Michael Swartz, President & Founder of Health Karma

Good Healthcare Starts With Understanding It with Michael Swartz, President & Founder of Health Karma transcript powered by Sonix—easily convert your audio to text with Sonix.

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Saul Marquez:
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Saul Marquez:
Welcome back to the Outcomes Rocket, Saul Marquez is here and today I have the privilege of hosting Michael Schwartz. He is the president and founder at Health Karma. His history as an investment banker has transformed into a career in health care, entrepreneurship and just some personal things that happened to Michael that led to him doing something about it. And that’s what karma is all about. I’m privileged to have him here on the podcast today to tell his story, but also the value that health karma is sharing with the world in health care. So, Michael, such a privilege to have you with us today.

Michael Swartz:
Thanks for inviting me, Saul. I’m really excited to be here.

Saul Marquez:
Yeah. And so before we dive into Health karma and the very interesting work that you guys are doing for consumers as far as your health insurance and finances, tell us a little bit about your why and how you got involved in health care. I mean, just a shift in what you were doing from the beginning that I think will be very interesting for everyone to learn. Definitely. Definitely.

Michael Swartz:
So throughout my career, I always wanted to be at finance. I wanted to be in investment banking or venture capital. And I finally got a job up in New York for investment banking, for security industry. And I got there. And about a year in, I was no longer eligible to be on the family plan. So I was in New York only there for a year. And all of a sudden I lost my insurance like that. And for me, of course, I’m used to technology, know searching. So what did I do? Well, I started looking and trying to find doctors that either had pricing, really doctors that weren’t in urgent care, because I was looking for that primary care physician. I really had no family up in New York. So I was lost on Yelp, HealthGrades, all these different things. And during this process, it kind of hit me that there is not that one place to turn for the people without insurance to really shop around. I mean, me as a millennial, I am so used to purchasing things online, booking things online, and I just could not find anything. And while going through that process, it really led me to think that has to be a better way. So it’s probably about one, two, maybe three years of me searching for something out there that would give that shopping experience. And there was nothing really out there that I could find that would serve me. And that’s what led to me starting to take that deep dive and led to the development of medical.

Saul Marquez:
Well, I think that’s great, you know, and you’re right there. And we’re so used to getting things at our fingertips and health care, health care insurance is not one of those things that it’s just overly complicated. And so you found yourself in this really frustrating place that all of us have been in Right.. Whether it’s finding a doctor or finding insurance, it’s not easy. And so you developed a solution to make that better. Can you talk to us a little bit about health karma and what exactly it is that you guys are doing to add value to the health care ecosystem and the individuals?

Michael Swartz:
Yeah, so I think it makes sense for me to start what we started building at first. And it was pre Health Karma. And what we wanted to build was something that gave people that didn’t have insurance like myself at the time, or if they had high deductibles, give them a place to shop around. So the original concept was a marketplace that gave you the same experience you have booking a flight or a hotel on Priceline or Expedia, but for medical services. And we developed the platform. We launched it. We were able to get close to twenty five thousand providers that were looking for new cash patients. And also we were able to drive consumers and that led to actual user feedback data. And what we realized was just because people are paying out of their own pocket does not mean that they’re ready to be a health care consumer. We hear it all the time, health care, consumerism. But what we found was people just did not have the knowledge, especially when they had insurance, to be a health care consumer, to act like a health care consumer. And all this confusion really led to hesitation, not only interacting with the marketplace we bill, but interacting with health care as a whole. And I always compare it to buying a car dealership prior to the standardized pricing at dealerships, where it’s like the price you see is the price you pay and. Online marketplaces like TrueCar, a lot of people were scared to go into the dealership because they weren’t confident in the knowledge they had in cars, and they felt that they’d be taken advantage of by the salesperson. And in health care, as I’m sure you and all your listeners know is way, way worse. People are losing trust in health care as a whole, whether their health insurance, the health system.

Michael Swartz:
And that insight, about 16 months ago, we took a step back and we said if we really want to create a product that people know and love, we have to bridge the gap and to bridge that gap we focused on taking this marketplace and tying it to really a place that people could turn to first understand what is going on in their health care situation. Do they have health insurance or are they uninsured? So you have health insurance being able to integrate your health insurance plan. So you have a personalized experience. You can understand everything that’s going on and then allow them to intuitively find what they’re looking for. Are they looking for primary care or are they looking for an MRI or are they just prescribed medications? They need to find the pharmacy that offers them the best price. Are they looking for a service that could be better off using telehealth? So we created that highway for that user to have a personalized experience to find exactly what they’re looking for. And then the third piece to bridge that gap is giving them the information that they actually care about. Is it coinsurance, co-pays, deductibles, or do people really just want to know how much am I going to have to pay out of my own pocket by providing that information, by flipping the script in a way that people can understand? We can bring the user to the point where they’re confident that they’re either booking, using their insurance or paying for a service. And that’s really what health care has evolved to that end to end solution that gives people that single place the turn to be able to manage their health.

