46:25.520 --> 00:46:27.990
We do about six to 10 a year that are
00:46:28.000 --> 00:46:31.270
really about the issue. Um and and and
00:46:31.280 --> 00:46:32.870
how people need to think about it. Yes,
00:46:32.880 --> 00:46:34.309
we'll talk about our products as part of
00:46:34.319 --> 00:46:35.990
it at sometimes. Sometimes we don't even
00:46:36.000 --> 00:46:38.230
talk about our products. U but really
00:46:38.240 --> 00:46:40.470
try to follow us on uh on you know
00:46:40.480 --> 00:46:42.630
follow us on LinkedIn. We do a lot
00:46:42.640 --> 00:46:44.950
through that channel. Um take a look at
00:46:44.960 --> 00:46:47.829
our websites and uh um you know just
00:46:47.839 --> 00:46:49.109
understand the issue. Go to some
00:46:49.119 --> 00:46:50.390
conferences. is we're at a lot we're at
00:46:50.400 --> 00:46:51.829
a lot of conferences and we're trying to
00:46:51.839 --> 00:46:54.710
help people understand the the impact of
00:46:54.720 --> 00:46:57.670
avoidance of care and how you know that
00:46:57.680 --> 00:47:00.309
that's that's causing problems and you
00:47:00.319 --> 00:47:03.510
know one way to try and find you know to
00:47:03.520 --> 00:47:05.589
solve that is to is to find a way to
00:47:05.599 --> 00:47:08.790
include financing either directly uh
00:47:08.800 --> 00:47:10.390
through one of our products and and we
00:47:10.400 --> 00:47:11.670
have number of competitors doing
00:47:11.680 --> 00:47:14.309
something similar or try and help your
00:47:14.319 --> 00:47:17.430
your network carriers to think about the
00:47:17.440 --> 00:47:19.829
way they can build uh patient financing
00:47:19.839 --> 00:47:22.230
into their overall solution.
00:47:22.240 --> 00:47:24.470
You know, it's just been I don't know,
00:47:24.480 --> 00:47:26.390
it's been really delightful to chat with
00:47:26.400 --> 00:47:28.790
you just because I think what makes your
00:47:28.800 --> 00:47:30.950
perspective super valuable is that
00:47:30.960 --> 00:47:33.109
you've been inside of the system long
00:47:33.119 --> 00:47:35.670
enough to know exactly where things kind
00:47:35.680 --> 00:47:39.270
of fray and you've made this
00:47:39.280 --> 00:47:43.510
you've made this conscientious choice to
00:47:43.520 --> 00:47:47.349
fix it from a different angle and very
00:47:47.359 --> 00:47:49.190
grateful that you came on to the show
00:47:49.200 --> 00:47:51.910
and just just being great conversation
00:47:51.920 --> 00:47:54.790
today. So for those of you that are
00:47:54.800 --> 00:47:58.150
listening to this, if you found it
00:47:58.160 --> 00:48:01.829
interesting, if you liked something,
00:48:01.839 --> 00:48:04.950
comment on it, engage with us, like it,
00:48:04.960 --> 00:48:08.710
share it with a friend. Um,
00:48:08.720 --> 00:48:10.790
we're a pretty interactive community, so
00:48:10.800 --> 00:48:13.190
this is a living, breathing ecosystem.
00:48:13.200 --> 00:48:15.910
Sometimes you got to give and share uh
00:48:15.920 --> 00:48:18.550
before you take. So, and if there is a
00:48:18.560 --> 00:48:19.829
topic that you would like for us to
00:48:19.839 --> 00:48:21.829
explore or maybe a leader that you want
00:48:21.839 --> 00:48:24.069
to hear from, um, drop me a note, drop
00:48:24.079 --> 00:48:26.790
me a line. And remember, it's a platform
00:48:26.800 --> 00:48:28.790
about community, not just content. So,
00:48:28.800 --> 00:48:30.630
thanks for listening, keep building with
00:48:30.640 --> 00:48:33.109
purpose, and we will see you next time
00:48:33.119 --> 00:48:34.710
on the Advancing Healthcare Innovation
00:48:34.720 --> 00:48:37.200
Show.