Matthew Dale of Point Health: “User experience data is easy information to find for most consumer-facing businesses”

June 29, 2021
Thrive Global

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Originally published here: https://thriveglobal.com/stories/2279066/

As a part of my interview series with leaders in healthcare, I had the pleasure to interview Matt Dale, CEO of Point Health

As CEO of Point Health and The Karis Group, Matt has directly impacted the lives of millions of patients seeking the best possible care at fair and affordable prices.

Matt began his career in 2000 when he joined The Karis Group as a patient advocate. For nearly a decade, he helped patients negotiate their medical bills before leaving to found a series of successful startups that he grew and then navigated to successful acquisitions.

His ultimate mission, making accessible and quality healthcare a human right for all, led him to found Point Health, which acquired The Karis Group in early 2021. Matt is now leading Point Health’s efforts to build a Smart Healthcare Platform to make healthcare easy to find, easy to understand, and easier to afford.

Thank you so much for doing this with us! Can you tell us a story about what brought you to this specific career path?

I started my journey to CEO as an unpaid patient advocate just as I was finishing my undergraduate degree in criminal justice.

My father asked me to come on board for a year with no pay to assist his healthcare company, The Karis Group, with patient advocacy and bill negotiation. In 2010, I left Karis and, during this time, founded several companies in the consumer goods space.

In 2020, I founded Point Health which ultimately acquired The Karis Group. I realized Karis had completely missed the opportunity to digitize and weren’t harnessing the power of mobile apps and smartphones. My goal was to modernize the company and make healthcare easy to find and shop for, just as consumers shop for anything else online.

I recently wrote a blog post, “From Unpaid Advocate to CEO” that chronicles my journey in more detail, which you can read here: https://www.pointhealth.com/post/from-unpaid-advocate-to-ceo.

Can you share the most interesting story that happened to you since you began leading your company?

I took over Point Health just as the company acquired The Karis Group. This was in the early days of the COVID-19 pandemic and it was an unusual time to deal with a pandemic and assume a new leadership role all while integrating two companies. It’s been interesting learning how to run an organization completely virtually and making sweeping changes inside of an organization during a pandemic.

We also have been hiring lots of new team members. Most of our employees have never met in person because they started in an environment in which they work remotely. However, it’s really important, even if you can’t meet in-person, to try and develop relationships. To do that, we’ve stressed the importance of having one-on-ones. I have one-on-ones with each of my direct reports at least once a week and I encourage my direct reports to do the same. These sessions are important at any time, but they’ve become even more important when we’re socially isolated from each other.

Can you share a story about the funniest mistake you made when you were first starting? Can you tell us what lesson you learned from that?

I’ve made a few mistakes, one story goes back to when I was a patient advocate with The Karis Group. Levi Smith, who was the CEO at the time, asked if he could borrow my wakeboarding boat to take clients out to eat at a local restaurant on Lake Austin. I got a call from Levi at about 10:00 p.m. that night saying they had run my boat onto dry land! He asked if I could borrow another boat to rescue them. Unfortunately, the accident did a couple of thousand dollars worth of damage to my boat and thankfully, Levi generously covered it. The lesson learned was don’t let a person with limited boating experience take your boat out at night in a treacherous waterway!

What do you think makes your company stand out? Can you share a story?

Point Health, in addition to The Karis Group, has helped so many people financially and emotionally. One case that we worked on recently involved a man who needed rotator cuff surgery. He was part of a limited benefit medical plan that, no matter the cost of the surgery, would only cover 3,000 dollars of the procedure. The hospital said that the procedure would cost 68,000 dollars and he would be stuck paying 65,000 dollars.

When he reached out to us, we made a few calls and found out if he went into the hospital and said he was a self-pay patient, he could have the rotator cuff surgery for 35,000 dollars. Or if he traveled an hour to have it done at a surgery center in the next town, he could get the procedure down to 10,000 dollars, of which his insurance company would still pay three. We were able to get his out-of-pocket costs down for him from 65,000 dollars to about 7,000 dollars. Anytime you can negotiate finances that big, you’re saving a person from a huge amount of financial stress and hardship.