Saul Marquez:
And well, I think that’s really neat. So it becomes kind of like a virtual broker of some sort.

Michael Swartz:
In a sense. One of the things that we really want to create and everything that we do is people don’t want choices to be made for them. They want to be able to confidently make the choice themselves. So it is kind of that digital broker that guides them to whatever decision is right for them. Health care is not a one size fits all.

Saul Marquez:
Yeah, I love it. You know, and that navigation piece is really big, would you say? I mean, and honestly, it’s the case. We all need it whether we have insurance or if we’re paying out of pocket or whether it’s it’s insurance that that we pay as employers or if it’s insurance that we get from an employer. This navigation piece is critical. So who would you say you target? Mainly, who can benefit most from the platform as it as it sits today?

Michael Swartz:
Yeah. So I think the core concept that we built Health Karma on was to be able to kind of personalize the experience, whether you have insurance or don’t have insurance. So who are we really providing that substantial value right now? I would say it has to be the individual. Either they have insurance or they don’t have insurance as well as what we call the individual employer. And what the individual employer is to us is employers that have one hundred fifty employees in line. As we started diving in, we found there was nothing out there to serve people in those two groups, the individual and the individual employee. So we want to create a place that if people are confused about their health insurance, if they are an employer, that maybe they don’t want to pay the cost to offer for health benefits. They can partner with health karma to be able to provide at least a benefit that allows people to make the most out of their health care, whether it’s telehealth, whether they have insurance, being able to get that value out of whatever their situation is.

Saul Marquez:
Got it. So the individual and then smaller employers, your company is able to help offer this concierge service to help them put together the best package that meets their budget needs and their health care needs.

Michael Swartz:
Exactly. And one of the things that we looked at as we started building health karmas, we started looking at other industries that might have had similarities in terms of very complex industry that was simplified using technology and the one that. Out like a sore thumb with the personal finance industry and before all those that nobody was out there looking for a tool like this, they have problems that they needed to solve. And these companies came out and really focused on three things. The first being an incredible value for that user, not really charging that user. The second is a personalized user experience that’s fun and easy to use in the third. And I would say most importantly, is to flip the script of personal finance so that no matter who you are across this country, you could pick it up and know exactly what’s going on. And we saw that and we wanted to create that same personalized experience that provides the education, the insight to guide it, and then also the actionable aspect of being able to book or prepay or pay for services.

Saul Marquez:
Yeah. So, yeah, interesting. Very interesting. And so talk to us about what you guys are doing and how it’s been able to help thus far. Yeah.

Michael Swartz:
So what’s been I would say one of the challenges that we’ve had to kind of tap into to be able to provide value to end users is really start to solve the problem on standardized data. It could be one insurance carrier to another. And they’re providing ending up with data on that insurance plan in a different way. So there’s no standardization. Now, we are starting to see things kind of move in that standardize direction. But one of the things that we’ve worked on is to be able to take this on standardized data and put it in a way that we can create a more of a consumer like experience. So that’s been a hurdle. It’s been finding the right data partners. So we partnered with one data partner that enabled us to tap into over 2000 different insurance plans, turning it into individual data points. We partnered with another data partner that enables us to have pricing data and provider data. And for us, it’s all about intertwining all these different data points and then putting it in a way that anybody who picks up health caba can understand. And then to where are we today and how is it help? Again, we launched Medical Dotcom’s a Marketplace three years ago and about 16 months ago we started building what we call the second generation and that’s Health Karma today.

Michael Swartz:
So we’ve actually went through several iterations of our first two iterations of data to really get to the launch of Health Karmas to the public. And that is actually November 2nd. But we’ve been able to start partnering with employers and one of them being a company called Oxford Properties Group. And there is 800 Agent Boroughbridge out of New York that has always wanted to provide health benefits to their age. But with how real estate and brokerages work, it didn’t make financial sense to provide full health benefits to every single one of these ages. So when we started talking with them, they saw this as a way to offer a benefit to their agents in an affordable way, and that can be personalized for each agent situation. Not every agent is going to find telehealth beneficial. Not every agent has insurance. But the way that we personalize the experience allows people to find the value for them when they need it.

Saul Marquez:
Yeah, it makes a lot of sense. And yeah, it’s those niches that you mentioned, the solo proner or the just the employer that has less than I think the number was. One hundred fifty employees. There is that dark area where you’re just like, how do I do it, what do I do, how can I provide benefits. And so November is the launch date of this. It’s super exciting. You mentioned one of the setbacks you’ve had is that data Right. consulting and data. Is that the one that you would point to as probably one of the biggest ones, or is there something else that you want to share that you feel led to a key learning that’s made you guys able to position what you offer better?

