← Becker’s Healthcare Podcast
Becker’s Healthcare Podcast
Building Trust Through Transparency in Healthcare Finance with Amanda Eisel of Zelis
00:11:40
Loading summary
Transcript19 lines
- [00:00]
A
Hi, everyone. This is Lucas Voss with Becker's Healthcare. Thanks so much for tuning in to the Becker's Healthcare podcast series. It's fantastic to have you excited to dive into new research today that explores the shifting financial landscape in health care. This new study captures really the perspectives of consumers, employers, and payers to uncover how cost pressures, price transparency, and emerging technologies like AI we have to talk about AI Are reshaping expectations. And I'm so very excited to welcome Amanda, Amanda Isoul, CEO of Zealous, to discuss how these priorities converge and why these findings ultimately create a roadmap for navigating complexity with clarity, empathy, and most certainly impact. Amanda, welcome to the Becker's Healthcare podcast. It's great to have you, Lucas.
- [00:48]
B
Thanks for having me. I'm excited for the conversation.
- [00:51]
A
Absolutely. To start us off, for those that might not know you, could you just share a little bit about your background and your work in healthcare?
- [00:58]
B
Absolutely. So I have spent my career building and scaling companies that use technology to solve complex problems, and healthcare has been a particularly meaningful space for me. So since 2021, I've had the privilege of being CEO of Zealous. We are focused on modernizing the healthcare financial experience. At the end of the day, our goal is to make care flow more easily by solving the inefficiencies and the fragmentation that plague the system, from inaccurate provider directories to outdated payment processes. Before Zealous, I was an operating partner at Bain Capital, working with technology and healthcare IT companies to help them scale. And then earlier in my career, I spent nearly a decade at McKinsey & Co. Advising consumer businesses, which gave me a really strong foundation for strategic transformations. Across all of these roles, I've been driven by a passion for creating organizations that make a real, measurable difference, especially in healthcare, where thoughtful technology can truly improve lives and let care flow.
- [02:08]
A
Amanda, so many great perspectives here from you, and I'm so excited to hear about them here. In a little bit, I do want to jump into our conversation about your latest report. I teed us up a little bit for this conversation here. It highlights both the challenges and the momentum building across the healthcare financial landscape right now. How are you seeing payers meet some of these challenges that you've identified head on? And where are you seeing some of that promising change?
- [02:34]
B
Sure. So our study, the State of Healthcare Financial Experience, uncovered a system strained by disjointed platforms, stakeholder friction, and burdens that fall disproportionately on payers, employers, and consumers. With insights from over 2,200 voices across the ecosystem. One message was incredibly clear. While the challenges are real, the appetite for progress is also very strong. Notably, cost pressures are intensifying and the ripple effects are felt by every stakeholder, from employers that are balancing budgets to members that are making tough decisions about their care, and payers that are caught in the crossfire of blame and expectation. So one stat for you. Our study found that 90% of employers expect premium increases and 68% of members have felt cost hikes in the last two to three years. In all of this, we think payers have an opportunity to ease that burden and restore confidence. So by shifting from reactive cost cutting to proactive optimization, payers are clearing the path for care to flow more seamlessly by removing barriers and creating space for better outcomes. This is where zealous provides value with a unified set of technology capabilities that address these pain points. So transparency is the connective tissue of the healthcare experience, bridging cost, quality and trust in ways that allow care to move with clarity and purpose. Our study also found that nearly half of employers say rising costs are their top challenge. And 35% now rank price transparency as their number one cost saving strategy. Payers who embed technology and transparency into the member journey, integrating cost estimates into provider search and care navigation, are not just meeting regulatory requirements. They're also rebuilding trust and creating competitive advantage. When platforms are interoperable and intuitive, they don't just reduce friction. They create a continuous navigable experience where care flows without interruption.
- [04:55]
A
And we'll touch on this is a very important point, I think, and we'll touch on this in a little bit because we'll talk about the member experience here in a minute. And I think what you just said is very important for that point. I do want to come back to something that you said earlier. I think you highlighted very well that this is an incredibly complex landscape. There's so many different factors that influence some of the statistics that you've mentioned and thank you for bringing them up. I think they're very telling. Where do you think health plans can make the most meaningful impact right now and what opportunities that are you seeing that are emerging to reduce some of this friction that you've also talked about?
