Episode 2: A Better Patient Experience

Terry Rowinski is president of Health Payment Systems (HPS), a privately held healthcare technology and services organization offering solutions to enhance the consumer health care billing and payments experience, while driving value to health care providers, health insurance companies, and employers. HPS’ single-statement billing and patient financing services help families combat confusing and unaffordable medical bills, while its guaranteed payment model eliminates providers’ collection costs and risk. Learn more: https://hps.md/

Curt Kubiak: I want to welcome you again to another episode of NOVO Live – The Podcast, where we’re bringing you health care information from different influencers throughout the health care community. And I’m excited to bring our next guest to you today from Health Payment Systems, who’s been a partner of ours for quite a while and has been in the industry for quite a while adding value to both physicians and employers. And so my guest today is Terry Rowinski, from Health Payment Systems. Welcome, Terry, glad to have you on the show.

Terry Rowinski: Thanks for Thanks for having me. Thanks for your partnership.

Curt Kubiak: Yeah, I’m excited to talk a little bit about some of the things that Health Payment Systems has been doing over the course of its history. But then also some of the innovations that you’ve been adding, even most recently, where you’ve kind of been reacting to what the market needs are and expanding on your value proposition. But maybe you can talk to us a little bit about the history of Health Payment Systems, some of the features of the work that you’re doing that are important to both the self-insured employers, as well as the physician groups that you work with.

Terry Rowinski: Oh, that’d be awesome. Thank you. So, Health Payments Systems, we were founded back in 2005, you know, from an idea. Founder-led organization. Our founder had a nasty bit with health care, and, luckily, was saved by great medical practitioners. And a lot of prayer to be pretty Frank. Came home after being in the hospital for just about four months. And his wife gave him a gift that was much like this table, she had dining room table full of medical bills, and said, Jim, now that you’re home, I’m glad you’re home, I love you. And my first gift to you is basically figure out what this mess is that the health care establishment gave us.

Curt Kubiak: Right? So this is an extreme situation, right four months in the hospital. But it certainly is, you know, the mother of invention, right is necessity. So I can imagine somebody seeing for months where the bills trying to figure out what do I pay? What do I not pay? How do I know where to begin? That’s, that’s a tough experience. But even for folks that are going through just, you know, one procedure, and trying to figure out the half a dozen bills that come along can be a challenge as well.

Terry Rowinski: Yeah, very, very, very much. So, you know. I always thought when I first got into this business, that this was a broken, you know, issue. Unfortunately, it’s the way it’s working the way it was designed to be by the medical establishment. And you know, Health Payment Systems really has these two products. One is a PPO network that we’ll talk about in a little bit. And another is this this thing that we’re terming Pay Medics, it’s our billing and payments network, which really helps the consumer make sense out of the nonsense of what happens within health care. And it can be a single incident, or it can be a family that has a birth, you know, at the end of the year, and then at the beginning of the year, another child has strep or a husband needs a medical check or something and, and just the inundation of both digital and paper that comes at the family, or the individual, is just at times overwhelming, and causes, unfortunately, mental stress, where people should be focused on their health and wellness and getting better. And we just try and make sense of that nonsense, or make sense of the mess, I call it, and just help people with ways to understand and then ways to pay.

Curt Kubiak: Okay, so as as chief executive of Health Payment Systems, you’re managing this organization. So talk to me about some of those feature benefits that your staff bring to life every day that address these issues.

Terry Rowinski: Sure, sure. Well, as I’d said earlier, you know, we really do have two products. The first is a very broad and high value PPO-like network here in the state of Wisconsin. Really focused from Madison east, you know, to Lake Michigan, and then up and down and terms of the coast, and and that’s a really high value PPO network that has, I’ll call it this, that has very good discounts, you know, come as you want to play the discount game with the major carriers. But it’s a very high-value network. So it brings value to the employers that are looking for a great network for their employees and access for their employees. And then for the employees in those families, you know, our Pay Medics and our billing and payments network is really a product focused for them. But also the provider medical services. And why that’s so important is that, you know, we make a contract with the provider that, you know, you are going to do these types of things to help our community heal and get better. We also believe in making a contract with the provider that the providers are owed the money that they are owed, and that the consumers that experienced health care do owe money to those people, but at times, they just don’t understand what they really owe, and how much and at times even why. And in that, you know, it’s that that whole aspect of the health care system works of people that read test results that you never see. People that may end up guiding your care along the way that are invisible in terms of how health care works that end up billing you at some point in time and the consumer just when they get the explanation of benefits that typically happens or when they get the bill that’s not a bill or they finally get the bill. They just can’t make sense of when do they pay and engage or not and we really help that go away.

