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The VisitPay Blog | Building Better Financial Relationships

An Insider’s Perspective: Can Consumer Platforms Swing the Healthcare Cost Pendulum in the Right Direction?

In an exclusive interview, Bill Geary, co-founder and partner at Flare Capital Partners, a leading healthcare technology venture capital firm, offers his take on how he sees the healthcare sector shifting from patient payment and financial responsibility point solutions and portals toward consumer platforms that can meaningfully swing the pendulum in terms of lower cost and improved access to affordable care. Read on to discover what it takes to solve a really big national healthcare problem.

The new healthcare economy is here. We are living in a time when everyone is acutely aware of what needs to happen to solve what’s become a national issue—healthcare costs must come down and access must go up. Consumers know it, hospital systems know it, everyone in the healthcare ecosystem knows it. But, how do you effectively tackle a trillion-dollar problem that impacts every US citizen?

In an exclusive interview, Bill Geary, co-founder and Partner at Flare Capital Partners, a leading healthcare technology venture capital firm, offers his take on how he sees the healthcare sector shifting from patient payment and financial responsibility point solutions and portals toward end-to-end consumer platforms that can meaningfully swing the pendulum in terms of lower cost and improved access to affordable care. Bill’s exposure to many emerging healthcare technologies and ideas gives us a rare opportunity to get an insider’s perspective on what’s happening in this emerging category.

Question:
What’s driving the continued shift towards an interest in patient financing solutions?
The financial relationship between health systems and patients is quickly evolving. As healthcare costs rise, the impact of higher obligations on the consumer has become crippling. To make an already tough situation worse, many consumers lack an understanding as to what most of their bills mean. “What do those codes mean that I can’t even interpret and why can’t I find out what they are; I didn’t even know I was responsible for that line item, what was it for and how can I afford to pay it?” In my view, I see three market forces all coming together simultaneously that are driving a need for immediate change.

#1 Healthcare costs and the increasing obligations of the consumer are crushing—unbearable for most consumers. 

he obligation of healthcare costs to consumers is something we are all facing. We’ve all seen it, some of us have lived it, I certainly saw first-hand with my own father who died some time ago after undergoing several complex surgeries and experiencing multiple chronic conditions that racked up enormous healthcare costs. This is a societal problem and it’s one where solutions are needed to help consumers manage their healthcare costs and their ever-increasing health care cost obligations.

#2 Health care costs continue to rise, exacerbating the very problem.

The healthcare cost increases faced by consumers are, in part, due to employers and insurance companies shifting to the consumer more of the expenses for their health coverage. These organizations are passing along their higher costs because it’s difficult for them to bear the rising costs on their own. It’s a double-edged sword—as the cost of care rises, the consumer obligation portion also continues to rise.

#3 Hospitals are finding themselves bearing a larger burden for the uncollected portion of these consumer-borne bills.

Hospitals are effectively functioning like banks and collection agencies—something that is not their core mission as healthcare providers. Being a financial services provider is not the business a health system wants to be in or a role they wish to play within their community—yet they need to be serving their constituents in the capacity that enables them to carry out their core mission—that of providing clinical care. This is an economic burden that hospitals bear that continues to add to the overall cost of care unless it’s properly addressed and corrected.

Question:
What are the key elements needed to come up with an approach that can address such a multi-sided problem within the healthcare sector?
The market is crying out for a solution that serves two masters
What’s really needed to solve the root problem is a solution that serves both the consumer and the hospital. On the one hand, consumers need lower healthcare costs and financing alternatives. They need consumer-friendly explanations of their bills so they understand what’s giving rise to their economic burden. And, they need to have visibility into their current and future financial responsibilities, before they decide to go ahead with a certain procedure.

The other side is a tandem solution for the hospitals. Hospitals cannot continue to act like a bank—it’s not their core business, and for many systems, it’s not a sustainable economic model. Hospitals need to be able to help consumers with their obligation, help them understand it, and help them in advance. A solution that enables hospitals to predict which consumers need these alternatives, and are likely to take advantage of solutions that offer them some economic relief as well as an understanding of their health care obligations, will go a long way to solving a systemic problem rather than managing a symptom.

