David 0:00

So I have health insurance. Most of you do. But maybe I don't have the funds to cover a deductible or a copay. So I put off getting care, and then I get even sicker and end up in the hospital anyway. Sound all too familiar? It does to a lot of us. The question is, how can we stop that cycle? We'll find out on this episode of Shift Shapers.

Announcer 0:25

Change either paralyzes or energizes. The choice is yours. You're listening to the Shift Shapers podcast. You're about to learn firsthand from businesses and entrepreneurs who have successfully shaped the shifts in their industries. Get ready to become the change you want to see.

David 0:47

This episode is brought to you by Triune Technologies, creator of the market-leading benefits connector Ben Admin software. Now with special pricing for smaller groups. To learn more, call Carol Motznick at 336-253-5722. That's 336-253-5722. Let Triune help you get out of the admin business and back into the selling business.

Announcer 1:16

And now here's your host, Story Brand Certified Guide and Chief Transformation Strategist at Shift Shaper Strategies, David Saltzman.

David 1:28

And we're here with Brian Worley. Brian is founder and CEO of Patient, which is an organization that thinks it can help folks solve the problem that we posed in our question. Welcome, Brian. Thank you, David. It's a pleasure to be here. Thanks. Tell us a little bit about your journey. How do you get to be doing what you're doing?

SPEAKER_02 1:44

I, you know, for almost 15 years loved working inside of a hospital. It was a special point of pride for me to be part of a mission-driven organization and team of people that people in my community, you know, friends, family, neighbors, uh, return to in their moment of need. But over those 15 years, I noticed the challenge of what I would call unfunded care. And it's something that affects everyone. And I decided in April 2018 to step out into the world and help bring patients and providers together more effortlessly with a, you know, experience that helps people access and afford care. And we call that patient.

David 2:22

So let's define for our listeners what the problem is. I mean, I kind of alluded to it a little bit in the open, but talk a little bit from your perspective in a little more depth about what the problem is, and then we'll go from there.

SPEAKER_02 2:35

Sure. Yeah. Let's start first with um maybe imagine, you know, we rewind the clock, maybe a couple of decades, and deductibles were either zero or low or meaninglessly low. And people were essentially in one way almost sort of overinsure. As employers have sort of rationalized that and moved more employees into higher deductible health plans, you know, it has reached a point where there is folks are delaying and deferring care. It's impairing access to care, it's impairing affordability of care. It certainly creates an all too painful experience all too often for far too many people. And the idea then is, gosh, well, how do we solve for that? How do we solve for that in a way that preserves the insurance card as is in people's persons, pockets, and wallets? And our thought was, hey, gosh, why don't we create, you know, using a Visa card as our sort of backbone and platform? Let's go out and see if um we can find thoughtful partners and insurance partners who wanted to slide something else alongside an insurance card and fill up that void of the deductible that maybe exceeds what the HSA is. Let's fill up that gap in between dollars that folks had already set aside in an FSA or an HSA that they had already set aside in their family budgets. And let's give them an interest-free amount of credit provided to them by their employer or a health insurance partner, and let's give it to them in that super, super simple thing that everybody already understands and knows how to use, which is just a PSA card. That Pisa card works at every medical, dental, vision, pharmacy, and veterinary provider in the country. They just swipe the card, providers paid in full day of the service, and then we give people time. So they they simply swipe the card and then select how they would like to split that transaction up over time, always without interest and fees, and essentially take the sting or the burden or the uncertainty out of what is already a stressful moment and a personal moment in in their life, and just simply give them time to break up that out-of-pocket spends into something that they and their family's budget can can't afford.

David 4:58

You've studied this. How did we get here? What was the line, the continuum that got us to the point where we have this problem to solve in the first place?

SPEAKER_02 5:06

Yeah, I I would even we can think of it as everyone is working uh along their own incentive vector or path. And this is just uh what happens when each of us locally are optimizing to our own specific problem or issue. And I just think that, you know, who has sort of gotten a bit lost in that has been the everyday consumer and what they're facing when illness comes knocking on the door of their home. And so, you know, as deductibles have increased, as out of the pocket maxes that have increased, uh sort of looking out into the world and saying, gosh, I wonder when someone will do something about this. And we decided, you know, to step out and to you know partner with thoughtful employers and uh carriers and really sort of forward-thinking consultants to uh solve it in a way that restores uh access without needing to change the health plan.

David 6:09

It's not just a problem for consumers, though. I mean, we you know we do have these folks. Somebody on the podcast a couple of years ago called them these people functionally uninsured, which I think is a great expression, a great way to describe where they are, but it's also a problem for plans, whether they're fully insured or self-insured. You know, waiting to get care inevitably drives up spend. Do you have any any stats or any research on what that part of the problem looks like?

