Decoding the Fine Print: How Hi Neo Makes Healthcare Make Sense

Speaker A: Foreign.

Speaker B: Welcome back to Healthcare on the Rocks. Employee benefits with a twist. I'm Brittany Hardaway, Director of Strategic Partnerships at Springbook.

Speaker A: Hi. And I'm Rachel Baumgartner, Senior Marketing Manager of Springbook. Today we're joined by a powerhouse in the healthcare innovation space, Tanya Tohill Farber, CE of High Neo. With over 20 years of experience in healthcare and pharma, Tanya brings a strategic, forward thinking mindset to everything she does. As the driving force behind High Neo, she is reshaping how patients understand, access and pay for care. High Neo is on a mission we can all get behind. No more fear or surprise when it comes to medical bills. They're bringing transparency and control back to patients, especially those who've been left behind in traditional models. So, Tanya, today we are so excited to have you.

Speaker C: Thank you. Appreciate it.

Speaker A: All right, we're going to dive into the first question for you. Let's start with the origin story. What inspired you to launch High Neo and what problem were you most passionate about solving from day one?

Speaker C: So the problem we tried to solve in the beginning really was about universal medical records. And it was a freak accident that my father had and my twin sister that gave us the idea to pivot. So this was during COVID My father suffered a stroke soon after the surgeries and the bills started coming in. I don't know about you, but the shock when she opened up a surprise bill that was over $30,000 put her in panic mode. And she called me, I told her to send me the bill and I would take a look at it. I'd been a biller and a coder earlier in my career when we had a radiation oncology center. So I did understand a lot about billing. And I realized that the surgeon had billed emergent, but it wasn't so. So I got them to correct the billing and we had no out of pocket expense. My twin then asked me, why doesn't any of your body know this? She said, I don't understand. And I said, it's really about your insurance plan. So I asked her how much she really did know about her insurance. I asked her what her coinsurance was and she said, much to my horror, I don't know. I just picked the plan with the lowest deductible. And so I don't know if you've done that, but it's probably not the best way to pick your insurance plan. So I said to her, let's go over how your copay, your coinsurance, your deductible and your out of pocket max are all tied together, then I can help you really understand how your insurance works. And so she said, you should build something that helps people understand their insurance. So my twin and I went on this journey along with my co founder Chris, who's our CTO to build HyNeo. And my sister helped me with the name she came up with. Hyneo. The H I and RHI is more than just a friendly greeting. It also represents the wealth of health information that we collect and synthesize daily. And Neo is new because we believe that healthcare needs a new experience. And we tried to make one that was simple and really accessible and affordable. And I am a Matrix fan. So Neo came as part of only not only as being new, but because if you watch the Matrix, Neo is the protagonist in his journey. And so we wanted people to become the protagonists in their own health journey. And maybe if Keanu Reeves hear this, maybe we'll have them voiceover High Neo character. That would be great.

Speaker B: So it sounds like High Neo is more than just an app. It's like basically a movement. For our listeners who may not be familiar, can you explain how High Neo works and what sets it apart from other healthcare navigation tools?

Speaker C: Yeah, that's a good question. Because there are a lot of tools that are out there right now. Our healthcare system's stuck, right? It's been made up of fragmented tools. And this has been going on since the High Tech act, which basically had providers incentivized to build a universal healthcare record and to put EMRs in place.

Speaker B: Right.

Speaker C: But that didn't happen very well.

Speaker B: Right?

Speaker C: Nobody looked at that and said, oh, maybe everybody system should be able to talk to each other. And so now we fast forward to price transparency mandates and we're repeating the same mistake, requiring data sharing, but not how to make it user friendly or actionable. And, and I think that's really how Hynio is different. Not only is this personal for us, but we didn't inherit these clunky legacy systems, so we built from scratch. And the one question that we pivoted around was what does a user actually need? So what Hynio did is cut through that. You can search procedures by facility, you can even do prescriptions, different languages, body parts to help you visualize if you don't know where particularly looking. And you can just type in what you're looking for. So we really try to make it very visual and then we give you real time, personalized estimates based on your insurance plan in real time. And that's important. A lot of transparency Applications, it's basically either a flat file or you can go in and you can look, but it's not really based on your own individual insurance and where you are. And because of your out of pocket max and your deductible, those costs depending on where you are, that's what decides what you pay out of pocket. And most people have no clue what that even means. And, and the bigger issue too is when you look at like healthcare costs, right, 38% I think of adults now delay care due to cost. So it's important to get you to understand that when you hit your out of pocket max, your deductible, you either have no cost for your procedure or very little. So I think for us it was more about high NEO being not just a price transparency tool, but a coach. So we don't just show you data, we try to make it really fun because healthcare is scary and most people don't understand healthcare. So we try to gamify it a little and give you bite sizes of information, but reminders when things are really important to understand like you've reached deductible or you've reached your family out of pocket max or hey, this month's coming along, you've got preventative services that are available that you should try to utilize before the end of the year, things like that. So I think we just handled it very differently.

