Q&A with Health Payment Systems CEO Jay Fulkerson

Health Payment Systems (HPS) helps consumers understand and pay their bills. In this interview, HPS CEO Jay Fulkerson answered my questions about the origins of the company and what they are trying to achieve.

What challenges are you trying to address?

As a technology company, we look for ways to close existing gaps or delays by streamlining the healthcare payment and billing process and connecting its various components. The current payment system is convoluted, confusing and wasteful. We need to rethink it from the ground up if we’re serious about doing the very best for healthcare consumers. We hope to bring an increased understanding of the process and simplification for the patients and providers, as well as empowerment for consumers.  Data shows patient satisfaction with their provider decreases 10 percent from the time of discharge to after receipt of the bill. We’d like to see that turn around—where the payment process is another opportunity to affirm the strength of that provider’s brand and mission

What is the Super EoB and why was it developed?

The Super EOB was developed after one of HPS’ founders, James Brindley, underwent treatment for cancer and saw the bills begin to mount.  After a full recovery, Jim gathered his stack of paperwork, met with his neighbor who was in the healthcare field and said, “There’s got to be a better way to make sense of all of this.” After two years of research and planning, they incorporated Health Payment Systems. Sometimes patients need to simply focus on getting well, and the overwhelming medical bills and EOBs do not help.

The Super EOB benefits three entities:

  • Providers receive a single electronic payment from HPS for both the benefit plan and patient portions of a bill
  • Employers save money because HPS passes along savings it secures from providers
  • Families receive one monthly statement, the Super EOB, which includes healthcare services from all HPS providers, for all family members.

It’s really a win-win-win for all involved.

What kind of feedback are you getting from patients?

We know that patients can easily understand what they owe, where to submit payment and by what due date. A process like this saves time, trees and money, plus patients understand it better and don’t have as many questions for employers.

In a recent focus group, we asked employees of a local county government what they thought about the advances in claims technology and the ability to receive something like a Super EOB. Participants liked that information for all family members was on the same page, and that they could make one payment for everything on the statement

Who are your customers? What is your business model?

Our customers range from small employers to large, self-funded companies.  We have a large portion of municipalities and school districts, as well as healthcare providers. As a healthcare technology company, our business model is aimed at taking waste out of the claims administration process, while making the healthcare payment experience easier for consumers to understand. Our provider network includes more than 6,500 healthcare practitioners in Wisconsin. We enroll more than 75,000 patient members and have 40 employees.

What impact is ACA implementation having?

The ACA was created to provide affordable healthcare to everyone. In order to do so, steps need to be taken to make healthcare more affordable.  Removing waste from the payment of health care services is our primary business, and is one factor that will help make healthcare more affordable.  There is no better time for employers to embrace the single payment technology offered by HPS.

Why did you develop the YouTube video? What do people think of it?

To tell our story better, we put together a short, animated YouTube video that demonstrates just how much paper the average family receives related to healthcare billing.

It’s a fun, easy-to-understand explanation of the current state of healthcare paperwork from the patient’s perspective. HPS actually has a stack of EOBs and bills that we counted to get to the numbers mentioned in the video. We have some pretty fascinating data that I’m not sure anyone else on the claims or provider side has researched before.

The response to the video has been positive.  It has helped HPS tell our story, as well as allowed our employees to share with their family and friends to help them understand what they do at work.

What’s next?  How else are you hoping to improve patient experience?

We have been out starting the conversation—meeting with providers and employers to see what their changing needs are and how we can help address them.  We need to shift our idea of competition in order to work together toward better value for patients and communities. That said, we would love to partner with a local provider about launching a Payment Value Stream. It would allow us to examine each step in the current process to see where we can remove waste and create value. From a lean perspective, this is an area of care not many people have looked at, and we think it’ll give us great insights. We continue to work at incorporating the voice of the customer and transparent performance data into our approach.  Finally, we are working on a consolidated billing product, will soon be rolling out a more robust patient portal and are looking at additional ways to empower consumers.


Bio: Jay Fulkerson joined Health Payment Systems (HPS) in 2011 and serves as the president and CEO of HPS. Previous to his role at HPS, Fulkerson served as chief executive officer of Touchpoint Health Plan in northeast Wisconsin. Following the acquisition of Touchpoint by United Healthcare, he served as chief executive officer for Wisconsin and then as regional chief executive officer for United Healthcare’s Midwest Region.

Interview conducted by David E. Williams of the Health Business Group.


April 30, 2013

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