Breaking Down Financial Barriers to Care with Technology

modern practice podcast

On this episode of The Rectangle Health Podcast, host Gary Tiratsuyan is joined by Chief Technology Officer Michael Peluso to discuss how providers in the healthcare, dental, and veterinary space can break down financial barriers to care, and treat more patients.

Tune in to hear how the industry can navigate the challenges of the economy, rising costs, and offer patients a manageable way to pay for treatment, with patient financing.

Through a partnership between Rectangle Health and Healthcare Finance Direct, the patient financing solution helps patients afford care regardless of their credit score. Patient Financing is a non-recourse financing arrangement, and providers receive their payment shortly after patients start payment plans with Healthcare Finance Direct.

  • Applications are started, and their status is visible, right inside Practice Management Bridge® – no third-party portals here.
  • Patients receive multiple payment plan offers just 30 seconds after applying, and Healthcare Finance Direct handles payments so you don’t have to.
  • Nearly every single patient* is approved for financing. Our approval rates are unmatched.


Gary Tiratsuyan: Hello, everybody, and welcome back to The Rectangle Health podcast! We’ve got a great episode in store for you all today – We’re joined by Rectangle Health’s Chief Technology Officer, Mike Peluso, and we’re going to be talking about how practices can increase the volume of patients they treat – Specifically, say Yes to more patients who may need financial help to get the care they need. Mike, welcome to the show. 

Mike Peluso: Hey, thanks for having me. Looking forward to the conversation.

Accessibility of Care: The Current Landscape

Gary Tiratsuyan: Let’s get right into it here, Mike. Given the current state of the economy, we’re facing some new realities and challenges. In healthcare specifically, the cost of care continues to rise  – the ability to afford care is harder than ever. So, if we were to put “Need for Care” and “Ability to Pay” on a scale, we’re really looking at a heavy imbalance, right? Can you talk a little bit about the accessibility of care in the current landscape?   

Mike Peluso: Yeah, sure. Gary, great, great question. And I look at it from a provider perspective, not necessarily from a patient perspective; patients need care. That’s why they’re at the provider. But I think what people overlook is that providers want to deliver care. There’s nothing in the Hippocratic Oath that says a provider needs to balance the cost of care against actually delivering the care. All of these providers, whether it’s a physician or a dentist, go to work every morning, and their goal is to make someone better, whether through a better smile or a surgical procedure; the providers want to be able to do that. 

It’s really hard for them to be able to weigh doing that against the cost. And that’s what you see a lot of times in health care. People walk in; they get the care, and they kind of leave. The idea of being able to afford that care gets overlooked. Because, again, the foundation of becoming a provider is being able to deliver care. 

What we try to do is eliminate barriers to care. There’re certain barriers that don’t allow providers to care. And I think when you talk about the imbalance, you’re really talking about, hey, providers, we know that you want to do all this care, you wake up every morning, and you want to make people healthier… so, enable [providers] to do all that. What are the barriers that can be removed? 

Making Care More Accessible

Gary Tiratsuyan:  So, if we look at everything from a 30K foot perspective, patients are more often pushing treatment off, canceling, and not even considering it due to cost. On the flip side, providers’ declination rates rise. If we look back at that heavy imbalance on the scale – how can the industry move to increase the ability to pay and level the playing field – ultimately, reduce declination and say “Yes” to care more often? 

Mike Peluso: Yeah. And, Gary, another good question, a good follow-up. We have to allow the patient to consume care. They have to be able to absorb it. The patient fully realizes, “I need a root canal” or “I need a cardiac procedure.” And I think they fully realize, hey, it’s costly. I could have a high out-of-pocket, I could have no insurance, or it could be an elective. And you know, I really want a better smile, how much does a better smile? I think the patients understand that they need the procedure. They understand there’s a cost to the procedure. 

How can we allow them to consume it? Again, there are a lot of expensive things out there in the world that people are able to consume. Because they want them or they have a need for them. They understand it. When you think about how to consume it, again, presenting options to the patient, maybe they have insurance. Maybe they truly can’t afford it. And there’s a government program that could cover it. Maybe they have an HSA, or maybe they have an FSA. 

What rectangle is trying to do is facilitate more ways outside of that. When we think about some of our ways, like patient financing, or even paying at the point of care with a discount, it allows those patients to consume the care. It also allows them to go, “yep, I definitely understand there’s an out-of-pocket responsibility; the provider is giving me options to consume that care. I’m going to take option one, or I’m going to take option two, or, you know, I really want this, and I’m willing to take an extended payment plan to be able to consume that care.” I think it comes down to being able to allow patients to become consumers. 

Healthcare is an industry where that concept is still hard to adopt. But I think once we adopt it, and once we understand it, and once we, we put in programs, again, like the patient financing, which I mentioned, allows the patients to become consumers.

Gary Tiratsuyan: Thanks, Mike –I remember an offline conversation we had, and you brought up a great analogy. Not many people walk into a dealership and buy a 30, 40, or 50K car outright in cash. The financing makes it possible for a customer to walk out with a vehicle to get to work, go to school, live their lives and be mobile. So why not in healthcare? – So I want to present a scenario – you are speaking to a provider – can be a dentist/vet/medical doctor, and they do not have a financing or recurring payment option available – what would you say are the 3 biggest gains from immediate implementation of a program like patient financing? 