Speaker A: You and your company have talked about the need to decode insurance fine prints and bring real time clarity to healthcare costs. What are some of the biggest misconceptions people have when it comes to understanding their out of pocket expenses?

Speaker C: You know, it's a good question because about 80% of people don't remember the plan that they signed up for. So when, what happens is when they go to see a doctor or they try to get and uh, they get a bill, this is where the surprise bill comes in. Most providers bill a multiplier. So and that's because the way that these legacy systems are built, even from a billing perspective, you can't bill your negotiated rate for each individual payer. So their systems are set up where you just built a multiplier and that's because you don't want to get shorted. What your reimbursement would be rate based on your negotiated rate. I think Medicare is still one of the few that still allows you to back bill if you've under billed. And so that's part of why you get a large bill. But not understanding that when you get that large bill in the mail, that's not what you pay. Right. It's still based on your plan. And your plan, especially if you have a family plan, has an out of pocket max. That's a family out of pocket max. An individual out of pocket max, uh, deductible, a family deductible, a copay, coinsurance and all that is a mathematic equation that tells you what you owe and it's based on where you are in real time. Did you have. I have kids who are athletes, so if somebody had to go to the urgent care, right. That goes towards my deductible. That changes what my out of pocket would be if I've met my deductible, my coinsurance. So I think that's probably the biggest misconception is how it all comes together. That's why you see, my God, I can't believe my doctor billed this crazy amount for my procedure. They billed it, but they're not getting it. They're going to get their negotiated rate that they negotiated with the payer.

Speaker B: Uh, personally, my brother just had an incident and landed in the hospital for about four days. And he got the bill just yesterday, ironically. And he said, I can't believe that this bill's almost $40,000. And I'm like the most that you're going to have to pay is 3,000 based on your deductible that we had already talked about based on that prior experience. But I'm like, don't wor that number might scare you, but you're definitely not going to have to pay that much. And he just didn't understand it because he's not in this industry where we have a little bit more access to the information to be able to decipher what these health plans really actually entail. So in tandem with that, healthcare affordability is a growing concern across the board. How do you see high neo helping employers and plan sponsors support their people, especially those navigating like chronic conditions or high cost care?

Speaker C: It's complicated, right? Because I think we have to look at not just you have a subgroup of people who may cost you more as an employer. Right. But overall you still have to look at the delay of cost for procedure or going to get a procedure because you're afraid of the cost is also an impact in your cost from a, uh, payer perspective. So I think what you have to look at is like how does price transparency align with like value based care? Right. For this particular group, we know that there's a huge price variation for common procedures like mammograms or Colonoscopies within a geographic area. I'd had that own experience myself. Right. If I went to, I won't say the health system, but one in New York, in Manhattan, for a procedure, it would cost me $15,000 more than if I went to the same health system in Brooklyn for the procedure. And that's because they negotiate their rates based on the number of lives. So there's a process to that. Right. But I'm not privy to that. And if I have a large coinsurance that has to be paid or a deductible that has to be paid first on top of my coinsurance, it's going to be really hard for me to make a decision. If I live in Manhattan, I really want to go there, versus having to go to Brooklyn, your employer can say, okay, let's look at all of the options. And if there is a different facility that has a 20% lower complication rate and they cost 40% less, they're in Manhattan, they can incentivize me as an employee to go to that higher value provider. And then that means my out of pocket is lower and I've reduced the waste for the employer. And we can customize those incentives in the app and that again, is all in real time. So that's an opportunity for employers to use it and we can put certain cohorts together. So if you have a high risk and you know that they're going to be going for particular procedures at a time, there's incentives that can be built in and reminders for them that can be customized into the app to help with that.

Speaker A: So we're seeing more healthcare solutions. Prioritize equity and accessibility. As a woman and minority founded company, how is High Neo weaving inclusion into its mission and product design?

Speaker C: We're minority owned and we do have some men in there. So I don't want the men to feel like they're not included. My CTO is a guy. Our belief is that building this application isn't just about us. I think as we built this company, I call it our little home because we're a group and we're spread out. So we're throughout the country, a lot of people remote, some people are in the office. But we built this as a way to grow but make sure that we take care of those in our charge. And so when I say those in our charge, not just our customers. Right. We want to do the best that we can and we're a fun team. There's no egos in this group, which is, thank goodness for that. But we're a family and so we like to have fun, but we want to leave the world in a better place. And we hire the right people, not just because they're female, not just because they're ethnic, not because they're men, because they bring the right tools to the table and the right energy. So we want to make sure that we're diversified, but they still have to fit our ethos. And I think our ethos is the most important thing to us.

