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Tuesday Morning with Justin Ft. Wally Gomaa

posted by TrueNorth Employee Benefits on Friday, February 12, 2021

In this two-part series, TrueNorth's Justin Futrell interviews Wally Gomaa, Co-founder of SimplePay Health to understand how health insurance can bring affordability to both plan sponsors and employees. 

A NEW, SIMPLER MODEL OF HEALTH INSURANCE.

Within the plan-sponsor insurance industry, healthcare has become costly and complicated for both the employer and their employees. Wally Gomaa, co-founder of SimplePay Health, and his team wanted to create a new model of health insurance that would bring affordability to both plan sponsors and their employees through a similar form of health insurance. 

At SimplePay, they believe that the greatest good of insurance is to provide access to the best healthcare possible. Using insurance as a vehicle, the goal is to connect patients with care, whether that be providers or programs, giving them the best chance at getting better.  

“Ultimately, we want to get insurance out of the way so that we can focus on health and care, we want to bring healthcare together.”

According to Gomaa, healthcare is no different than any other consumer-based industry because there are differences in both cost and quality. SimplePay focuses on the quality because they feel that it is the greatest untapped opportunity in the in employee-sponsored insurance space. 

“When we look at our data set of over 140 million patients, when patients go to higher-quality performing providers, they’re on average realizing about $5,000 in lower cost of care per patient per year,” Gomaa said. 

This lower cost is not because of deeper discounts and lower price tags, but a result of going and getting the best care from the best providers. These providers have the fewest complications, re-admissions and infection rates. 

REPLICATING THE CONSUMER JOURNEY AND PROCESS. 

When SimplePay Health was founded, the goal was to replicate the consumer journey and process used by other industries and bring it into the healthcare market. This includes eliminating deductibles and co-insurance that prevent the consumer from knowing what the price is ahead of time.  

Not to be confused with the many point solution and transparency programs, rather this is a new design in payment model. SimplePay Health is proud to bring this to a national level, partnering with CVS Health. 

HOW DO WE GET EMPLOYERS ENGAGED?

As a company that has served thousands of employers and many millions of lives over the years, SimplePay Health has realized that the complex insurance design and payment model is actually preventing patients from being empowered to make better decisions toward better care. They have built a new model of health insurance that has a new design and payment model to make the consumer or patient journey work from a decision-making perspective. 

“Our experience is that when you simplify the design and payment model, that results in better patient decisions that connect them with better care and ultimately produces better outcomes at a lower cost,” Gomaa said.  

This means that people should no longer be satisfied to let insurance stand in the way of connecting patients with the best healthcare. 

WANT TO LEARN MORE?

We live in an era where organizations of all sizes are expected to do more with less. Business owners and decision-makers face the daunting talk of balancing financial goals and aspirations against the cost of supporting a healthy and productive workforce.

"Tuesday Mornings with Justin" intends to showcase effective ways that organizations can leverage innovation, technology, and teamwork to grow their business and optimize their workforce.

Contact Justin 

This publication has been prepared by TrueNorth Companies, L.C. and is intended for informational purposes only. Transmission of this publication is not intended to create, and receipt does not constitute, a client relationship with TrueNorth Companies, L.C. This publication does not constitute any type of representation or warranty, and does not constitute, and should not be relied upon as, legal advice. This publication is not a contract and does not amend, modify or change any insurance policy you may have with an insurance carrier. © 2021 TrueNorth Companies, L.C. All rights reserved.