Michael Swartz:
I would say that really. And I’m not going to call it a setback, but of course,

Saul Marquez:
You’re not .

Michael Swartz:
The biggest hurdle and challenge that we faced was realizing and now being stuck in a single way of thinking, not being tied to our own idea. If we go back to Medics sold.co, Out of the marketplace. We really thought that people were ready to be a health care consumer and it really took us looking at what we built professionally and really digging in to say if we keep on going this route. Yes. Can we have and create value for consumers? Yes. But are we going to be able to really solve the Right. problem that creates a product that people know? So I think what we’ve learned is, one, people, consumers, most Americans just do not have the knowledge to effectively and competently manage their health care a lot. Don’t even know that they can ask the question to the doctor, how much is it going to cost or ask what the cash price is. So that ties with health care cannot be a one size fits all approach. You need to understand that health care is personal. So health care for me is going to be different than health care for you, which is going to be different than health care for our parents. So realizing that and understanding that we are not solving problems for the user, for the consumer, for the provider, but we are offering a place that they can turn so that they have the information, the tools, the access to be able to confidently and simply manage their health and well. And I think that personalized peace and the understanding of we need educated health care consumers to really change how health care is delivered is one of the biggest things we learned over the past five years.

Saul Marquez:
Love it. And you guys are helping out in a very unique way and so appreciate you highlighting the learnings that you guys have made. And so as you reflect on all of the things that you’ve learned and this platform that you’ve put together, what would you say you’re most excited about?

Michael Swartz:
What am I most excited about? Yeah, I think what I’m most excited about is really launching this and starting to have consumers starting to have providers start to drive the direction that this platform goes. I think it is so important that as an entrepreneur, as a growing company, that you don’t get stuck in a way of thinking that your idea is the right idea. So I am so excited to be able to offer a platform out there that really can provide that personalized experience, but most importantly, will create more value the more that the users interact. So I’m a big fan of building and problem solving. So from the standpoint of our consumers and also the standpoint of building the health committee, I mean, we’ve grown about seven to 10 additions to the team just in the past six to eight months. And that also just is incredibly exciting for me. And the success of the company is not always going to be based on the quality of the business model. Now, we do have a great business model, but it’s always going to evolve. Technology is going to mature, it’s going to grow. Data is going to become more and more standardized. The success of this company than most companies in general are going to be based off the quality of the people. And I do have to say, I’ve been incredibly proud and I’m incredibly excited to continue building the plus team we have here at health care.

Saul Marquez:
Well, who knows, man, that’s great. Getting the right team assembled behind this awesome vision that you guys have is certainly critical. So congratulations. And this launch is going to be exciting, that moment that you experience that a lot of us experience and that frustration, that that confusion, the opaqueness, I mean, all that stuff, we need more answers like this. And so really excited that you guys have stepped up to the plate to deliver on this gap. And so I want to just conclude this by giving you an opportunity to give our listeners a call to action, something to think about. And then the best place where they could reach out and learn more about you and what the company has to offer.

Michael Swartz:
Yes, I think one of the things to let the listeners know is health care has so many problems, it’s not going to take one company to fix all these problems. And one of the drivers of our model has been creating a highway. So we’re always looking for technology partners that. Are out there innervating parts of the health care journey, because it’s going to take really a collaborative approach to be able to create an experience in health care for consumers in the health care providers that people can be excited about, that people can love using. So whether you’re an employer, whether you’re a technology partner, we’d love to hear from you. You can shoot me an email at mswartz. That’s m s w ar t z @healthkarma.org. You can also go to the site and check out what Health Karma does, how it works by going to healthkarma.org. So I’d love to hear from you. And we’re always looking to build partnerships to improve that health care experience for all ends of the health care journey of it.

Saul Marquez:
Now, this is great and folks take them up on it. Healthkarma.org, that’s karma with a K, health karma dog to learn more about how you could step up your experience in health care. It’s available. It’s an outstanding resource, so be sure to take them up on it if you’re listening to this before it goes live. They do have a sign up for their wait list, so be sure to check that out. And otherwise really grateful that you guys are doing this, Michael. I think it’s a great opportunity for all of us to get better information and really a better way to access our health care than we have in the past.

Michael Swartz:
I appreciate it Saul and I really thank you for letting us shine a light on just making that health care experience better for consumers and letting us come on here and talk about what we’re about to launch in Health Karma.

Saul Marquez:
Always a pleasure, my friend.

Michael Swartz:
Really appreciate it. Thank you, Saul.

Saul Marquez:
Hey, everyone. Saul Marquez here. Have you launched your podcast already and discovered what a pain it can be to keep up with editing, production, show notes, transcripts and operations? What if you could turn over the keys to your podcast busywork while you do the fun stuff like expanding your network and taking the industry stage? Let us edit your first episode for free so you can experience the freedom. Visit smoothpodcasting.com to learn more. That’s smoothpodcasting.com to learn more.

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