Two sides of the same problem, inextricably linked
The consumer solution and the hospital system solution are inextricably linked. This dual-purpose solution is what the market needs to solve the problem of rising health care costs, the increasing burden the consumer bears, and hospitals acting like a bank for the uncollectible portion of the consumer obligation. To take the giant down at its knees, we need a two-pronged approach: a solution that gives consumers low-cost financing alternatives that are consumer friendly combined with an easy-to-understand explanation of patient bills that offers consumers a variety of payment options that work for them financially. One that seamlessly enables consumers to manage their current health care obligations and to predict and assess their future health care obligations and manage them in advance.

In the absence of this kind of solution, hospital usage will likely continue to decline. We are seeing it today— people are postponing care, or worse yet, declining to have procedures because they simply can’t afford them or fear the financial obligation will be unmanageable. This behavior acts to fuel the increasing healthcare cost cycle.

Unraveling the ball of knots
Hospitals, like most organizations, spend a disproportionate share of their dollars on the administrative costs associated with delivering care but wish to spend more of their dollar on the actual care delivery. Administrative costs include items such as estimating costs, billing and collecting. To tackle the problem of increasing administrative costs, hospitals need greater visibility across their entire workflow of processes.

  • What is this obligation for which they now seem to be responsible and are responsible?
  • What is the consumer financial obligation?
  • How do they get a handle on this? How do they assess it?
  • How do they predict it in advance of it happening?
  • And then, how do they optimize the collectability of it while fully understanding that they want to be a good member of the community?


Question:
How can health systems and providers take advantage of some of the new innovations that are emerging to improve their financial administrative processes?
Many health systems and providers struggle to really understand the full economic impact on their business of their current administrative workflow and how it can be managed and improved.

As a trusted clinical caregiver in their communities, health systems and hospitals want to be socially responsible. They also wish to be friendly to consumers, yet, they are incurring obligations for which they need to get paid. Hospitals must get their arms around the increasing financial obligation of consumers and what it means for their own business before they get negatively surprised.

In some instances, health systems cannot even gauge where they sit in relation to the amount of debt owed them. They lack the tools and the resources to predict and fully assess the total amount of obligations from patients. From the hospital’s perspective, there are several questions which need answering—and the answers to these questions lie in access to data and visibility across many disparate systems and processes.

If health systems can tighten their administrative procedures in ways that are consumer friendly, get their arms around their growing receivables obligations, forecast amounts and predict issues before they happen, they’ll be in a better position and will avoid negative surprises. At the same time, if they can offer a solution that consumers need and want, they stand to further benefit because their collectability will improve, their cash flow will increase, and their administrative cost of doing business will decrease.

Question:
What made the VisitPay solution stand out as an investment opportunity?
Investing in a team that fully understands the problem from multiple dimensions
As a venture capital investor, we focus entirely on healthcare technology, health IT and digital health solutions that aim to solve two fundamental problems in healthcare: (1) lowering the cost of care, and (2) improving outcomes.

When we canvassed the market, we looked at the solutions providers in this market space including the larger legacy incumbent IT organizations, in addition to young emerging companies and startups. VisitPay stood out as a solution that really addresses the market needs with a management team that deeply understands the problem and its multiple dimensions.

Question:
What makes the VisitPay solution so unique and compelling?
VisitPay provides a solution that’s consumer friendly and offers flexible financing alternatives, while at the same time explaining bills in simple easy-to-understand language and helping hospital systems reduce their costs and improve their cash flow.

Highly relevant perspective and unique strengths
The VisitPay management team has uniquely identified the multisided opportunity which exists in this market space. The team has a hugely relevant background coming from health care, hospital systems, IT and consumer payment businesses. When you bring all these skill sets together in the VisitPay team, the result is a highly differentiated solution designed through the lens of their interests and perspective. They can see all the angles of this market opportunity and they know how to address them. The culmination of these strengths is the delivery of low-cost financing alternatives that are consumer friendly, easy to use and seamless.

At the same time, the team acutely understands the need that hospitals must lower their own administrative costs and get a handle on the economic burden of the uncollectible portions of their health care bills. Hospitals naturally want to spend more of their dollar on clinical care delivery and less on administrative costs. This is exactly the opportunity the VisitPay team has identified and on which their end-to-end solution is uniquely capable of delivering.