This story is one example of the rising healthcare costs and the huge economic toll they can take on families. In fact, two out of every three bankruptcies (66.5%) in this country are related to a medical incident — either because of high costs for care or time missed from work. (Source: American Journal of Public Health) This goes to show how quickly the out-of-pocket costs can go up for someone, even with insurance, if they don’t know how to navigate the system. This is where Point Health really stands out.

What advice would you give to other healthcare leaders to help their team to thrive?

In healthcare, there’s a pretty clear dividing line between the clinical and the financial sides of the business. If you’re on the clinical side and a healthcare provider, you’re helping patients and it’s really clear what your north star is. When you’re on the financial side, it’s not always as clear. Either way, no matter what you do, you’ve got to put the patient first.

You must understand that most of the time you’re intersecting with people when they’re going through a major struggle. If you can do that, not only are you going to build a big business, or a successful business, but also you’re going to build an organization that your team wants to be part of. People go into healthcare, or study healthcare management, for the same reasons that people become doctors and nurses. It’s because they want to help people. You want to empower and encourage and have business practices where you’re patient-focused.

Ok, thank you for that. Let’s jump to the main focus of our interview. According to this study cited by Newsweek, the US healthcare system is ranked as the worst among high-income nations. This seems shocking. Can you share with us 3–5 reasons why you think the US is ranked so poorly?

Probably part of the reason it’s ranked so poorly is that we are one of the few countries where you have this extremely vocal press that criticizes the healthcare system. The reality is that the healthcare system in this country does an amazing job. When you look at the innovations that come out of the U.S.healthcare system, it’s truly remarkable.

Healthcare has also become political between the right and the left sides in this country. This is one of the reasons that it’s constantly being attacked, and the press has some extremely negative things to say about the healthcare system. The reality is that the U.S. healthcare system, while not perfect, has many more pros than cons.

However, those cons, the negatives, are real. If you’re uninsured in this country, you’re going to have a harder time getting medical care. That’s not a myth; that’s a statement of fact. Patients who are un- or under- insured are frequently left with large portions of medical bills that result in medical bankruptcies. Those issues cloud why people have a negative perception of the healthcare system. It is because they have a bad experience with the financial side, even though they’re probably getting a best-in-class experience with the clinical side.

The reality is that we have some of the best innovations and some of the best care in the world. The media more prominently presents the negatives, including pricing and access, but there are so many positives to it as well.

You are a “healthcare insider”. If you had the power to make a change, can you share 5 changes that need to be made to improve the overall US healthcare system? Please share a story or example for each.

People need to be able to make more informed choices as healthcare consumers in this country. If there’s one thing that everybody is great at, it’s shopping. To be informed shoppers, there are three things to understand — price, quality, and customer satisfaction, or what your user experience will be like. The medical system in this country lacks those things.

It’s hard to be an informed healthcare shopper for medical procedures because getting the cost of care is almost impossible. Unless you find a provider who is an active participant in the transparency movement, the cost of care is really hard to come by. On the quality side, there needs to be a way to accurately rate hospitals and physicians that are outcomes-based. These ratings need to be easy to understand for the average person.

User experience data is easy information to find for most consumer-facing businesses. Because there are so many companies that provide this information, all you have to do is go to Yelp or Google reviews to find reviews and information about the total experience (about parking, wait time, how friendly the staff is, etc.). This needs to be available for medical businesses, too.

At Point Health, we’re tackling the issue of healthcare price transparency. Our Smart Healthcare Platform allows patients to compare the cost of care from providers and make a choice about which provider to go to. We’re working on incorporating quality of care and customer experience metrics into our technology as well, so people will be able to shop for healthcare the same way that they shop for anything else. They’ll see what a visit or procedure costs, what the quality is, and how good their user experience will be, or how they should expect to be treated during the process.

