A Vision for Accessible Healthcare: Joel Tompkins

<p>hello everyone this is Cole from the American Journal of healthc care strategy I'm joined by a very special guest with a really interesting career uh Joel and Joel can you please introduce yourself and your role sure uh thanks Cole Joel Tomkins and I am the CEO of lassy Health [Music] it's so great to have you on you you have a really interesting career you've had a very fast kind of Rise I guess fast not necessarily in terms of without hard work you've done a tremendous amount of hard work but it is impressive the amount of transitions you've made just looking at your resume because you started as uh a nurse right and then a nurse anesis and then kind of gotten all the way up but how did you start off exactly what got you into the healthare field what got you into patient care to begin with sure now um yeah absolutely it started my career as a uh nurse um and from a almost a familial history so my mom and dad are both actually nurses so I knew about the nursing profession uh albeit my dad actually transitioned into a business role in the Interventional Cardiology space uh but when I was you know finishing up high school and trying to figure out what what I was going to do with my life um I realized that you know going to college for me wasn't about getting a degree and then trying to figure out you know what I was going to do I actually wanted a degree that you know gave me some purpose and uh nursing certainly fit that role uh but I also knew that it opened up um an amazing amount of opportunities to do pretty much anything and everything and that's the best part about I think being a nurse is it's a foundational degree uh that allows to provide patient care but then after that uh you could do a myriad of other things uh and about three years into my nursing career uh which at the time I was working I worked in intensive care unit coronary care unit and then actually a cardiac cath lab um I decided to transition and go back to school to become a nurse nesus and that was actually really from a friend of mine who called me and said what are you doing and I said I'm just working he said you should go to anastesia school and I said okay that's pretty good so uh I ended up taking The Graduate record exam and uh then a couple weeks later moved to Pittsburgh so where I attended uh in school at the University of Pittsburgh um had great training there and um and then up actually meeting my wife at the University of Pittsburgh and uh then moved to sagon Michigan and our oldest son was actually born there we ended up moving back to Northeastern Ohio my was from Pittsburgh where um kind of led me to you know my next um iteration of of my career I ended up starting in anesia group with a friend of mine and fast forward a few years where we were kind of growing that group uh but we were also doing you know all of the work so we were working you know 80 hours a week in the operating room and we were doing payroll and billing and all the other Associated things with having kind of a small business and in 2010 we ended up um uh one of the hospitals that we were covering actually had multiple anoc groups covering it and a group out of Texas ended up bidding on that hospital and kind of winning the whole entire you know bid and that company's called nurer anesthesia time I met the two principles that started the company uh and they said gosh hey we'd love some help with this hospital that we you know we just won in Ohio where we have no business and we really don't know the market we don't what the compensation should be and we have no providers I think 17 crnas in about 90 days so my partner and I'm help them uh transition that facility and at the same time we were still getting you know opportunities you know put forth to us in our own group to be able to grow our business and we made a conscious decision to to Pivot because we were at an inflection point where we either either we're going to put uh a lot of money into the company to be able to grow it standpoint of working capital um and at the time we said you know what let's just help try to bring some of this business start so came a employee of north at that time and from 2010 to 2013 really kind of grew the business in the midwest in Ohio Pennsylvania uh Illinois parts of Michigan and then that led me to uh kind of 2013 we had a bit of a pivot uh because I was doing a lot of still in the operating run between 20 and 30 hours a week and also you know uh administratively kind of managing my own p&amp;l uh across the Midwest and uh we actually had a private Equity transaction in 2013 brought in our own or kind of our first probably professional CEO and had a conversation with him and said I need to kind of either go One path or the other I can't continue to do both so in 2013 I ped lied more to A administrative Ro responsibility where I was the general manager um of what we call the Midwest and I became VP of operations and then SVP of operations then Chief Operating Officer uh that led us all the way to about 2018 where we had another private Equity transaction and uh became the chief plan officer and then eventually the president of the company and that took me from about 2010 to uh uh late 2023 and then uh you know I had the wonderful opportunity to with a a group of other um Healthcare folks start Lassie hell uh and and that's how I got to to where I'm at it's pretty impressive right like this is not you know an easy thing to accomplish and and I guess what's really interesting to me is you went from you know clearly being an excellent clinician you know nurse nursing is challenge in right a CRNA school is challenging and being a CRNA is very challenging as well but then there's this business side of things like you mentioned you know your father had transitioned into a business role but how did you know how to do these business things right like I mean how would you know how to start your own uh you know group like these things seemed challenging in themselves it it was and uh it was um you know really on the job training uh for a lot of it to be honest with you you know kind of figure things out along the way and you make some mistakes and you learn from those mistakes and even you know post having you know my own group and transitioning