Improving Patient Care and Provider Liquidity via the Azure Cloud


Receiving Care Without Financial Burden

Founded in 2004, CarePayment provides patient finance solutions to hospitals, physician practices, and ancillary service providers nationwide, and have helped more than 4 million patients pay their medical bills. Their mission is to help providers get paid while helping patients achieve their financial obligations and get the best medical help they can.

The Double Bottom Line

The problem with patients’ ability to pay out of pocket expenses is national, and daunting. According to the Federal Reserve Board, 40 percent of Americans can’t cover a $400 emergency expense without borrowing or selling something. This is made more complicated by the increase in high deductible health plans (HDHP). The IRS defines a high deductible plan as “any plan with a deductible of at least $1,350 for an individual or $2,700 for a family”. An HDHP’s total yearly out-of-pocket expenses (including deductibles, copayments, and coinsurance) can’t be more than $6,650 for an individual or $13,300 for a family – a far cry above the $400 so many Americans already cannot pay.

CarePayment offers affordable payment plans to any patient who needs help paying their bills. Sponsored by the provider, the plans are 0.00% APR, and require no application and have no impact to a patient’s credit score. Everyone qualifies for the CarePayment program. The win-win relationship for both patients and providers lets patients seek the help they need while still being able to meet their financial obligations. For example, DeSoto Memorial Hospital, a rural hospital in Arcadia, Florida, with 149 in-patient beds serving 20,000 patients per year, had a small staff that struggled to collect payments. Their leadership believed people in the community were not seeking the care they needed because they could not afford both the deductible and out of pocket expenses. By partnering with CarePayment, DeSoto reduced costs for managing self pays and reassigned five full-time employees to other core business functions in the hospital, which resulted in an accelerated cash flow and return on investment1.

Unlike most traditional patient financing companies who only offer payment plans to those patients who actively ask for payment help before, during, or soon after their care, the CarePayment program is available to all patients at any time during their care journey – before care, after discharge, or months later when they are struggling to meet their financial obligation. Working in partnership with a hospital or doctors’ office, CarePayment offers zero percent interest solutions to patients to help fill the gap. CarePayment is the only program to work with providers to extend an invitation to their program to any and all who may need help – whether they actively ask for it or not.  As a result of this comprehensive program, the number of patients served is extensive.

Moving to the Azure Cloud

CarePayment recognized they needed to move to the cloud incrementally, building a cloud-first infrastructure. Speaking about their transition, Steve Kukulka, Chief Technology Officer said, “I want to reduce our spend and move toward more of a Platform as a Service (PaaS) architecture. If I don’t have to manage external services, I can use our dollars to deliver business value. The cloud gives me flexibility.”

Although they are a 24/7 service, CarePayment experiences peak volume from 7 a.m. – 7 p.m. CT. The cloud gives them the ability to scale up to meet their performance during that time while scaling down on weekends, which lowers their spend. “Ten to 15 years ago, there was a big move to capitalize as much of your IT spend as possible with hardware and services. It’s CapX but it’s cash none the less. Now the cloud comes in and it’s letting us shift back to an operating expense model. What matters at the end of the day is if you lower your IT spend.  For us, it’s lower with the cloud – you only pay for the propeller when it’s spinning rather than buying the whole airplane.”

When Kukulka joined CarePayment, they were in a Microsoft environment and the alignment to Azure was perfectly in place. “People – both staff and clients – were comfortable working within a Microsoft environment,” said Kukulka. “Given our existing stack, Azure was better aligned with our Microsoft environment, and given the clients we were servicing, they had a security mindset that made them comfortable with Microsoft,” said Kukulka. “We get all of the services we need in an IT stack that is highly optimized and a vendor that is aligned. With each passing day we never look back; we’ve seen how Microsoft has grown and their pace of innovation – we believe we’ve picked the winning horse.”

CarePayment’s customer base of providers want to see HITRUST certification assurances for protecting and securing PHI/PII. “That’s where ClearDATA came in,” said Kukulka. CarePayment needed protection for the applications that support their business which all contain sensitive data in the cloud. Faced with a small team, CarePayment relied on ClearDATA for infrastructure security, management and architecture, compliance to HIPAA and other frameworks, as well as the sound secure operational running of their applications.

“A core benefit of working with ClearDATA is the HITRUST 9.1 certification. Each provider has a very lengthy questionnaire and being able to map HITRUST to their requirements reduces the time required for me to complete these forms, and makes the process run more smoothly,” he said.

“As CarePayment continues to grow, ClearDATA is making sure my business continues to be successful. The ability to get on the phone with cloud architects and network engineers and say, ‘Here is what I want to do, and here’s what I’m thinking, and get their expert advice stemming from deep skill sets allows for long term resolution and success.” CarePayment chose and remains happy with ClearDATA for four primary reasons:

  1. Getting the security and compliance they need so that they can meet client obligations and protect their business
  2. Superior operational performance
  3. Expertise in healthcare and in the cloud
  4. Being a true partner.