Read the full article as it originally appeared in Authority Magazine.
As a part of our series about women who are shaking things up in their industry, I had the pleasure of interviewing Laura Collier.
Laura Collier is president of Penstock Group, a healthcare payment integrity and reimbursement company that is reducing healthcare costs by finding innovative ways to eliminate billing and payment errors that cause patients to pay more than they should. With two decades of experience in payment integrity supporting large healthcare organizations, Laura joined Penstock in 2021 and the company has thrived under her leadership, achieving profitability and more than doubling the size of the team. Penstock only generates revenue when it lowers healthcare costs for clients, so its success is directly tied to its mission of removing wasted spending from the healthcare system
Thank you so much for doing this with us! Before we dig in, our readers would like to get to know you a bit more. Can you tell us a bit about your “backstory”? What led you to this particular career path?
I started my career during my senior year of high school working in investment banking. I worked full time while attending college to complete both my bachelor’s and master’s degrees. After working for about 10 years in the industry, I was approached with an offer to work as a technical writer for a large IT consulting company.
As I learned more about healthcare and, more specifically, payment integrity, I switched my focus and began working externally with health plan clients to help reduce costs and find solutions to fix some of the issues within the broken healthcare system. This is where I met Jeff Snyder, who is now vice president of operations at Penstock, and Chris Gallagher, who is now Penstock’s vice president of delivery. As we worked together and began to implement lasting changes for both the organization and the clients we supported, my passion for fixing our healthcare system really began to develop. The three of us traveled together to client meetings and began having discussions about the bureaucratic nature of large companies. We talked about how great it would be to start our own company where we are not bound by red tape and distractions and could focus on our true mission of developing healthcare reimbursement policies and practices that are transparent, fair, efficient and accurate for all patients.
Jeff was introduced to, and began discussions with, Mike Waterbury, CEO of Goodroot Inc. He pitched the idea of the company that the three of us had spent so much time envisioning. The company would become Penstock, and its mission and vision are in lockstep with Goodroot. Mike supported this endeavor, and Jeff and Chris both joined the Goodroot organization. After several discussions with Jeff and Chris, I took the leap and joined Penstock in June 2021 as the chief operating officer and was promoted to president this year. The three of us had finally found the right place to allow us to truly focus on fixing our healthcare system and bringing our ideas to life. I could not be happier with this move, and I am so proud to be a part of this amazing group of people who are so supportive and passionate about the overall mission to lower healthcare costs.
Can you tell our readers what it is about the work you’re doing that’s disruptive?
A leader is only as good as the team that supports her, and I am backed by an amazing group of individuals who are identifying new ways of doing business. We are developing new concepts and industry-leading solutions that create transparency in healthcare billing and prevent medical billing errors that add to the rising costs of care and our nation’s massive medical debt problem. The Goodroot infrastructure and culture provide an environment that allows its companies and individuals to express ideas, develop solutions and implement changes that disrupt the industry.
For people with an idea, a disruptive idea, one of the most difficult obstacles to overcome is having a foundation or infrastructure in place to support the work that needs to be done. All the time spent on the ancillary aspects of a business is time not being spent on solving a problem. Goodroot provides that for its community of companies, so I don’t have to worry about marketing, payroll or IT. My team is able to dedicate its entire focus to reducing wasted healthcare spend and saving our clients money.
At Penstock, we are disrupting the healthcare payment integrity industry. There is a lot of complexity and lack of transparency in healthcare that leads to billing errors that either are never identified or occur repeatedly. Rather than simply finding and correcting errors and collecting a fee (potentially the same fee over and over), we are making a study of chronic problems in the healthcare industry and addressing them at the source to ensure that care is billed and paid for accurately going forward. We’re correcting errors and providing education and training to prevent those errors from occurring again.
For example, in the state of New York, state-level surcharges and assessments are applied to products and services offered by healthcare payors. In 2020, total surcharges collected rose almost 7 percent over 2019 levels. This is the largest annual increase since 2011. Through 2024, the surcharge is expected to exceed $4 billion. At Penstock, we have expert resources that are on a mission to find out why.
This solution is expanding rapidly, having already corrected and recovered over $25 million without impacting plan members or providers. An additional $25 million has been identified and is pending processing. By Q3 2022, the industry will be seeing additional innovative solutions coming out of Penstock in the payment integrity space. We’re focused on end-to-end audit management, an innovative tool to help skilled nursing facilities eliminate overpayments altogether, and improving the way post-acute skilled care is delivered and paid for.