Speaker B: Awesome. Um, let's talk about impact. What kinds of outcomes are you seeing with the users of the high NEO platform? Whether it's cost savings, reduced confusion, or simply improved engagement?

Speaker C: I laugh all the time because people always talk about statistics and your numbers and how do we compare to some of the others? I think the bigger difference for us is that we approach this with the, you can't hope that if you build it, they will come. And you have to understand that healthcare is scary. It's really hard for them to understand. I've been in a couple other applications and it's hard enough to even figure out how to search for what you want. So what we did was, and I think it's probably why we've got really good engagement, is that we built it almost as if you were looking for flights or hotels. We do all the coding on the back end, but once you're in it, you just put in your zip code or whatever zip code you want and there you go and you can save that information. And again that's in real time. So I think that's probably why people really like it. I think from a savings perspective, the data's out there. It's. If you use a transparency tool, you save money. When you look at it from a standpoint, uh, of what's the roi, right. If employees are not getting care because they're afraid of the cost, then you lose productivity. Right? That means more sick days, more mental health days, higher turnover, employees taking leave. Now if you have to replace that employee, that's six to nine months of their salary instead of hoping they don't use their services. The short term savings of lower healthcare utilization doesn't outweigh the losses. There's plenty of data out there to support that right now. And I think you just have to look at it from a standpoint too, that employees are looking for this tool. So if you want happy employees, then there's no reason for you not to do this. And for a self funded group, it's not an option anymore, it's regulated. You're going to have to do it. So you might as well pick the best tool and use it as a strategic advantage. It's uh, a win win for both people. So the savings are there, right? You'll get that with every good tool that's out there. I think you'll get better m savings when you have a tool that has better engagement. And so I think we beat people when it comes to how we've done that because we've built it from a B2C perspective. Very different than everybody else who built it B2B.

Speaker A: So we all know this and you've just described it so well. Healthcare is complex. What have been some of your biggest challenges as a founder and how have you navigated them?

Speaker C: I think the biggest challenge was we started building this a little early and I don't think the regulatory and the legislation hadn't really pushed this. The data that came out was so bad it took us forever to clean the data. It's getting better now. You have to have pricing for every CPT code. That was a mandate. Does everybody have it? Nope, it's getting better. So I think that's probably. The data is probably the hardest challenge. When we work with payers, you'd be surprised how many of them don't know how bad their data actually is. I think we were surprised. We thought that they would have a better handle on it. So I'd say data has probably been the biggest challenge.

Speaker B: So looking ahead, what's next for High neo? Like any upcoming features, partnerships or bold moves on the horizon that you can share.

Speaker C: So we've working really hard on RX transparency and so that we're going to soft launch that I think probably next quarter and then hopefully by the end of the year. That will give people the same ability to price compare for their prescription. Not only will they be able to look at what the cost of their prescription is from their insurance standpoint, but they'll be able to utilize any discount card that they want to if they don't want to go through their insurance. So we're trying to make that in one application. So it's not just about medical procedures. You can look at medical procedures, you can look at that. If you've got kids, your family should always be part of it. So I think we're just going to continue to grow on our metrics and we're just going to want to work on fun ways of teaching and engaging and continue to grow our roadmap. But like I said, we want to make sure that we do that with integrity and we treat each of our companies that we work with and that we partner with as part of the family.

Speaker B: That's awesome. Sounds very exciting. It sounds like your passion for transparency and advocacy in healthcare is very admirable and it's clearly driving real change or at least attempting to. Right?

Speaker A: Yeah.

Speaker C: And I think we've. I've been in healthcare my entire career. Probably one of the few. I was passionate about science from an early age and I even worked as a dental assistant when I was a teenager because I thought I might want to be a dentist, but moved on to biochemistry. Uh, degree. But if it's a passion, then like, I don't find it work when I do this. I love it. I really love High Neo. I think it's going to help a lot of people. I put the team together that feels just as passionate about it. So I'm really proud of us.

Speaker A: Thank you so much for your time today, Tanya. We really appreciate it. And for our listeners, if today's conversation sparked your interest, be sure to check out hi Neo and the work that Tanya and her team does to simplify healthcare for everybody. And don't forget to subscribe for more insights on how innovation is transforming employee healthcare and benefits.

Speaker B: Until next time, stay healthy and stay informed.