in into my role at Northstar uh that was a lot of on the job training you know uh we were when I first started a uh what I would say is a large mom and pop anesthesia company that wanted to be you know a um Enterprise national you know company and I was put in uh I was glad to take the position of hey you know let's kind of figure some of this out along the way so it gave me great opportunity to be able to learn manage care Contracting and you know how to uh manage clients and how to look at Financial reports and manage other people um so it was it was a great on the- job training and I'll I'll be the first one to admit I made mistakes along the way but you know thankfully I also learned from those mistakes uh and you know you put all of those experiences kind of in your toolkit and now you have instead of one screwdriver a thousand screwdrivers to choose from you know as you're um as you're kind of navigating not only healthc care but you know business in general what you know so you could have just said after one of these mistakes I'm going to wrap up shop and just give back because you I mean you know crnas make a reasonable of money right and your wife is a CRNA as well correct yeah dual income you know you would not have been you know destitute there but you you kind of kept pushing through these mistakes and you kept advancing why did you choose to do that right what is some of the qualities that you developed or the experience that you had that had pushed you to continue yeah I think you know um perseverance is is something that um you know was kind of instilled Into Me by you know my parents my mom and dad all had been driven to succeed and you know the you know for me you know the goal line always kept moving I just kept either purposely or it was contined to be moved further away and while I would Advanced you know sometimes to the one yard line the next day I realized hey I'm really only at the 20 um and and I think you know that's both probably um an internal you know thing for me that you know I'm always trying to strive to be better and and at the end of the day um the other piece that I've you know always have been um a big proponent of from a from a mental standpoint is always continue to learn you know you have to continue to learn and if you get to a point in whatever your career is where you say geez I'm just not learning anything anymore then it's probably time to hang it up um so I've always you know been of the mindset of all right you accomplished that goal what's the next goal nope that makes a lot of sense and so it makes sense that you had achieved this presidency level right where you're kind of overseeing you know near the top of the organization and then you decide to go into ly Health but even though it makes sense right because you're starting this new challenge with a lot more potential for upside but also a lot more risk this was not long ago right 2023 uh so at this point you know you're a bit older than you were when you switched over uh and became CRNA so risks might be a little scarier to some people as they you know have have more responsibilities how were you able to take that risk right how did you decide to confidently go over and do this completely new thing because this is also a new area than what you had done before right you hadn't necessarily run a business like Lassie before no totally totally different obviously been in healthcare for you know going on pushing 30 years now but uh um you know think you know my family supported me making a change um and you know I have a 19-year-old a 17-year-old a 16y old so you know one in college and two in high school and you know trying to trying to make sure that I was still actively engaged in something that gave me purpose and um they supported me 100% And you know again I've I've um been blessed with being able to be a quick study on things uh and so as I started learning kind of this industry you know which obviously is healthcare related um but I had to do you know a lot of Deep dive into a lot of different you know pieces and parts of what this industry looks like and uh also you know was blessed with being able to surround myself with a group of people that are on the team at Lassie heal that have a vast uh array of experience in different pieces and parts of healthcare and business that you know you're only as good as the people that you surround yourself with and and hopefully they're better than you and I think a lot of them are so that that's it's been um no while challenging it's also been eye openening exciting too because I get to you know learn a whole slew of you know new new information no that's uh I appreciate that a lot because that's something I believe very much is that the people are like the most important thing and I love people who are smarter or faster or better than me in any way because it you know gives me something to learn from right can learn that's so important so what is last ealth right because you know we're familiar with your previous work a lot of people know what anesthesiology is they know what you know these practices are but Lassie health is kind of completely different right so how you know what is it exactly and then also why did you come to get involved with this you know what was the inspiration this episode of the strategy of Health was sponsored by modality Global advisers modality Global advisors optimizes Hospital Revenue enhances patient experience and delivers proven results visit modality Global advisors.com to learn more yeah yeah I I'll start at the inspiration so I've been a huge proponent of um transparency in healthc care and transparency in pricing um you know for a long time and that was you know it's difficult when you're in the anesia space because if you do your job really well people don't remember you and hopefully they're painfree and then when you work for a third party organization like an Outsourcing the CJ management company a patient you know an end user gets a bill call it 30 or 45 days later and it says Northstar anesthesia they don't really realize who that was they didn't know that Joel the CRNA you know worked for Northstar uh all they know is they you know had someone put them to sleep and they get confused you know in those situations so um you know if you if you