SPEAKER_02 6:35

I think, you know, I want to be a little bit mindful around um we our perspective, my personal perspective, observation, is like I don't believe that high deductible health plans in and of themselves are the problem. I I think that they are a symptom of you know, some uh just how the system as is, as has worked to cope with incentives as as they exist. And I think for for many people, you know, a high deductible plan is what their personal choice is in terms of that's the appropriate amount of insurance coverage that they decide that they want for themselves and the family. What we're doing is saying whether you have a low deductible plan or a high deductible plan, you know, the the sting and the stress and anxiety of an out-of-pocket payment is something that we can make better, or just moreover, the idea that you know how do we translate large unexpected expenses in the in the rest of our lives and non-healthcare? How do we make those instances affordable for us and easy? How do we make life easier? And we use credit as a tool to turn large unexpected expenses into manageable things, manageable everyday expenses. And so the idea here sort of just conceptually is that credit or the idea of financing belongs or has an appropriate and appropriate place in the design of health plans. And so it's sort of almost saying, gosh, let's use the insurance card for its design and intended purposes, and then let's let's fill in this harmful void with the friendliest possible way to enable people to access and forward uh you know everyday life.

David 8:20

Right. But do deferring care is more than justifying the financing part of it, is the maybe the cause, right? I've got this big deductible, whether it's a good thing or a bad thing, that's not our judgment to make today in this in this program at least. But I've got this hurdle, and I don't have a way to overcome it. So I'm gonna wait and see if I get better. And inevitably, you take maybe a youngster who's got a cold or a bad flu, and they end up in ICU, pediatric ICU for six days with pneumonia. And I guess kind of what I'm asking is do we have any idea what that kind of deferral of care ends up costing the system? Because it's got to be significant.

SPEAKER_02 8:57

It's certainly more, right? Yeah. And so our our idea and our thought is hey, by by filling in that gap, by filling in that void with something, that enables people to access and afford care. We just completed a survey. I'm really proud, um, really excited to say that, you know, we, you know, with one of our insurance partners, when folks were using the card, we we prompted and said, you know, within the app right after after the spike and said, hey David, if you didn't have patient, what what would have happened here? And David, you know, almost 70% of people said, I would have delayed, deferred, or skipped care altogether. And that and that like gets you further down that line. It makes that early more cost effective, you know, less um intervention sort of means of of trying to shape the course of treatment. Like that's not the care we want to put off. Like you're you're higher, you have a higher likelihood of a larger cost, a larger expense, a more higher intervention with all kinds of risks and things associated with that. And so, you know, what we're doing is enabling folks to more easily get the small things looked at when they're still small, or at least you know, the you know, w when they're easier to address.

David 10:14

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SPEAKER_02 11:31

That's a great question. I think the idea is everybody understands it outside of healthcare. And then I think it's crossing the chasm of belongs, you know, or at least financing or credit worthy ability to pay overtime, like natively embedded as a part of the health plan design, that that is helpful. It helps employers adopt health plan designs that put all their people into a better place from like a liquidity perspective. You know, gosh, like I'm a really, really large employer. We have employees, you know, all across the country, and an exotic, you know, plan that only works in one market, like doesn't help me, you know, solve affordability at scale. Like this is a way that I can affordably address at scale wherever my employees are. This is how I can avail or make you know millions or tens of millions or hundred millions of dollars available to all of our folks, wherever they may be, and fill their pockets with with you know funds that they're able to now use for healthcare. So I think, I think it's you know, crossing the chasm of the like this does belong, you know, in healthcare. You know, it it you know, I think it was CMS, you know, it's it's it was we all are familiar with the acronym now, but it does, and and you know, but prior to 2001, you know, just the the acronym you know didn't exist. It was it was well what was it? It was HCFA Healthcare Financing Administration, right? Before it was CMS. And so, you know, not that that was a you know credit organization or anything like that, but it just just the the notion or the idea of a sort of solving the problem or issue upstream from the provider, you know, actually there at the employer or with the insurer designing this in in a way to make that plan, whatever deductible it may be, friendlier, easier for people to use. What we've seen, you know, across our 400 plus employers and partners is that like people love it, people understand it, they know how to use it, and a meaningful number of people are swipe their cards to more easily and effortlessly access A-For Care.

David 13:39

So, you know, there's a huge resurgence of interest, as you know, in in self-insured plans, even going down to some smaller employers where maybe even just five years ago we wouldn't have thought that to be a viable option. This solution that you're offering is plan design agnostic. Can it work both with fully insured plans and with level funded plans and with fully insured plans and all of the different plan designs we see in the market today?

