Personalization and Innovation in Healthcare Payments at Cleveland Clinic with Flywire

Summary

---

Becker’s Healthcare Podcast Summary

Episode: Personalization and Innovation in Healthcare Payments at Cleveland Clinic with Flywire
Date: November 7, 2025
Guests: Rob McDaniel (Cleveland Clinic), Keith Jebelkin (Cleveland Clinic), John Talaga (Flywire)
Host: Brian Zimmerman (Becker’s Healthcare)

---

Episode Overview

This episode focuses on how Cleveland Clinic, in partnership with Flywire, is modernizing the patient payment experience. The conversation delves into historical challenges in healthcare payments, actionable strategies to improve patient and caregiver interactions, the role of technology platforms, and broader lessons for healthcare leaders looking to personalize financial experiences.

---

Key Discussion Points & Insights

1. Historical Challenges in Healthcare Payments

Speaker: Keith Jebelkin [00:42]

• Fragmented Payment Channels: Patients expect seamless payment experiences across all touchpoints—kiosks, front desks, digital portals—but Cleveland Clinic faced inconsistent experiences, with devices sometimes not working, leading to downstream workflow disruptions.
• Impact on Patient Experience: Disjointed payment systems inconvenience patients and place additional burdens on staff, ultimately affecting perception of care.
• Foundation for AI & Future Innovation: Jebelkin emphasizes that a unified, reliable financial experience is essential groundwork for leveraging AI and other future technologies.

"If it's not working... you have to have other people that move off of their jobs... At the end of the day, it's the patient that's hurt." — Keith Jebelkin [01:16]

---

2. Redefining Success: Patient & Caregiver Perspective

Speaker: Rob McDaniel [04:10]

• Patient Viewpoint of Success:
  • No financial surprises.
  • Timely, consistent, personalized communication about payment options (e.g., Apple Pay, Google Pay, checks).
  • Convenience and adaptability based on patient preference.
• Caregiver & Staff Viewpoint:
  • Access to accurate, consistent tools and information.
  • Reduced stress in financial conversations due to improved transparency and streamlined processes.

"From the patient perspective, a successful financial experience in my mind means no surprises." — Rob McDaniel [04:13]
"The tools we use to deliver information need to be accurate... so they can deliver the best communication to the patient." — Rob McDaniel [05:07]

---

3. Advice for Other Healthcare Organizations

Speakers: Rob McDaniel, Keith Jebelkin, John Talaga
Timestamps: [06:20]–[09:38]

• Unified Approach is Crucial:

  • Cross-departmental alignment (Treasury, Revenue Cycle, IT) is needed from project outset through implementation.
  • Consistent objectives prevent scope drift and implementation paralysis.

• Patient-Centric Mentality:

  • Anchoring every decision to patient benefit ensures initiatives aren't just about technology but practical impacts on care quality and experience.

• Partnerships Matter:

  • Flywire’s role: Not just a vendor but a partner, bringing external expertise and facilitating internal coordination.

"If you keep changing your mind, you're never going to get anything accomplished... Bringing in someone like Flywire... has been paramount for our success." — Rob McDaniel [06:58] "What are the problems we're trying to solve today, what are our patients asking for?... That was our North Star." — Keith Jebelkin [07:28]

---

4. Building Forward: Lessons That Shape the Future

Speaker: John Talaga [10:03]

• Customization Despite Standardization:
  • Even with common tech (e.g., Epic EHR), each health system’s workflows vary.
  • Flywire leverages learnings from Cleveland Clinic to iterate products, but recognizes each client requires integration best suited to their internal processes.
• External Partnership Drives the Roadmap:
  • Product development is shaped by on-the-ground client input, not just internal ideation.