Curt Kubiak: So your staff interacts with the patient directly and help them to understand what what they should pay on their bill. But you go further than that, Right? So you actually offer them really a single bill to pay. Correct. So can you talk about how that work?

Terry Rowinski: Yeah, we turn that the super EOB. So when a super explanation of benefits that actually is a bill and the EOB, all in one, and that’s really delivered to them, just like a credit card like statement is delivered on a monthly basis. So as a person gets their Visa, or MasterCard or American Express bill, you become really comfortable with that from a medium perspective, and you have trust in that, because what you’re being billed on the pages following the first page all add up, and it makes sense in the whole of what you’re doing. We believe that a similar approach should be given to health care. And we deliver a statement to the employee and their families on a monthly basis, just like a credit card, where the front couple pages are just summary of what’s happened since the last time that they’ve received, you know, a bill from us. And then ultimately, we also give them a HIPAA compliant, you know, journey of what happened and their health care life over the past calendar month or so in terms of what’s happened. And the beauty of it, it ties together. Sure, and even bigger part of it, if it doesn’t, for some reason, because even though we’re trying to make sense out of nonsense, occasionally, it’s health care, things still do not make sense in the whole. They can call us they can ask for help, they can call our advocates and we leap into action to work on their behalf with the provider, potentially, with maybe even their employer, if something is a little bit amok. With other people that are in the community that are providing health care, like your team in terms of what goes on, so that we just help be their advocate so that the stress of understanding and paying for health care, while will never be eliminated, because even I have a little stress when I write a check or send or you know, pass that credit card, it is not the financial stress that’s letting people not get better. It’s the fact that they now can pay attention to things that they should be.

Curt Kubiak: Sure. So I’ll Health Payment Systems, then you have an encounter, you get this list of bills, a list of items that you’ve been billed. If I’ve got a question on a single line item, similar to my credit card, I’ve got a question I can call my credit card company and they’ll explain it to me this was the purchase, this is what it was related to right, you do something similar. You can say, yeah, that was a diagnostic read for an MRI scan, for example. Right. So that’s the radiologist bill. Those of us that are consumers of health care infrequently might not even understand how all of that works. But your team does.

Terry Rowinski: And if for some reason we even get over our skis a little bit in terms of something that’s really complex. That’s where we’ll basically tell the customer, do you wish to be with us on the phone as we reach out for help? You know, do you wish to be part of a multiple party conversation? Do you want to just solve it will get back to you in a timeframe commitment that’s good for you. And we’ll take it and run with it and then come back to you with what the answers are. And at times, if the medical establishment was incorrect, and what it did, we help unwind that for the consumer and essentially play it backwards. So that then when they get billed, again, things make sense. Or at times, we just help them be educated in terms of what’s happening, which in the end is all that people really want. When you have understanding, and you have faith and trust in the system for lack of better, then people do engage, and we find that they pay and they pay very well.

Curt Kubiak: Right. So you get to the bottom, I’ve got the single bill I can pay right now in the event that I can’t pay that entire bill off all at once, right? Because health care is expensive. And a lot of these bills are more than folks can pay off at one time. Talk to me about how Health Payment Systems uniquely addresses that issue.

Terry Rowinski: Sure, really in a few ways. You know, first and foremost, we just helped to make it simple, like I said before. But you do have those situations where, you know, up until the pandemic, you know, a normal family in the United States couldn’t hit an unexpected $400 to $500 bill in their midst. And that’s on the low end of health care expense at times. So, you know, we help people by effectively offering them either some payment plan terms that they can work directly with us as Health Payment Systems to do that for them. And those are, you know, one to two to three-year time frames that are at no interest in terms of what we do, which is really good. It’s better than than traditional medical systems do themselves.