Ok, it’s very nice to suggest changes, but what concrete steps would have to be done to actually manifest these changes? What can a) individuals, b) corporations, c) communities, and d) leaders do to help?

If corporations and healthcare leaders took concrete steps to streamline the efficiency of care, this would allow doctors and nurses to spend a lot more time with patients. So much of a doctor’s day is spent interacting with the tools and mechanisms that the financial side of healthcare needs in order to make sure the hospital’s able to bill for a procedure. The clinicians likely spend more of their day working on these things than they do on actually providing medical care.

If we fix some of the things on the financial side, we would likely see an increase in quality. There are studies that show what happens when physicians spend more time with patients and how that can lead to improved outcomes.

I’m interested in the interplay between the general healthcare system and the mental health system. Right now, we have two parallel tracks, mental/behavioral health, and general health. What are your thoughts about this status quo? What would you suggest to improve this?

I have a lot of thoughts about the mental health system. People that are struggling financially have a more difficult time interacting with any part of the healthcare system. You have a high correlation between mental health and financial problems intersecting with the medical world.

The more serious the mental illnesses, the harder it is for someone to have a job, and the less likely it is that they are going to have insurance. We need to put additional resources into mental health facilities to serve the homeless population and groups like that. There should not be such a dividing line between mental health and physical health. One of the things that I’m a big fan of is functional medicine. Functional medicine is when a physician takes a look at all aspects of a patient’s health.

They don’t view things as these separate systems — such that a cardiologist only takes care of your heart, and your neurologist only evaluates how your brain works, or that your gastroenterologist manages disease of your intestinal system. These are all the same ecosystem. That fact is, surprisingly, lost by the specialization of medical care. Many times there’s an intersection between these different systems and health issues can be fixed if you take a more holistic approach to patient care.

How would you define an “excellent healthcare provider”?

I go back to the three things you need to make an informed healthcare decision. An excellent healthcare provider is going to have an affordable cost, good quality, and successful outcomes, along with providing a positive patient experience.

Going to see a doctor or having surgery is not on the list of things that you necessarily want to do. If you have an informed choice, there are clearly some places that do a better job.

We’ve all had experiences in the medical system where we interact with a doctor and walk away feeling that the doctor really took time to ask questions and understand us. They were empathetic and listened and we agreed on a course of treatment.

At other times, we felt rushed through an inefficient assembly line. You get there, wait for 45 minutes in one room. Then you get shuffled to the next room where you wait for another 45 minutes to see a nurse for two minutes, they check your vitals. Then you wait another 30 minutes. Finally, you see the doctor for five minutes and you’ve got a total of seven minutes of care, but it took two hours of waiting to get it. What if we could flip that around? Let’s get five minutes of waiting with an hour of care.

Can you please give us your favorite “Life Lesson Quote”? Can you share how that was relevant to you in your life?

“I think it’s possible for ordinary people to choose to be extraordinary.” Elon Musk.

People should never feel limited in what they can accomplish. This is something I’ve taken to heart as I approach any task. I can always choose to be extraordinary with whatever I am working on, no matter how trivial of a task it may be. I try to encourage others on my team to choose to be extraordinary as well.

Are you working on any exciting new projects now? How do you think that will help people?

The big project that Point Health has been working on is creating that shoppable healthcare experience. We’re looking at massive amounts of data from multiple sources to provide recommendations to patients and caregivers. We want people to have options — what practice, clinic, or office they want to go to, where they will get great quality and cost of care and where they will have a good experience with the provider. Our goal is that people will shop for medical care with the same confidence that they make other major purchases in their life.

What are your favorite books, podcasts, or resources that inspire you to be a better healthcare leader? Can you explain why you like them?

There are a couple of podcasts I listen to fairly regularly, most are business-related. One is called Daily Jo, which is a guy named John Oberg and he talks a lot about business and healthcare and life.