"Our roadmap is really kind of designed around solving problems and constantly evolving... It's not from within. It's really externally with, with our partnerships." — John Talaga [10:41]

---

Memorable Quotes

• "A frustrating consumer experience over something small... a frustrating financial experience over your health, I can just—it's easy to empathize with that." — Brian Zimmerman [02:51]
• "It's an incredible shame if someone has a bad patient financial experience... and next time they go somewhere else that is subpar clinical care, just because from a payment perspective, it was easier." — Keith Jebelkin [03:02]
• "These kinds of regulatory changes... are only going to make it worse. So I think there's an affordability crisis for sure that I think is being addressed by Cleveland Clinic." — John Talaga [12:52]

---

Important Segments & Timestamps

• [00:42] Keith Jebelkin on historic payment channel challenges
• [04:10] Rob McDaniel on patient and caregiver definitions of success
• [06:20] Unified approach lessons & importance of stakeholder alignment
• [07:15] Keith Jebelkin on maintaining patient as the North Star
• [08:38] John Talaga on cross-functional partnerships and technology role
• [10:03] John Talaga on Flywire's roadmap and client-driven innovation
• [11:25] Final takeaways from all three guests

---

Final Takeaways

• Keith Jebelkin [11:26]: Empathize with patient journeys—considering family impact, costs (both planned and unplanned), and striving to meet patients where they are for affordability and seamlessness.
• Rob McDaniel [12:13]: Projects that fundamentally change patient experiences are challenging but necessary. Health systems shouldn’t shy away from hard work if it’s the right thing for patients.
• John Talaga [12:52]: Rapid changes in reimbursement and regulation are raising patient financial responsibility, making affordability a top priority. Health systems that fail to innovate risk negative outcomes for both patients and organizational finances.

---

Tone & Flow

The conversation is candid, collaborative, and empathetic, emphasizing patient experience above all, while acknowledging the complexity and significance of modernizing healthcare payments. The tone is practical, layered with encouragement for healthcare leaders to tackle difficult transformation projects.

---

Transcript

[A]

Hi everyone, this is Brian Zimmerman with Beckers Healthcare. Thank you so much for tuning into the Beckers Healthcare podcast. Today we're going to talk about personalization, innovation and the future of healthcare payments. Joining me on site at Becker's Health IT Digital Health RCM event here in Chicago for today's discussion are three terrific leaders. Rob McDaniel, Senior Director, Revenue Cycle Management at Cleveland Clinic, Keith Jebelkin, Executive Director, Digital Business with Cleveland Clinic, and John Talaga, EVP Healthcare with flywire. Gentlemen, great to be with you.

[B]

Thank you.

[C]

Thank you.

[D]

Thanks.

[A]

Keith, let's begin with you. So, by modernizing the patient payment experience at Cleveland Clinic, what historical problems has this solved and what opportunities does this create for the future?

[B]

Yeah, great question. So right off the bat is first off, because we deal with payment processing all throughout our life and a variety of different channels, whether it's in person or over the Internet or through our phone, is we all just expect it to work and to work seamlessly. And that's not been our experience at the Cleveland Clinic. The experience in each of those different channels can vary, including just if they're even working. And so what I just mean by that is we have a number of devices at whether it's welcome kiosks or in person at different front desks that we're not even aware of aren't working. And then it has all of these downstream impacts because if it's not working and you cannot see successfully check in a patient to take their co pay, then you have to have other people that move off of their jobs to be able to do that. There's all these downstream impacts. And at the end of the day, it's the patient that's hurt. And so that's a core problem that we really need needed to solve, which is that this is a seamless experience for the patient. Now the other thing is, just as we look forward to the future, as all of us know, in order for AI and generative AI and those types of capabilities to really be able to work, it's all built upon the foundation of what you have. And so by really unifying and creating this very strong foundation, none of us know, you know, what, what the future will be, but we know that that is going to be a core part of our future. And absolutely, the patient experience, the patient financial experience and ways that that can be done, it's all going to be foundational on this working well so that we can build into that and just make that a much better experience in the future. So it's core to that.

[A]

Yeah. And to go to your, the, the, the sort of experience people are used to. I mean, I'm, I personally will get frustrated when if I have a trouble like you don't take Apple Pay. I'm not buying this. Yeah. You know, over a gizmo where I imagine health care stakes are just much higher.

[B]

That's right.

[A]

And so I would have a frustrating consumer experience over something small, whereas like a frustrating financial experience over your health. I can just, I mean, it's easy to empathize with that, Right?