kind of take that at a 40,000 foot View and you think about Healthcare and General Healthcare is the only industry where you know you don't walk into an electronic store and you see a bunch of TVs on the wall and you're shopping for a TV and you go I'm gonna take this 65 inch one there's no price on it but take it home with you and 90 days later you get a bill for $4,000 and you well number one it's a surprise and you know and it's the equivalent of you don't know that you had a $4,000 deductible uh because number one you the vast majority of people don't understand their traditional health insurance and number two if they had a procedure no one's telling them in advance of what the potential cost is in very few situations does it actually happen you know you can look at the Ambulatory Surgery Center space they they oftentimes will do a pretty good job of you know running a 270 271 transaction which looks at the eligibility of the end user and they know what their deductible is and they're going to try to give them you know kind of a good faith estimate on what those costs would be so you know when we started Lassie Health was truly to create a digital front door platform that's a membership plan uh that would assure the American public that they could have high quality access to transparently priced care um we are not out to replace traditional insurance we think and a lot of times we can be an adjunct to it um but when we created you know l e Health it was it's really to have a user experience then independent on who's behind that digital front door that we have our partners uh the end user has the same experience every time um and what it is it's transparent and uh access to care you know is Paramount uh I mean you know right now um you know about half of you know people in the United States that they are saying that they have a difficult time affording you know Health Care U and you know we're spending $4.7 trillion do on Healthcare in 2024 with it going to over trillion by 202030 is what you know the CB cbos say kaer Family Foundation that's untenable that's not going to work for employers and it certainly isn't going to work for you know the citizens of the United States of America you know so we have to figure out other options that give people um a choice and what we feel you know is really important as well is you create the opportunity for the American public to be cons consumers of healthare instead of users we use healthare today without understanding all of the different dynamics that can affect how much they spend for something or don't and when you know when we transitioned from um you know deductibles of $500 up to you know now 57500 and out of pocket maximums that are you know $12,700 when that needle started to move you know really you know we thought geez we'll bring in HSA days and that's going to make people actually um utilize their health dollars more like a consumer well not if people don't understand how to do that and we never gave people the opportunity to understand how to do that and so you know what we're trying to do is provide that opportunity for people to say hey maybe you do have health sh or health insurance but how can we give you access to something that's going to say here's what your cash price would be for something here's a very costeffective membership plan at $30 that gives access to Virtual urgin care virtual mental health 400 generic medications discount programs for labs and imaging and bundled payments for procedures you know for $30 a month um the value proposition is there you know and we see you know I think it's like 40% of people in the past 12 months have pushed off some type of health care because they can't afford it and if people know the cost of something up front that gives them the opportunity to say okay now now that I know the cost I can either save for it um you know or I'm just going to you know bite the bullet and and and wait uh and to be able to pay for it so that's that's uh that's what we're doing that's so important because it's uh it makes the economy very challenging for people because they can't plan right they can't plan out their future you know they might be saving for a house and then they have to have you know a kn repair thing done and then all of a sudden well now I can't get a house anymore right I mean that's that's happened so often yeah but what does the experience I guess actually look like so let's say I was a consumer you know an average individual can you just walk me through what getting your service actually looks like sure yeah um we have you know a web- based platform it's a sass based platform where where um the end user can register choose a plan we currently have four different plans ranging from for an individual $30 all the way up to $275 and once they register for the for the appropriate plan they have a username and password and they basically use our our um you know website and saspase platform to be able to access you know pretty much anything they need uh so you can search for a physician you can use it to access uh to schedule direct primary care you can use our platform to access you know um all of the aggregated discount cards for pharmaceuticals that we have or you know access the the the free drug formulary as well so they can access our the virtual urgent care or behavioral health or their direct primary care that they can actually do uh via tell Health our T Health platform as well um so everything is meant to be accessed via our fpace platform and that's why we truly wanted to make it you know I use that term digital front door and people use that kind of ubiquitously now but that's that's really you know the framework that we chose so that again the end user they don't care you know who the vendor is on the other side they want that user experience to be the same um and that's really important to us as we think about expanding our offerings you know like I said on the $30 plan and all the way up to we have a health share and direct primary care for in-person care uh because we know that uh you can't do everything virtually uh and so we have to have access to uh in-person care um from Physicians as as well as the opportunity for you know those kind of large Health expenses you fall and break your ankle and need surgery to