SPEAKER_02 14:01

Absolutely. In fact, you know, what we get really, really excited about is when, you know, sophisticated employers or employers who are really mindful of what is the employee experience as it relates to being able to get care for them and their family? How are we enabling people to easily and effortlessly walk into a provider's office and get care, pay for care, ultimately buy care. How can we be an enabling platform for that? And how can we design, you know, partner with those, with those folks, with those employers and with those consultants to accompany uh and help and accompany and enable whatever their their objectives are of their self-funding strategy. Yeah, it's it's so cool to see. Like I think we're in this really kind of renaissance area here where you know it's not your choice isn't A or Z. You know, there's there's whatever 24 letters in between those. And so there's all kinds of variations of of plans that can be designed or almost even personalized. And I think, you know, if all of them, you know, if all of them have some component of out-of-pocket spend, like whatever the philosophy is of that employer or that consultant or you know, the client, like whatever they're trying to achieve with the design, thinking about if there's an out-of-pocket component, how do we reduce that burden for all of our employees? How do we ensure that the everyday employee, you know, and the executive suite all have an equitable and equal ability to access and forecare? Like that's really, really super important to us. And that's where we really feel that we're serving out our mission of ensuring that everyone is able to, again, easily and access, uh, easily able to access and forecare.

David 15:51

Well, I mean, it it is, use the right word, it is kind of a renaissance. I mean, that's why we started the podcast eight years ago. I mean, arguably, whether you think ACA was a great idea or a bad idea, it shook up an industry that needed to look for innovation and probably had needed to look for it for quite some time. And no one is more amazed than I that eight years later, almost nine years, it'll be nine years and a couple of months, I'm sitting here still talking to entrepreneurs who are bringing new ideas like yourself to the marketplace to try to solve some of the inherent problems of the system. So it is a renaissance and it's great. Question for you, what does the broker conversation look like? If I'm a broker, because a lot of our listeners are client-facing, if I'm a broker or advisor, whatever term I particularly choose, what's that conversation with an employer look like?

SPEAKER_02 16:40

Yeah, I think right now the conversations are a number of employers and us included, we're you know, staring at 2023 and 2024 and really being mindful about you know every dollar that we're entrusted to be good stewards of and looking at ways of you know, how do we ensure that we're providing an incredible employee experience here, that we're taking great care of our people and enabling them to get care for themselves and care for their family members and ideally and to do that in a lower cost way than we have in the past. And so, you know, where patient or companies like Patient can enter into the equation is, you know, golly, if any of those designs, you know, revolve around how do we ensure that people aren't going to delay care, that they're not gonna defer care, that folks who are experiencing sort of inflation-induced anxiety in their pocketbook that they're looking for some relief, you know, immediately. Like, golly, like, how could I avail or give my 10,000 employees, 20,000 employees, 20, you know, 100 employees access to $5,000, $8,000, you know, on a card that they can easily just slip in their alongside their insurance card. Partnering with a company like Patient is a way that they can do that uh without risk for the employer. It's just a turnkey key method. We're certainly the category creator here and it's sort of commercial leader, and um uh it's a very privileged position. And you know, we uh we we certainly, I think, have gotten here by you know just listening and seeing if there's ways to partner with consultants and solve problems for them and their their clients.

David 18:20

We've got about a minute left. Where do you see the future? Where do you see this going over the next year, two, three, four, five years?

SPEAKER_02 18:27

Uh, year, two, three, four, five years. I think we'll continue to serve our clients and our partners, and uh we're extremely uh grateful uh for the opportunity to serve members, you know, every single day. I think in some ways it's a really exciting time because you know there tend to be this country has has a history of of you know healthcare innovation. Periods after recessions tend to be times where there's really interesting innovation in how healthcare is either financed or afforded or extended. And so I'm really excited to see like what's on the other side of this. And I think it is an exciting time uh for consultants. I think your listeners are probably you know thinking every single day about golly, how can I better serve our clients and you know put them in a better position, survive and thrive through the next 18 months, and then come out on the other side of that with a fantastic experience for more people, and we certainly would love to be a part of that.

David 19:23

Well, and that's the goal for all of our folks who are client-facing, is they just want to create a better environment for their employers and for their employees and help them spend better and spend smarter and improve health and patient experience along the way. That's a great place to end our conversation for today. Brian Warley, founder and CEO of Patient. Brian, thanks so much for sharing your expertise with our audience. Thank you. It's a pleasure.

Announcer 19:46

The Shift Shapers Podcast is a production of Shift Shaper strategies and may not be reproduced or quoted in whole or in part without our express written permission. Copyright 2020, all rights reserved.