Curt Kubiak: Really good. I think it’s underestimating it. I mean, I do 0% interest. So I get a loan for two to three years to pay off a medical bill through you? And there’s no cost to me to make those plans with you? That’s crazy.

Terry Rowinski: And then there’s just the freedom of access and we believe in almost an Amazon like experience from a digital wallet. You know, a person can pay through check or e-check or credit cards. These days as employers are embracing tax advantaged savings plans for their employees and their families. We can take funds directly from those as well so that everybody benefits –  the employer, the employee and ultimately us that are helping to pay forward to the doctors. And then ultimately as we go forward, we’re going to add more services and as new types of tender come about that are happening in this world. And then also things like some people prefer to have payroll deduction done as a as a way to pay off so that they know that that money is not theirs, and they don’t have the temptation to spend it. So services like that, that we offer to just really create this frictionless experience and a really low hassle experience for the for the consumer.

Curt Kubiak: Excellent. So let me just kind of summarize where we’re at so far. So you’re working, you know, directly with different health care groups to negotiate the best possible rates that you can. When these members then go and use those health services, they can count on the fact that they’ve got a very competitive rate. But then they’re also going to have an explanation of benefits that comes to them like a credit card statement, they get one bill at the bottom, I can see the total that I owe. And if I can’t pay it all off, I can actually finance that at 0% interest. A huge benefit offering. Right? Is there another group that you’re aware of it offers similar services? Are you fairly unique in that regard?

Terry Rowinski: Nobody’s really attacking it holistically, like we are at this time, you know. I would expect that this is the way that health care should be in the future. Ultimately, you know, health care is here to help people be healthy in all facets of what’s going on. And ultimately, as organizations and as employers and as large insurance companies, and larger and larger employer groups come into the marketplace and look for alternatives to try and attract and retain talent, benefits like this will become I think, very, very needed. And very, very commonplace. I hope over time, I hope that we are the lead duck in this case.

Curt Kubiak: Yeah, I think you’re onto something, and you’ve been doing it for quite a while. And I think the market is now catching up and starting to realize the value that you bring. So let’s talk a little bit about the value that you bring on the provider side. So the folks that are that are providing health care, what is your value proposition that Health Payment Systems has, for groups like the Orthopedic & Sports Institute that I represent, or NOVO Health member?

Terry Rowinski: You know, there’s a few really. You know, first and foremost, you know, access to new to new individuals to new employers that really believe in taking a non-traditional approach to health care and want to do things in a really proactive fashion. You know, those are great consumers, you know, from a health care perspective for the providers. Second, because we do pay money forward on behalf of the member, we end up paying the providers full to whatever the discount is that we talked about earlier. And we do that incredibly fast. So ultimately, to a provider, providers are made whole much faster, through an experience with Health Payment Systems than they are in the traditional insurance mechanism that takes place where they may be wondering for 60-90-120 days, if the consumer is even answering on the other end when they’re sending a bill because of just the engagement mechanism that takes place. And then really third, and what I think is really important for folks to realize is that, you know, not only do we have this frictionless Wallet for the consumer for an ability to pay, but we allow this frictionless provider, you know, consumer patient experience. The provider isn’t interrupting somebody at the front desk, asking them to make a deposit down on a outstanding bill that they haven’t paid yet. Or, even maybe denying care at that point in time. So we are taking away from that poor person at the point of service at an independent or major medical system, those uncomfortable financial conversations that I see all too commonplace take place. And we’re getting rid of that, because we’re helping to take care of that as a part of the continuum of our services.

Curt Kubiak: So to say this in a way again, that, you know, my audience will understand me that I can understand, a lot of times the patient owes a portion of that total bill, and the employer owes a portion of that total bill or the insurance company pays. So I owe a piece as a patient and the other portion is paid, you know, by another payer. In this case, there really isn’t any patient portion that the provider has to go collect. And that’s the reason why we eliminate those uncomfortable conversations. Because that doesn’t exist in your model, you pay the entire bill. And then work with the employee, as we’ve talked about previously. So from the providers’ perspective, as a physician group, or as a health system, I’m getting paid entirely 100% of what I billed. And I’m getting it paid timely,

Terry Rowinski: Which is in today’s world, for the providers of health care, you know, very, very high value.

