AblePay Health Company Profile

Background

Founded in 2016 and headquartered in Bethlehem, Pennsylvania, AblePay Health is dedicated to transforming the financial landscape of healthcare by addressing the challenges associated with rising out-of-pocket medical expenses. The company's mission is to provide a trusted solution for both healthcare providers and patients, offering a more efficient payment platform that benefits all parties involved. AblePay Health's vision focuses on assisting providers and patients with resources that ultimately lower the cost of healthcare.

Key Strategic Focus

AblePay Health's strategic focus centers on enhancing patient financial engagement through a proprietary model that offers savings, flexibility, advocacy, and convenience. The company aims to reduce healthcare costs for patients while ensuring providers receive prompt and dependable payments. By streamlining the patient payment cycle and guaranteeing payment within 14 days, AblePay enables providers to better manage receivables and lower collection costs. The platform integrates seamlessly with existing provider processes and vendor systems, minimizing workflow disruptions and enabling quick implementation.

Financials and Funding

As of April 2024, AblePay Health secured $11.3 million in a later-stage venture capital funding round. This funding is intended to support the company's expansion efforts and enhance its patient financial engagement platform.

Technological Platform and Innovation

AblePay Health's platform is designed to act as a secondary payer, allowing providers to add AblePay into their system while maintaining all current processes and vendors. The implementation process involves:

1. Partnership: AblePay contracts with providers, compensating them at rates significantly higher than the current average collection rate.

2. Engage Patients: Providers offer AblePay directly to their patients.

3. Membership: Patients become members and present AblePay cards at the time of service; providers enter AblePay as a secondary payer into their system.

4. Payment: Providers receive a guaranteed, risk-free payment within two weeks of when a patient is billed.

Leadership Team

John Fistner: Founder and Chief Executive Officer. Prior to founding AblePay Health, Fistner served in multiple roles at Coordinated Health, including CFO and COO. He holds an MBA in Finance from Lehigh University.

Matt Horstmann: Chief Growth & Strategy Officer. Horstmann brings extensive experience in strategic growth initiatives within the healthcare sector.

Competitor Profile

Market Insights and Dynamics

The healthcare financial engagement market is experiencing significant growth due to increasing patient out-of-pocket expenses and the need for efficient payment solutions. Providers are seeking options to improve revenue and patient satisfaction, while patients desire a more affordable and better billing experience.

Competitor Analysis

One notable competitor in the patient financial engagement space is PayZen, a venture capital-backed company based in San Francisco, CA. PayZen focuses on providing flexible payment solutions for patients, aiming to make healthcare more affordable.

Strategic Collaborations and Partnerships

AblePay Health has established several strategic partnerships to expand its reach and enhance its offerings:

SRHO – The National Association: In November 2020, AblePay partnered with SRHO, a consortium representing over 400 hospitals and healthcare systems, to bring its model to a broader range of medical providers across the United States.

Zelis: In May 2023, AblePay announced a partnership with Zelis, a healthcare technology company, to combine their expertise and reduce the cost of care for healthcare consumers.

Healthcare Council of Western Pennsylvania (HCWPA): In June 2022, AblePay partnered with HCWPA to introduce its patient financial engagement program to HCWPA's members.

HANYS Marketplace: In July 2022, AblePay partnered with HANYS Marketplace to bring its platform to hospitals and health systems throughout New York.

Indiana Hospital Association (IHA): In May 2023, AblePay became an endorsed business partner of IHA to help Indiana hospitals and their patients manage out-of-pocket medical expenses.

Operational Insights

AblePay Health's unique business model benefits both providers and patients. For providers, the program reduces costs associated with collecting out-of-pocket payments and enhances revenues by guaranteeing payment within 14 days. For patients, AblePay offers savings of up to 13% on out-of-pocket expenses, flexible payment options, and free advocacy support services. This dual-benefit approach strengthens the relationship between providers and patients, ultimately lowering the cost of healthcare while providing an enhanced patient experience.

Strategic Opportunities and Future Directions

AblePay Health is poised for further expansion, with plans to achieve a national presence and completely change the way out-of-pocket patient costs are paid. The company aims to lower healthcare costs, improve the patient experience, and make a positive impact on members' lives. With strategic partnerships and a scalable business model, AblePay is well-positioned to capitalize on opportunities for growth and innovation in the healthcare financial engagement sector.