- [05:30]
B
Yeah, so we personally think integration is the game changer. Another stat for you. Our study found only 47% of employers rate their current transparency tools as excellent, which might sound good, but that's a 15 point gap between importance and performance. Seamless, interoperable platforms that combine cost estimates, provider directories and prior auth can dramatically reduce friction this is where zealous is focused and where we think we can bring differentiated value that benefits payers, providers and members. Another thing to bear in mind, generational engagement also matters. So Zealous study also found that 73% of Gen Z and 69% of millennials use transparency tools, but only 49% of boomers do. Designing for generational preferences mobile first for younger members Simplified interfaces for older populations can boost engagement. Care doesn't flow in silos. Payers who co create with employers and providers build ecosystems where financial clarity and clinical quality reinforce each other.
- [06:42]
A
Now coming back to the member experience piece. And again, you've highlighted some of those numbers there in your answer. And I always think about myself as a consumer consumer as well. And I know transparency is very important to myself. I know that integration is very important. I want an easy an easy experience. What does this all mean for the member experience?
- [07:03]
B
Yes, I think you better remember obviously members aren't just seeking answers. They are navigating a journey. A care journey, which is deeply personal. Of over 1200 consumers surveyed as part of our study, only 39% report positive billing experiences and 71% are willing to pay for price transition transparency tools, which is pretty amazing. Payers offer clarity and simplicity through consolidated billing and navigation tools. They are not just solving problems, but they are guiding care forward. Members feel empowered to make informed decisions, reducing frustration and building loyalty. Transparency isn't just about cost. It is about trust. Embedding provider ratings, outcomes data and quality metrics into transparency tools helps members balance cost and care, driving better choices and deeper trust.
- [07:56]
A
And I think we get lost in that sometimes, right? We talk about transparency and we talk about these terms, but it does have a real impact on care. It does have a real impact for the patient, for the member experience, and it is truly, truly an important tool and truly an important piece to talk about. This is probably my my favorite question of our conversation here today. Not that they're not all great, but this is probably my fav favorite. What innovations or shifts are you most excited about when you're looking ahead? Shaping that future of the financial experience for payers and members alike? What are you excited about?
- [08:33]
B
We really believe the future is about unified platforms moving beyond point solutions to experiences that combine transparency, analytics, engagement and digital enablement. This convergence will drive smarter decisions and measurable outcomes. Perhaps no surprise, AI will play a growing role in automating administrative tasks, in personalizing member experiences, and in supporting decision making. Our study found that while only 10% of payers actively use AI across all functions. 78% believe AI will improve their processes in the next two years, a relatively short time frame. The key will be ethical governance, transparency and explainability to bridge the perception gap and drive adoption. Integrating quality metrics, provider ratings, outcome data into cost estimates will also help members make choices that balance affordability and care quality, elevating the value proposition for payers.
- [09:34]
A
Here I thought, Amanda, we were going to go without mentioning AI.
- [09:38]
B
Never.
- [09:40]
A
We cannot, we cannot write it. It wasn't the title. Well, Amanda, again, thank you so much for all these insights. Fantastic numbers coming out of that report. I encourage everybody to take a look at the full report to get those insights. Very, very interesting. I want to turn the floor over to you, Amanda. Anything else that we didn't touch on that we haven't mentioned that you think is important for our audience to understand or know?
- [10:04]
B
If there's just one thing I'd add, it's this. The future of healthcare finance isn't just about systems, it is about synergy. We deeply believe that when payers, employers and members align around transparency, trust and innovation, we create a landscape where care doesn't just happen, it flows. We think we're seeing real momentum in this. Tools are evolving, expectations are rising, and our study shows that the appetite for change is stronger than ever. A few more stats for you to close out. Percent of payers agree modernization is already showing measurable improvements. Employers are optimistic. 85% of employers have faith that meaningful health care system modernization is is achievable in the next few years. And finally, half of consumers feel that accessing health care has gotten easier and 48% of consumers believe that care quality will improve. So a lot of optimism out there. The challenges are complex, but the commitment to progress is clear and we are excited to be part of it.
- [11:10]
A
I love that we're ending on that note because it can seem daunting and we do talk about challenges quite a bit and all of the negative things and some of the things that might be harder. But there are a lot of positives and people are looking forward to them. Amanda, thank you so much for your time and insights today. What a great conversation. Thanks for being here.
- [11:27]
B
Thanks Lucas. Appreciate it. Great to talk.
- [11:29]
A
And we also want to thank our podcast sponsor, Zealous. You can tune into more podcasts from Becker's Healthcare by visiting our podcast page@beckershospitalreview.com.