Curt Kubiak: So for our audience, right. If you’re paying attention, whether you’re an employee, whether you’re an employer or a provider, there’s really some unique attributes, you know, to the model that you’ve created that really bring value to the entire continuum.

Terry Rowinski: We really feel that we bring all the parties together under this continuation of services that we have and what we do to just try and help everybody have their own responsibility, both in terms of health and wellness and financial health and wellness, to just help the medical system and the consumer work better together. And in the end, that’s what we all want, I think,

Curt Kubiak: Exactly right. Yeah. So again, explain to me just because we tend to get going with, you know, three letter acronyms pretty quicker. So for our audience, the PPO again is?

Terry Rowinski: For folks that are listening, it’s a provider network. And it’s, you know, a PPO is a preferred provider network. And ultimately, what we’ve crafted here in the state of Wisconsin is an incredibly broad network of just about all the physical hospital system locations, outside clinics, a majority of the independent provider practices as well, so that we could effectively offer very broad and compelling network. Just like any of the major insurance companies do that are out of state entities that are trying to do business and frankly, take money out of Wisconsin. We’re trying to keep Wisconsin money in Wisconsin.

Curt Kubiak: I applaud that for sure. As a fellow Wisconsinite. And so the broad component, I think, is important for folks to know, because we’re not going to limit choice, right? So you can choose your doctor, you can choose, you know, the network that they are part of, and odds are, you’re going to be able to be seen with the Health Payment Systems program.

Terry Rowinski: Yes, yes. Very much. So.

Curt Kubiak: Wonderful addition. So talk to me about some of the things that are coming up by with Health Payment Systems? What are some of the things that you’re excited, you know, that maybe aren’t even in fruition yet? Or you’re thinking about? Where are we going?

Terry Rowinski: We believe, you know, as you do and your team, you know, that health care is going to continue to evolve. You know, we’ve been incredibly excited and blessed to be a partner of yours and the NOVO health organization in terms of what we’ve done, to the point where we see for any clients significant savings opportunities, you know, through the actual now utilization of bundled payments. Not just talking about it conceptually, but actually seeing it work. And we’ve seen clients that we’ve shared together anywhere between 15 to 20% of their services being rendered, are covered by a bundle that offers substantial cost savings. So for a provider, that’s good, because they are offering services at these rates that basically are getting them good volume. But, they need to be high quality. And without, you know, without the quality aspect, it doesn’t matter what your charge somebody. If it’s low quality, I just don’t want to send a person there, to be pretty Frank. So we continue to be excited about all the legislation that’s coming out around price transparency. We believe that quality should definitely be a part of that in the self-funded space to allow folks to really understand the quality metrics of what’s happening. And then ultimately, as we go forward, as well, we believe that more things should fit underneath bundled payments as a part of the Value Based Payment strategy that our government is trying to put in place, but isn’t being frankly, adapted to very well by the major insurance industry players.

Curt Kubiak: Well, again, as you said it right that the history has kind of set itself up to be successful for the incumbents, which makes good sense. But when we think about the way that we buy healthcare, it’s so vastly different than any other service that we buy, right? Whether it is a roof repair, or buying an automobile, or any major purchase, we know what the cost is going to be in advance. There are financing mechanisms for these things that we can adhere to. We know that if we’re paying a little bit more, that we’re probably getting better quality. And all of these things are questions in the health care space that we have to help folks decipher. Because it’s interesting that the highest quality provider potentially could be among the most cost-effective, in other words, may not be the highest cost.