[B]

Absolutely. Absolutely. Yeah. And then get to that. Is that, you know, depending on where you live, there can be other places that someone can go. And ultimately would be an incredible shame is that someone has a bad patient financial experience on that journey and then next time they go somewhere else that is subpar clinical care. But just because from a payment perspective, it was easier and that's not what we want for the patient.

[A]

Completely undermines that great experience that they had with their physician.

[B]

That's right.

[A]

They have a frustrating financial experience. And then you know what? I'm going somewhere else next time.

[B]

Exactly.

[A]

Rob, as you think about sort of the launch of this project, changing the payment experience for patients at Cleveland Clinic, what does a successful patient financial experience look like from that patient's perspective? And what does the success look like from a caregiver perspective as well? Because this also has implications for caregivers, also for staff just across the board. If you're having to have a conversation with a frustrated patient, that's not a great way to spend your day as a caregiver or staff member either.

[C]

Yeah, exactly. Thanks. Great question. From the patient perspective, a successful financial experience in my mind means no surprises. Information should be delivered in a timely and consistent manner and really tailored to the patient's preferred payment method. Like you said, you want Apple Pay. We haven't had Apple Pay available at our facilities. We will now. Whether they want to pay with a check, with a credit card, with an E wallet, Apple Pay, Google Pay, or what have you, we want that experience to be as convenient as possible to meet them where they want to pay. And that's really what success looks like. It's creating a positive, meaningful and consistent end to end experience for the patient to help achieve their successful outcomes. Similarly, really from the caregiver perspective, the tools that we use to deliver information need to be accurate, need to be consistent. So they're the ones. To your point, they have to talk to the patient, they're in front of the patient, and they're the Ones that are being held accountable to. This is what my co pay is, this is what my deductible is. And the patient needs to know that that's consistent and accurate. And so the having the tools for the caregiver to make their job as stress free as possible and delivering that message is of the utmost importance. And so that's what success means to me from a caregiver perspective really is to have the tools that are accurate so they can deliver the best communication to the patient.

[A]

Yeah. And of course it's easy to then think if, like if they, if the caregiver doesn't have the tools that are accurate, they're going to be upset with somebody.

[C]

Right.

[A]

So I guess thinking about this, and this is for Rob, Keith, John, you can chime in here too if you like. Just sort of curious to hear what advice you would give to folks out there who are trying to modernize the patient experience. Because Cleveland Clinic, obviously, you know, you're a very advanced system, very innovative system. You know, if Cleveland Clinic is having some problems with the patient financial experience, it's easy to extrapolate that out and think about, well, a lot of folks out there might be struggling here. So I'm sure some folks would love to hear some advice from you all in terms of what you've achieved here.

[C]

Yeah, I would say overall what I've learned, and I know Keith and John and I have talked about this, is having a unified approach from the very beginning is paramount. So at the Cleveland Clinic, before we even went down this journey revenue cycle, it treasury, we were all aligned in what our objectives were and we have not deviated from those objectives throughout the course of not only the RFP process of trying to find the new solution, but also in the implementation process. When you try to redo the financial journey, it's not a small feat. And if you keep changing your mind, you're never going to get anything accomplished. And so I think the biggest lesson learned from our standpoint was we were unified from the beginning. And bringing in someone like Flywire to really help us be the glue to keep us together, show us where we needed to go and guide us based on their expertise has been paramount for our success.

[B]

Yeah. And what I would add is foundationally is to come with the mentality of what is best for our patients by doing that, everything they're the North Star of what we're doing. This isn't just a technology project that we are going to enable these different components. It's what are the problems we're trying to solve today, what are our patients asking for? What are they looking for? And that can look different depending on where you are. If you're a more rural hospital care system, that journey may look a lot different from one that's more urban. And so really into this, you know, as you working with Flywire and as they showcase to us what these different capabilities are, we really looked at our patients and said what we're patients as well, and what would we want? And that was our North Star. And so there were times we had to challenge what even was already existing and what we needed to move into because we wanted to make sure it was what was best for the patient. And at the end of the day, when this is all said and done, if what we're doing is best for the patient, that's when we can look back at this and said we've done something to move the needle in a very positive way, not just because we've implemented this technology solution.

