HIStalk Interviews Bird Blitch, CEO, Patientco

Bird Blitch is CEO of Patientco of Atlanta, GA.

Tell me about yourself and the company.

My background is in the payment space. I started a company that had a lot of focus on that. From a healthcare perspective, it was the situation where my wife delivered our first baby girl. You get home from the hospital and everything’s great until a couple of weeks later and all sorts of crazy bills start showing up. I turned to my wife and just felt like there’s got to be a better way. That was how we got started down the road at Patientco.

It also helped out that we were in Atlanta, the headquarters of healthcare IT and payments. Eighty percent of all the payments in the world are routed through Atlanta with all the big companies that do that – TSYS, Global Payments, Elavon, WorldPay, and so forth. Then of course with healthcare IT, there’s a lot of great companies in the state of Georgia. It was a really good place for us to get a lot of wind behind our sails and push off on Patientco.

The last touch patients get from a hospital is the bill. Are you getting calls from people who are realizing that the nature of sending out a bill can spoil the relationship that the clinical side has so carefully developed?

Yes. I’ve really been interested in how you’ve been following that subject. That engagement or patient engagement is a big industry buzzword. We feel strongly that we’re leaving out a real vital part of that conversation, which is the financial portion of the patient engagement, which does happen when that patient leaves the hospital.

I think the real-world example is you have a great stay at a fantastic hotel. You have great food, great amenities. You check out. The bill is lots of different bills. It’s the wrong bill. You can’t understand it. It’s hard to ask questions. They haven’t even thought about how you’ll pay for it. If you left that hotel, you probably wouldn’t feel too comfortable about returning and telling people to go there. We feel like patient satisfaction is a big key in this whole part.

Do you think there’s a lot of interest from patients and providers for managing medical bills online?

I really do. When you think about it, there’s a huge problem out there right now. The fastest-growing payer is the patient. If you’re a provider, you’ve got to wake up to the fact that times are changing real fast and there needs to be a different way to manage this whole billing process. We have a cloud-based technology platform to bill patients and the key is in the consumer-friendly way. Patients have a way to uniquely pay providers in a consumer-friendly way. 

I would certainly argue that patients have a big say in this, too. I think I saw recently that is that patient is five times more likely to refer a friend to the hospital if their billing experience is a pleasant one. That relates to the total value of a patient to the hospital.

You tweeted an article recently about the Consumer Reports gripe-o-meter of healthcare complaints. One of the top problems was the patient’s dissatisfaction with the billing process. I think it’s really important. People talk about Meaningful Use, people talk about ICD-10, but there’s a big focus coming back to the revenue cycle. Our key focus is to put the spotlight on the patient. We like to talk about that in terms of patient revenue cycle.

In terms of selective marketing, it would seem that the patient revenue cycle is doubly important because if the patient is the one who has to write that check, then they are more financially desirable patients.

That’s right. Customer loyalty is really important to think about in a consumer space. That’s what we’re dealing with.

Patients are consumers. If you’re a Hilton Honors program member, they treat you differently when you check in if you’re a really good customer. I think it’s important to treat good patients in a really special way that we don’t today. We just send them a bill and hope that they pay. We do that for all patients across the entire spectrum. Why can’t patients be treated differently, especially in ways that would help them understand more and help them pay faster? That’s a real big benefit that we think we can bring to the marketplace.

The other side of that is hospitals really only have one way to deal with this problem today. A lot of times, they might outsource it to an EBO or an agency. That’s great, but sometimes they spend a lot of money to do that and they don’t get great results. It’s one of those things where patients don’t like it. I’d argue in the long term it’s not good for providers either. We just try to get people to think differently about that. 

That also goes to how you pay your vendors — pay your vendors differently. One tactic there is just to stop paying billers for percentage of what the patient pays. It’s your money to start with, so whatever the contingency you pay the agency, it’s probably too much, period.

Patients have always thought of themselves as consumers, but I’m not sure that hospitals have seen themselves as businesses that have competition and that need to cultivate them as customers. Do you think hospitals are going to be able to change their mindset to be directly accountable to the patient?