be able to use a health share um you know we're actively working on a couple ACA compliant plans because we know employers are struggling right now uh when when Aon and others say hey at a minimum there's going to be a 9% increase in premiums next year and we've seen that you know we've seen that for the past you know 10 years where premiums continue to increase and it doesn't matter you know how healthy the pool of individuals are that you're ensuring your premiums are going to go up and how can we create um a platform where folks have another option you know they obviously you can look at kind of the booker out the blues and United and signas and atnas but give employers and in particular know small employers that you know let's say more than 50 EES that have to comply to the ACA but they can't afford to do so and so you know we're um we're really excited about the opportunities that we have to create ACA compliant plans that give employers another option that is you know significantly cheaper you know upwards of 50% premiums cheaper than you know kind of your traditional route um and and we think that's important to be able to you know number one small business is the backbone of the United States of America we need to support those folks uh to be able to continue to be successful and so that they can use those dollars to reinvest back into their employees and in their businesses to you know kind of that trickle down effect of of uh you know creating you know more value for for not only the business but their employees as well and that's that's the problem for small businesses especially is a lot of the current um options out there they're so expensive and they provide so little for the employee and if you want to attract top talent they want you to have all of these you know extra benefits but even really expensive insurances they do not provide nearly anything right I mean you'd be lucky if half of them give you um you know behavioral you know tella health I mean most of they give you Behavioral Health but you can never access it right or they give you a dentist but you have to drive an hour to get to the dentist so I mean that's I'm excited to see what those those ACA compliant plans look like like I want to ask you a final question though you you were successful in your career you and your wife were you know financially you know you you had a lot of responsibility you had children why not just you know ride out the next 20 years and retire right I mean because that's what a lot of people would have done right why why take this this jump do you have a personal experience or something that really got you to say I really want to change this I really want to improve this yeah I think you know for me you know personally and professionally you know one I have to have a purpose and this is a great purpose to have is to you know create high quality access to transparently priced care and I have been in the position to be able to see every side of this equation right as a as a uh as a health care provider taking care of patients which is an unbelievable gift that you know is given to us as as uh Healthcare Providers but then also Alo from the other side of it you know as a patient you know with or or you know as a father of patients with my kids and different experiences that they've had you know over the course of time with you know accessing care and then and then trying to follow the the you know your EOB and um you know even being in healthcare you you have to learn how to look at an EOB and how to manage all those things um and then just you know just the statistics of you know the the vast problem you know that we have right now with the way our our healthc care industry you know is managed and when if if a premium for an individual is $188,000 a year on average and then they have their deductible you know call it 5,000 and then they're out of pocket maximum on top of that that's you know it's just not it's number one it's just not tenable and number two you know I was you know given the opportunity again to start this company and and hopefully make it easier for people to access care make it more affordable uh so that they don't push off Healthcare so that they can actually access the system you know as we think about how um healthare is moving from inpatient to outpatient and hospitals to hospital at home we have to create opportunities for folks to be able to access care um and we all know that there's you know kind of these healthc care deserts out there for family practice and things like that and you know our mission is to is to make those things heck of a lot better you know for the American public and do so in a in a costeffective way but at the end of the day you know we all need a purpose uh and and I think our purpose at Lassie health is is is to create that opportunity for folks thank you for sharing that because it's you know it's important to to understand people's motivations especially when we trust them uh nothing wrong of course with people you know who are providing for their families or or what not but it's important that you know we have indiv individuals like yourself who are really dedicated to actually making like this big impact in the community and it just it's such a big problem right I mean you know here in Philadelphia I see this all the time you know people who have insurance um they're also just confused right like we we know that the dnut hole like we you know we had talked about before they don't understand why in the middle of the Year their drug cost you know shoot up and then now we're going to be getting rid of that but it introduces other problems and so it's just been a challenging system and we need organizations like yourself who think about this a bit more logically a bit more you know kind of business-minded but with a consumer focused right which is which is what you guys are doing it's so consumer focused so really appreciate you sharing your motivations and your career history with us I'm excited to see those ACA compliant plans when they start coming out and hopefully we can have you back on to talk about about those no I'd love to yeah thanks so much for the time I appreciate it of course great talking with you Joel and I hope you have a good rest of your day thanks you as well</p>