[A]

Some great points. John, would be curious to hear from you on this too. And then I have a separate question for you.

[D]

So I think the most important thing in going into these, I want to echo what Rob said is bringing together the different stakeholders, making sure the stakeholders are aligned. And I think we look at our role in this ecosystem as a partnership in bringing technology, functionality, solutions, experiences from other providers to Cleveland Clinic. And at the same time as we do that, we're hearing from the Cleveland Clinic team as to how they want to adapt, change and add things, which becomes a huge part of our go forward of offering that to other hospitals as well. So I think it starts with, I've said this before, we've gone into hospitals where we're introducing people from treasury to rev cycle and sometimes people from IT to rev cycle. And it's important to make sure that everyone's objectives and is focused on the the same thing in the end.

[A]

Yeah, let's talk more about that sort of the go forward, as he put it, sort of the momentum here. After working with an organization like Cleveland Clinic, can you get into some more details about how that kind of partnership, that kind of experience will influence sort of flywire's roadmap for the future? How do you really take the lessons learned from this and bring innovation and offer that to other partners in the future?

[D]

So health systems will always say there's no two health systems that are the same, right? Two may be on epic. It doesn't mean they're the exact same experience. So from our perspective, we can standardize data, we can standardize technology offerings, but we have to be able to integrate it into the system, the ehr, as well as the workflow of the system. And so we get better at kind of fine tuning our technology and solutions as we are challenged with the same challenges that a customer like Cleveland Clinic has now, those things often will kind of extend into similar challenges that other hospitals have. And we are solving problems for them as well. So our roadmap is really kind of designed around solving problems and constantly evolving it from that perspective. And it's not from within. It's really externally with, with our partnerships.

[C]

Yeah.

[A]

And the problems are varied and they're, they're out there and you're going to keep running into them. And that's probably what makes the work gratifying too, is 100%. There's, there's challenges to be solved out there. Since we are on site at the conference, I'm going to end this the way I would a panel. I'm actually going to tap on each of you to, to share a final takeaway, one closing thought with our, with our listeners. Keith, let's begin with you.

[D]

Yeah.

[B]

So my final thought for you is just as you hear what we're saying here and you think about your healthcare system, you're thinking about your patients and you're thinking about their financial journey, think about the fact that they have families, your patients. And the thing with healthcare is some things are planned and oftentimes things are unplanned when it comes to healthcare. And that can include the cost. And so as we put ourselves in those patients shoes, what is the best way that this journey can be affordable for them and seamless and meets them with where they're at and just see where you're at today? Is that where you want to be? Is that what's best for your patients? Or do you need to look and see what else is out there that can be a much better experience for them and affordable?

[A]

Thank you, Rob.

[C]

Yeah, no, thank you. And I think that's a great point, Keith. And to expound on that, really what I would say is projects like these of trying to change the experience for an entire patient set, they're not easy. And because they're not easy, I think a lot of health systems might be scared off and not even want to dip their toe into that or not really look at it from the patient perspective. And so I challenge everyone to really think about what Keith said about how this is impacting the patients. And although not easy, it's the right thing to do.

[A]

And that old adage, right. Everything that's worth doing is hard to do. Right. Thank you, Rob. John, what do you have?

[D]

So things are changing quickly. Like you have reimbursement that's changing. Uncertain is out there as well. And then that's impacting continued increase in patient responsibility. And these kind of regulatory changes are only going to make it worse. So I think there's an affordability crisis for sure that I think is being addressed by Cleveland Clinic in terms of addressing what's best for the patient and doing things the old way or not changing fast enough is going to have some real strong impacts both on the patient as well as the financial health of the organization.

[A]

Most definitely. Well, John, Rob, Keith, it was a pleasure speaking with you today. Thank you so much for coming on the podcast and thank you to our podcast sponsor, flywire. You can tune into more podcasts from Becker's Healthcare by visiting our podcast [e-mail].