In today’s parlance, being disruptive is usually a positive adjective. But is disrupting always good? When do we say the converse, that a system or structure has ‘withstood the test of time’? Can you articulate to our readers when disrupting an industry is positive, and when disrupting an industry is ‘not so positive’? Can you share some examples of what you mean?
In the healthcare industry especially, disruption is often viewed as unwelcome or uncomfortable for a lot of people. It challenges what they have come to know and are comfortable with. Disruption, however, can be a good thing. It forces us to evaluate the status quo and to identify potential opportunities for positive change.
The advantages of disruption include things like improved business processes and workflows, opportunities for growth, and access to broader resources. For example, Penstock is currently developing industry-leading technologies and solutions to help improve the way healthcare claims are paid. The results of this disruption will be the ability to easily identify overpayments, permanently correct billing errors, and the lowering of the overall cost of care in this country. Our payment integrity tool is designed to help streamline audit management workflows, from the initial data ingestion through claims adjudication. While it sounds complicated, the result is a level of clarity in data currently not available to healthcare payors who can use our tool to assess, track and compare performance.
We are also creating a tool that will enable Medicare Advantage Plans to pay skilled nursing facility claims more accurately. It will help to simplify the complex payment methodology that has led to inaccurate code assignments and improper payments. These tools are examples of positive disruptors, as they are helping us accomplish our mission of developing unique solutions, eliminating unnecessary costs, and creating lasting systemic change with the goal of decreasing the cost of healthcare and increasing access.
Can you share 3 of the best words of advice you’ve gotten along your journey? Please give a story or example for each.
- Opportunities surround us. Look for the reasons why you can instead of identifying reasons why you cannot. Too often in life, it is easier to say we cannot do something, or we sit and wait for the right opportunity to come along. Opportunities are everywhere, and instead of waiting for what you perceive to be a big opportunity, focus on the opportunities that are available here and now. Value can be created in all situations. Problems can be solved. Improvements can be made. Steps, even if they are small, can be taken in the right direction. This outlook is crucial in the notoriously broken US healthcare industry.
- Always do the right thing even when no one is looking. This shows a person’s true integrity. This is more about having a good moral compass guiding my decisions and not expecting acknowledgement or praise.
- Surround yourself with successful people. As I’ve watched friends and colleagues advance in their lives and careers, it has helped me stay driven to reach my own goals.
We are sure you aren’t done. How are you going to shake things up next?
We will continue to find ways to remove waste from the healthcare system, ultimately lowering the overall cost of healthcare. The biggest achievement for us would be to “put ourselves out of business” because we have fundamentally fixed this part of the healthcare system by creating transparency in healthcare and a fair cost of care.
However, our focus at Goodroot is one system at a time. We know our healthcare system cannot be fixed overnight — instead, as a community of companies, we take it one system at a time and find small ways to fix the system that can add up to big changes. So, because of the support of the Goodroot community and the platform we have, our team at Penstock is always focused on the next piece of the healthcare system we can reform.
In your opinion, what are the biggest challenges faced by ‘women disruptors’ that aren’t typically faced by their male counterparts?
Some of the biggest challenges faced by “women disruptors” that aren’t typically faced by their male counterparts include the following:
- Barriers related to women with families and working spouses
- Stigmas related to working moms versus stay-at-home moms
- Cultural stigmas surrounding working women
- Mentorship programs in male-dominated workplaces
- Personality traits related to gender differences
We’ve come a long way in addressing these challenges, but there is still a long way to go. There are many companies, like Goodroot/Penstock, where women are provided opportunities for growth and advancement.
You are a person of great influence. If you could inspire a movement that would bring the most amount of good to the most amount of people, what would that be? You never know what your idea can trigger.
We are in need of a drastic change within our healthcare system. Too many people are going without the necessary and proper level of care. Too many people are going bankrupt as a result of medical debt. The cost of care is unknown until after the services and procedures are provided and debt has accumulated. We are paying high costs for health insurance with large, out-of-pocket premiums. We need more people to come together to help develop solutions that enable us to overcome these issues. This is what our community of companies at Goodroot is working toward, providing the resources and community of like-minded, passionate innovators and disruptors and bringing new voices to the fold that have the expertise and ideas to improve our healthcare system.