Another one is The Jeff Nippard Podcast. This is a guy who is a fitness guy, but one of the reasons why I like his podcast is because he doesn’t editorialize the content. There’s so much health advice out there where you’re dealing with anecdotal evidence. However, Jeff is always going into scientific studies, their key points, and how to interpret them.

He discusses chronic conditions and the link between these conditions and lifestyle. If you want to understand the causes of some of the most common things, whether it’s cancer, heart disease, diabetes, high blood pressure, etc., he goes on a deep dive there. He talks about the underlying causes and the steps that you can take to prevent these issues.

You are a person of great influence. If you could inspire a movement that would bring the most amount of good to the most amount of people, what would that be? You never know what your idea can trigger. 🙂

The vast majority of us that live in the western world won the cosmic lottery. We’re born into a country with tremendous freedom, prosperity, and economic opportunity. It’s really important to try to find an opportunity to help those that didn’t win that lottery based on where they were born or the circumstances that they were born into.

Many organizations and individuals are giving back. Similar to what Bill and Melinda Gates or Warren Buffet have done with their giving. We see movements in social corporate responsibility, where corporations are donating a percentage of their revenue to charities. It’s a really important principle to live your life by, whether it’s because you’re religious, or you believe in karma, that there’s something about blessing others that are less fortunate.

As a company, Point Health is very involved in trying to bless others. We take a percentage of our revenue and donate that to charities and nonprofits. We also provide matching time for employees, while on the company time, to volunteer. In the past, The Karis Group would actually take employees who opted in on a trip where they went to some other part of the world to either help build affordable housing or provide clean water. It’s in our DNA as a company to try to actively take steps to try to help and bless others.

I’m also a huge believer in helping develop people into the best version of themselves. Whether that’s nurturing leaders inside Point Health or investing time and resources to help our employees succeed in life and achieve their goals or objectives. We try to take care of the whole person. You can encourage someone to join a gym or get a trainer, but you also want to provide resources for them to do that. It’s the same on the mental health side. People are stressed out or anxious, and some of the time, they don’t have the resources, or even if they have the resources that they wouldn’t necessarily do it on their own. When we as an organization provide it, it’s because we want to take care of our people and that’s important to us.

How can our readers follow you online?

Matt’s website: www.matthewdale.com

Point Health website: www.pointhealth.com

Matt’s LinkedIn: https://www.linkedin.com/in/matthewdale1/

Matt’s Twitter: https://twitter.com/MattDaleATX

Thank you so much for these insights! This was so inspiring!

Download How to Leverage Ambulatory Surgical Centers for Lower Costs and Higher Satisfaction

Discover how TPAs, health cost sharing groups, and limited benefit medical plans can benefit from the use of ASCs.

Is Your Health Plan a Tech Whiz or a Dinosaur?

Take the quiz to find out!
TAKE THE SURVEY

Download the Patient Advocacy 2.0 White Paper

Discover what health plan members had to say about the value of patient advocacy in our survey.

Download the Complete Guide to Retaining Health Plan Members.

Learn the best strategies and tips for retaining your members while keeping costs low.

Download the Complete Guide to Growing Your Health Plan Membership

Learn the best strategies and tips for growing your members while keeping costs low.

Download the Complete Guide to Lowering Member Costs

Discover what health plan members had to say about the value of patient advocacy in our survey.

Download Healthcare Consumerism 101: A Playbook for Health Plans

Learn the best strategies and tips for retaining your members while keeping costs low.

Download Your Guide to the Transparency in Coverage Rule

Discover how the the new rule will affect TPAs and health plans and how you can start your journey to compliance.

Download Your Guide to Unique Benefit Offerings that Don't Break the Bank

Discover how to add value to your health offerings that delight clients and members but don’t cost a fortune.

Download the Complete Sedera Case Study

Discover what health plan members had to say about the value of patient advocacy in our survey.

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