Terry Rowinski: Very true, Very true. And we see that time and time again, actually. We see that both in our partnership with you, and as we just use the vast amount of data that we’re that we’re having within our organization about medical claims that are taking place and reoccurrence rates and readmission rates and things as well. So ultimately, you know, if you follow the bouncing ball, if you have quality and a good cost differential, you will see those providers become even stronger participants in the market that will then drive more innovative solutions for our consumers, that should be acting like a consumer, not just a patient. People should have information available to them to understand these things and to be able to shop for a service just like you do to buy a car. You used the analogy perfectly.

Curt Kubiak: So I think the data is going to get better. We’re going to see we’re going to see more data, it’s going to be complete data, it’s going to become more transparent. So it’ll be on the cost side as well as on the quality side of things. And again, through our partnership. I know that we talked about this regularly, how is it that we can you know, be better stewards of that data? We’re using that data for decision making so that we can make it a little bit easier for the consumer, whether that’s an employer or their employees? You know, in creating a benefit plan design and deciding how it is their employees are going to get educated about how they buy health care and ultimately how those transactions take place.

Terry Rowinski: You hit on a really crucial part. You know, the consumer of health care really is both the traditional employee and their family. But it’s also the employer as well and when I started, you know, in this organization, you know, six plus years ago, you know, a little bit wet behind the ears from a health care perspective, I saw way too many employer groups that weren’t acting like health care was really a fiduciary responsibility of theirs. As I talked to CEOs or CFOs, or CXOs of organizations, many didn’t even understand that it was one of their top five expenses. They always thought, oh, you know, shipping and that, you know, materials and of course, wages. But they didn’t take into account the cost of their employee benefit program, it was really impacting and what they could do if they tweaked it to make it different. When you have self-funding, you know, clients and you have great employee benefit consultants go out in the marketplace that believe in working with the data, you can create such a differential in your benefit plan that you can actually save substantial money over time while giving better services to the people that you care about. And that’s your employees and their families. And if you could do that, who wouldn’t want to shout that from the mountain tops that success that’s going on?

Curt Kubiak: Yeah, it’s a competitive market route for wages and labor right now isn’t?

Terry Rowinski: Oh, my goodness, just on the way up here from Milwaukee, I mean, you know, $15 an hour $18 an hour 20 plus dollars an hour starting wages, it is just incredible. I’ve never seen this in my my career lifetime, for sure. And ultimately, it’s going to be one of those things that differentiate your, your, your team, your company and your value to your employees and their families. And healthcare should be one of those things, not just the wage.

Curt Kubiak: For sure, yeah, we get better benefits. But then also, we can make them cost competitive, maybe we can fund some of those higher wages with some of the health care cost savings that we generate, using some of the strategies that we’ve talked about today.

Terry Rowinski: Yeah, very much So. And if we see when programs, you know, as we’ve partnered with you at NOVO Health and our employer groups, some of the employer groups are even willing to cost, you know, share back to the employee, you know, reward the employee for making great healthcare decisions, for taking care of themselves, and for making very cost effective, high-quality health care decisions that benefit everybody. And that’s just an amazing thing to see that happen to see some of those success stories and have some of those people be testimonials for both of us.

Curt Kubiak: Yeah, people are motivated by cash. You and me Both. So if we can, you know, add to their paycheck, you know, a sum of money, whether that be you know, $50, $250 up to 2000 In some cases, those are significant dollars added to somebody’s wage. And, again, make you pause and make sure that you’re, as you say, being good consumer of

Terry Rowinski: Right, right, very much so.

Curt Kubiak: Well, we’ve covered a lot of great ground today, Terry, I want to thank you so much for joining me on today’s show, and for sharing all of your knowledge. I mean, you’ve got a vast knowledge of information that you’ve collected over the course of time. And if people have questions and want to get ahold of you and have conversations, they can reach you on your website, or how should they get a hold of you?

Terry Rowinski: So my email is just simply Terry@hps.md. I’m on LinkedIn. Luckily, the only Terry Rowinski that’s out there so far. Or by all means call in to our main number, which you’ll find off our website as well.

Curt Kubiak: Excellent. Terry, thank you so much for being on the show. I appreciate it. And as always, you can get a hold of us via our website, social media, and we’re looking forward to having the next conversation with you with our next guest sometime soon. Until then, let’s keep the conversation going.