HPS/PayMedix expect TempoPay acquisition will help more afford care

HPS/PayMedix expect TempoPay acquisition will help more afford care

Milwaukee-based Health Payment Systems/PayMedix expect their acquisition of TempoPay to help more patients get the care they need.

HPS offers an independent network of more than 100 hospital facilities and 29,200 providers. PayMedix, which began as its financing arm, processes and guarantees medical payments for providers, while helping patients finance care with simplified monthly statements.

TempoPay offers interest-free financing via VISA cards. Companies can overlay the offering with current plans to help employees cover medical, pharmacy, dental, vision and other care.

HPS/PayMedix President Brian Marsella said providing upfront credit can improve healthcare access, preventing higher costs that could result from patients becoming sicker because they’re avoiding care.

“They get it when they need it, not when they think they can afford it,” he told Wisconsin Health News.

HPS/PayMedix have grown in recent years. Marsella said they expect more than $30 million in revenue next year, up from $11.8 million in 2021. They anticipate having 70-plus employees, up from the 50 or so they had back in 2021.

He anticipates their ability to serve Wisconsinites to “expand dramatically.”

“We’re still a small piece of the puzzle,” he said. “We’ve got an awful lot more opportunity here.”

Edited excerpts from the interview are below.

WHN: Why did you pursue your partnership with TempoPay?

Marsella: This is really a play to make it very easy for people to get care. Forty-three percent of Americans are avoiding or delaying needed care because they’re afraid they can’t afford it. That’s because 49 percent of Americans can’t afford a surprise $400 bill.

We’re doing a really good job of helping people. Anybody that’s on our plan gets full credit, without us ever looking at their credit history, up to whatever the out-of-pocket maximum is on the medical side. And then they can pay us back over time at zero percent interest. We still believe this is a great solution, and we’re having conversations across the country with different networks … But it’s complicated. We have to align with the providers, the administrator of whoever’s paying the claims and then the employers to be able to drive that solution.

We learned about TempoPay through some discussions we’re having in the market. Their solution is primarily driven at the employer level, so it can be dispersed nationwide right away … What we do is we work with the employer to set a limit of dollars that we would do zero percent interest financing on, and then everybody in their population gets credit up to that limit to use to pay for these claims. So again, we’re trying to solve the same issue and get people to actually go get care and not see financial barriers.

WHN: How does this complement your offerings?

Marsella: We believe we’ll be able to begin to sell this to significantly more members and more employers than we had before. For our folks in Wisconsin, where they’re getting full credit from us on the medical side, this can also be added to get people credit for pharmacy, dental claims, vision claims, maybe even for vet care …

In the dental world, for example, usually, preventive care is paid 100 percent, but any major restorative care might be paid at 50 percent. For some people to get a crown, it might cost them $400 or $500. They may not be getting that, which is deteriorating their health. But they could come in and use our card to pay for that, and then they’d have 12 months to pay that back with zero interest.

Vision plans that are out there today, oftentimes, cover your vision exam, and they might cover a portion of your lenses or your frames. But, usually, it’s an additional amount of cost out of your pocket. You could use it for that.

We think we have an additional solution for our employers that expands the number of coverages that you get zero interest on. It also could be put over anybody else. The client doesn’t have to be with us. They could be with other network solutions or other insurance carriers in the market.

WHN: A few years ago, PayMedix, which provides prompt payments to providers and repayment plans to patients, became available to networks beyond the one HPS offers. What’s been the uptake?

Marsella: That has been, in all honesty, a little bit slower than we had hoped. We are going to be launching Jan. 1 in about three different new locations. We also have availability in Wisconsin over some additional providers who don’t have us. And then we have a lot in the hopper for 2025. We have all kinds of different groups that are seeing the advantage of how our PayMedix solution helps the provider, the member and the employer. We’re hoping to significantly ramp up our sales in that area.

WHN: What’s next?

Marsella: More employers are having to increase their deductibles and out-of-pockets because they’re getting large increases from the insurance carriers, and they’re having to pass some of that on to employees. The need from the employer perspective is growing. More and more hospitals, because of that issue, are starting to request cash up front to even get services … The amount of people that will need access to our types of solutions is increasing dramatically.

But there are also adjacent components. There are a lot of new entries into the market that are saying, ‘If we can steer you to certain providers that might be higher quality, lower cost, we’d like to steer you through zero pay for you to go there.’ There are a number of employers that are willing to do that right away, but there are a number of employers that are saying, ‘No, we’re not willing to do that.’ If we could come in with some financing to allow them to get to a good spot, we could help with that solution. We’re talking to a lot of groups that are direct primary care groups that are looking for a way to make sure they don’t have to become a collection agency and with different network entities that are trying to build out their partnerships with providers and want to do it so providers don’t have to be involved in payment structure there either. There’s a lot of different ways that we can get engaged in the system

This article first appeared in the Wisconsin Health News daily email newsletter. Sign up for your free trial here.

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