Benefits of Implementing Patient Financing

Mike Peluso: And again, going back to one of the previous questions/ previous answers, it removes that barrier to care. It allows that provider to talk freely about care because they have plenty of options to get the care. I was at an eye doctor’s office the other day, and it was actually a surgeon, and he had explained to one of his patients that it was time for them to get cataract surgery. Cataract surgery, for those who don’t know, is where they replace the lens on your eye. And he said to them, well, Medicare covers the ability for you to see distance. But if you also want the new lens on your eye that will allow you to see up close, there’s an extra fee for that. Who doesn’t want the option to see up close? If you layer in that, that description, and you say, “Okay, there’s an option to see up close.” And we can set up a way for you to have access to it, and we can set up a way for you to pay for it. 

Medicare will cover the first part, and the office has a payment plan for the second part. The conversation was, well, the second part isn’t covered. Well, the second part isn’t covered. But the second part is so much better than the first part. Everybody wants to see far away and up close. But when you frame that conversation to say, well, far away is covered, up close, not covered. Rather than going far away as covered up close, we have options for you; we may be able to bill your secondary insurance. We may be able to spread it out over a payment plan with patient financing. We may be able to give you a discount if you can pay in full today. There are a lot of different ways to frame up that conversation. And again, [when] you’re removing that barrier…providers are allowed to do more care. Again, the first part of the conversation and the second part of the conversation were, “Hey, that’s not covered.” Immediately the patient’s going to go, “Well, I don’t want it.” As opposed to, “Hey, you can have the up-close vision and the far-away vision, and we can work out [a] payment [plan]. 

Now that providers are doing more surgeries, they’re doing more of that upgraded procedure. It drives more business to the provider. 

And then I think the last one is just the overall patient experience. Right? You don’t want to read a Google review saying, “I went to Dr. XYZ, and he said the cataract for seeing things closer-up wasn’t covered.” You want to read a review that says, “I went to Dr. XYZ, and they said the cataract lens is the lens for seeing something up close was part of the process, and there was a way that I could get it.” Not that it just wasn’t uncovered. You want to remove those negative reviews. You want to have positive reviews. If you put a positive spin on giving patients more options, you put a positive spin on removing those barriers to care, your overall going to get good feedback from your patients.

Gary Tiratsuyan: That’s amazing, Mike. I keep going back to that balancing act of needing care and being able to make it happen financially. Patient financing will bring that imbalance back closer to equilibrium. There are benefits on both sides – patient and provider. Last question, Mike – in a perfect world – what does the patient payment landscape look like? 

The Ideal Patient Payment Landscape

Mike Peluso: You want to be able to get that balance that you just mentioned. And patient financing certainly helps. In a perfect world, it’s where all of this is standard and accepted. It’s a lot like your car dealership example. We all go into the car dealership. Most of us aren’t walking in with a duffel bag full of cash to pay for the car. We all go in fully knowing that the car dealership is going to say to us, “Hey, the car is x 1000s of dollars, but we can break it into monthly payments for you.” We’re also all okay, with the car dealership trying to upsell us on something. “Oh, yeah, I do want our windows and power locks.” Of course, you want power windows and power locks; everybody wants those. Well, it’s an extra $5 a month rather than an extra $5,000 option. 

But when we think about health care, we have to make these types of conversations part of the process. We have to let patients know that financing is part of the process, that card on file is part of the process, and that Text-to-Pay is part of the process. 

In that perfect world, I think all of these things become mainstream. Card on file, again, for any of us that have a Netflix membership, is that you can’t sign up for Netflix without putting a card on file. It’s mainstream; it’s okay. It’s understood. We have to bring that into healthcare, and we have to make that part of healthcare. Even patient financing can be part of healthcare. High-cost procedures, lack of insurance, and the ability to get elective procedures, these items aren’t going away. 

So we have to bring in the barrier removals that we talked about, the ability to deliver more care; we have to bring those in and make them mainstream. In a perfect world, and I think it will come, a lot of these items will be mainstream. At one point in time, a $5 copay was pretty mainstream. Today, we have never heard of a $5 copay. They’re all $50 co-pays, deductibles, or coinsurance. I think over time, these types of tools that are mainstream in other areas, almost in every other area where we’re a consumer, will become part of that patient-provider experience.

Gary Tiratsuyan: Thanks so much, Mike. I love the direct comparisons you mentioned:

For our listeners interested in learning more about patient financing, follow the link in our description below. I invite you to have a conversation with one of our practice solutions consultants, who can take you through the details of this program and how it can increase your cash flow, make for happier patients, and increase loyalty and retention. 

Mike, thanks so much for taking the time to join us today. I really appreciate your insights and look forward to having you on the show again soon. 

Mike Peluso:  Thank you, Gary. It was fun.

Gary Tiratsuyan: Before we wrap up, I want to remind everyone that you can tune in to the Rectangle Health podcast on Soundcloud, Spotify, Apple Podcasts, Google Play, or on our site.

Till next time everybody. 

Editor’s note: This interview has been edited for length and clarity.


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