Question:
What’s the outlook for health systems and consumers adopting the VisitPay approach?
The outlook for the health systems adopting the VisitPay approach is extremely positive. It’s a good news story for both the consumer and the health system in the short-term and longer term.

The short-term benefits for the health system are essentially around giving them the headlight they need to be able to see what their true financial obligations are and how they can manage them—without negative surprises. The longer tail benefit is a reduction in their administrative costs, which will ultimately help to lower the overall cost of care.

When it comes to lowering expenses, removing unnecessary administrative cost is one obvious way to have a sizable positive impact. Given a choice of where to focus efforts to be more efficient, streamlining workflow and lowering the economic burden of the costs of administration has a powerful benefit and is the first place for health systems to start. It’s the right way to remove waste without negatively impacting the provision of care.

“The VisitPay solution does great good for consumers, as well as for the hospital systems that serve each of us every day. It’s socially and fiscally responsible.” Bill Geary, co-founder and partner at Flare Capital Partners

Question:
In your view, are there other solutions on the market that offer comparable benefits to both the consumer and the hospital system?
VisitPay has delivered a solution that acts to lower costs and reduce the administrative burden, making it seamless and easy for consumers. The company is going after a unique market opportunity where everyone benefits—the consumer and the hospital system. Certainly, the VisitPay organization has a massive advantage in terms of its underlying technology—incorporating machine learning, predictive modeling, and the configurable capabilities on the front-end. And, where the solution is being used today, it’s delivering tremendous value for its clients.


The secret ingredient is really the talent
The management team at VisitPay has extensive consumer understanding and deep knowledge of the needs of healthcare providers. It’s this unique combination that’s so fascinating about the VisitPay team and it’s profoundly embodied in the solution they’ve built. The composition of the professionals and the people at VisitPay are the real secret ingredient to their success.

“I think the advantages of VisitPay are less about the unique technologies they deploy and more about their people. In the end, it’s really about the team’s deep understanding of the customer needs and the market opportunity integrated with the advanced technology necessary to deliver the best solution.”Bill Geary, co-founder and partner at Flare Capital Partners

Having these unique vantage points to bring to the table creates a win-win for health systems and consumers. VisitPay is not just great at two or three of the items that appear on a request-for-proposal (RFP), they offer an extremely comprehensive resolution to an intricate problem developed and delivered by a team that truly understands the challenges from all angles.

It takes a truly unique team to solve a really big problem
To solve a big enough problem and have a measurable and demonstrable impact, an end-to-end deep solution is a requirement:

  • End-to-end, that is a complete solution for consumers and for the hospital system and provider customers; and
  • Easy to implement and use with seamless integration.

“Visitpay is simply unparalleled in their technology, their solution, their customer understanding and in their ability to execute.”Bill Geary, co-founder and partner at Flare Capital Partners

This is where the VisitPay solution excels. It is easy to use and provides frictionless interactions with consumers, as well as delivers an end-to-end solution for provider systems. Once implemented, the solution offers a compelling return-on-investment with demonstrable and measurable results for providers and consumers.

Prospects are bright for a future of development advances
VisitPay will continue to broaden its product offerings as well expand its rapidly growing customer base. They are the market leader in a category which is extremely important to both hospital systems and consumers—and potentially a silver bullet when it comes to lowering the cost of care.

About Bill Geary
With more than a twenty-year tenure investing in young and emerging healthcare technology companies, Bill Geary has served on the Boards of numerous industry-leading companies and has played a critical role, actively helping and working closely with founders and management. Flare Capital Partners raised one of the healthcare technology industry’s largest independent venture capital funds and investments include Aetion, Bright Health, Circulation, ClearDATA, Curisium, HealthReveal, HealthVerity, Iora Health, Valence Health (Evolent Health), VisitPay and Welltok. Feel free to email Bill at bill@flarecapital.com and follow him on Twitter @billgeary

VisitPay

VisitPay is the only online financial engagement platform that simplifies the entire billing experience for both patients and health systems—providing greater transparency, choice and control.

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