One of our goals is if you treat people right, they’ll treat you right. That’s how we run Patientco, that’s how we want healthcare to be. People treat patients right on the clinical side. You’ve got to change and think differently.

Our biggest competition is often the status quo and providers who aren’t daring enough to make a change for the better. Times are changing in healthcare. It’s important we educate people about the fiduciary responsibility they have and they can play in making this equation healthy again with patients. The tough thing is, how do you treat patients differently? We try to share to our business intelligence engine ways that patients respond differently across the IDN. If a patient’s done one thing to pay a bill differently, then we think we can share that experience.

Let’s say on a cardiology bill, we send out two e-bills with a ten per cent discount and another bill with a healthy heart recipe on it. If that makes you want to pay faster, then don’t you think that something that the hospital that owns that cardiology group would want to know?

You offer patients a secure messaging feature to interact about their bills or to clarify. Do patients use that a lot?

Yes, they do. It’s interesting because it’s hard to ask questions about your health, especially in a public place. When people are on the Internet, perhaps at work, you’d be surprised at the payments we see coming through from people around lunch hours. When they’re on lunch break working at their desk, they don’t feel comfortable about asking someone about their endocrinology bill. But through Patientco, there is that secure messaging that allows people to access questions and get answers quicker, so they feel more comfortable on what they’re being asked to pay for.

How do physicians fit in the mix?

Physicians bill patients also. If you think about the problems in healthcare, you’re going to go to a hospital. You’re going to get a hospital bill and four or five or six different physician bills. A lot of times those bills come out of different practice management system than the bills that come out of the HIS system. 

It’s important because physicians have really strong personal relationships with the patients. Patients often want to pay those physicians first before they do the hospitals. The unique thing is if you group all these bills together in one place, then a rising tide really does lifts all boats and people pay faster. The other side of that is physicians’ bills are often just as complicated and the goal here is simplicity for everyone.

Are patients are more likely to pay like a solo physician in practice instead of a faceless entity such as a large group practice or hospital to which they don’t have much allegiance?

Yes. We see that case a lot. From the hospital’s perspective, if they can be grouped together with the physicians’ bills then, there’s a 36 per cent chance that when you pay a physician bill and  the hospital bill is there for you to see through Patienco, you’ll pay that bill as well, just from a simplicity’s sake. Think about it. Why are all the different car dealers on the same side of the town? They are because it’s easier for people to make decisions around buying a car. It’s the same thing here. Where you have simplicity and everything in one place, it’s better for the patient.

What would people be surprised to learn about how patients pay bills or how they interact with people doing billing on their behalf?

We focus just as much on the providers as the patients. I’ll throw that out just to say that we look at it from both sides. 

I just talked to one of our CFOs in one of our hospitals in Iowa. He said that one out of every three members of that community pays their medical bill through automation with Patienco and he just thinks that it’s interesting when it’s all together. When you have the ability for patients to pay 24/7 in a variety of different ways and you make it easier for them to not just understand but schedule payments and whether it’s paper or electronic and you make that dynamic, then you’re going to have a lot of different types of results. We measure those results and report on all those to our providers.

What’s the status of healthcare IT and startups in Georgia?

This is a great place to start a company. There’s a lot of resources around here and of course there’s a lot of healthcare IT. You’ve got McKesson Technologies that is headquartered here. You’ve got Greenway. You’ve got athenahealth that is moving a lot of their resources down from Boston. They’ve all chosen to be here because there’s a strong employee base here of people who are knowledgeable. 

Also, it’s more affordable to live in Atlanta. It’s got a lot of the big city amenities. You see companies even like Streamline Health that moved down from Cincinnati. They all come here because you can hire great people and it’s a good city to be living in.

Any final thoughts?

We think that there’s a lot of needed change in the industry, so we want to go toe-to-toe with the incumbents. Change is good. I think if we can make patients happy and providers happy, those are the two entities that usually when one wins the other loses in today’s environment of revenue cycle. Now we have a great challenge and opportunity in front of us that we can make them winners, and what’s good for the patient is also good for the provider. 

Outside of that, it’s just all about easing healthcare’s transition towards a real patient-focused, consumer-focused transition to understanding healthcare and adding vendors that really towards having good responsibility towards the providers.