Podcast Transcript 

Bart: Hey builders, if there’s one thing we can rely on, it’s that healthcare will continue to be a hot topic for the upcoming elections. It’s also an industry that many entrepreneurs avoid entirely, but the fact that it’s a struggling industry is exactly what drew Steve Neeleman into it.

Bart: As he was finishing college, Steve Neeleman worked as the general airport manager for Morris Air. By combining efficiency, technology, and excellent customer service, he helped Morris Air succeed in a rocky industry. Years later, after Steve became a surgeon, he had an idea to save another struggling industry, healthcare. Today, we’ll hear how Dr. Neeleman started HealthEquity and built it to stay. So Steve, thanks for joining us today.

Steve: Thank you, Bart.

Bart: Built to Stay is all about building businesses for longevity. You’ve been working on HealthEquity for the past 17 years, and with a $4.8 billion market cap, and healthy financials that have outperformed the S&P 500 for the past five years, it looks like you’ve built it to stay. So to get started, Steve, I’m wondering if you can tell us just a little bit about your story? How did you get started in the airline industry and then move over to healthcare?

Steve: Yeah, I think it’s a little bit different than other folks. So when I was in college, my brother started a small airline here in Utah called Morris Air, and I was working up in Alaska one summer with him and then came down to Salt Lake, and over time as I finished my college, he asked me if I’d stay on and be the airport manager.

Steve: They were getting ready to do a public offering, and so everything was about trying to really manage things tightly, save money, get ready to go public, and so as I was doing that, right kind of in the middle of our IPO, Southwest Airlines called us up, and they acquired the company. So, this was in 1993.

Steve: At that point, I stayed on for an extra year to transition but decided to go back to medical school. Now on my way to medical school, I had this medical experience, which I think everyone kind of has their story as to why they start a business. In my case, I had a stomach ache for probably the first time in my life that was so severe I couldn’t go to school or anything.

Steve: I went to see a couple of doctors, and ultimately, the insurance company denied the claim, because in one of my doctor’s visits, I had told them I’d had a stomach ache before. So they said, ‘Well, we’re going to deny it, because that’s a preexisting condition’, and I thought, ‘You know, there’s this inequity here. I’ve given this company thousands of dollars of premiums, and they denied my claim over a $150 claim.’

Steve: Went back to the doctor, and said, ‘I can’t pay this’, and he cut the bill in half, and said, ‘Well, I typically only get $75 for that anyway from the insurance company’, and it took me five months to pay him $15 a month, the claim cost, and so that really kind of got the creative juices flowing.

Steve: I did go into medical school, went to the University of Utah, and then ultimately trained as a general and trauma surgeon and worked for 12 years as a trauma surgeon. But along the way, I just kept thinking of that experience I had, and how consumers going into this new world of higher deductibles, and different types of accounts they could pay for them, I thought, ‘You know what? Consumers need effectively a tour guide. They need someone that’s going to help them navigate these kind of crazy waters of healthcare.’ So, that became the initiative to start HealthEquity.

Bart: Okay. So you worked for 12 years as a surgeon, and during that time, you’re thinking about this idea. At what point did you say, ‘Hey, I need to go do this’, instead of continue to–‘, I’m not going to say it’s riding a gravy train, but surgeons make a decent amount of money. It’s a good living. I mean, was there an entrepreneurial spirit that you kind of tapped into there and just knew you had to go and pursue, or how did you make that transition?

Steve: Well, I mentioned that my brother had sold this airline to Southwest. He went off to work for Southwest, and he was their chief innovation officer, and he wanted to implement some of the things we had done at Morris Air: electronic ticketing, home reservation agents, just some really kind of cool things we had done. At Southwest, they weren’t interested, so then he went and started JetBlue.

Steve: So, he sent me his business plan while I was finishing my residency in surgery, and he kept talking about bringing humanity back to air travel, and again, I thought, ‘We need to bring humanity back to medicine,’ and so it was really just as I was finishing my residency, so this was nine years in postgraduate. So, four years of med school, five years of residency that I started writing the business plan, and then just as I finished my residency, I did it. And so HealthEquity we started in 2002.

Steve: I went into practice part-time as a general surgeon, and started the company part-time, had some great partners, started the company above a garage, and our whole question was, is, ‘How do we help healthcare consumers navigate kind of the new world of healthcare?’.

Bart: Okay. So, let’s just pause a minute and make sure that all of our builders recognize what you just said. So, your brother is the founder of JetBlue, Dave Neeleman.

Steve: Yep.

Bart: And so you had some inspiration, you had worked with him, you had seen that he could make something big happen, and you kind of felt like, ‘Hey, I can make something big happen and solve another problem.’

Steve: Yeah. I mean, David is eight years older than me, but we worked together. We used to work together when we were a lot younger at my grandfather’s store, and to see what he was able to do with JetBlue, first Morris, then JetBlue, and now Azul, and Brazil, and TAP, and Portugal, and he just announced another airline, certainly gave me inspiration, and when I went to David with my business plan in early 2002, he knew I was going to ask him for some money, and he gave me some just fantastic advice.

Steve: First thing he said is, ‘I’m going to send you an article called the constant customer,’ and he said, ‘It’s about how to turn customers that are normal customers into passionate customers.’ He said, ‘You need to incorporate those principles of that article into the DNA of your company.’ He said, ‘You also need to get me some more research to make sure this can be a bonafide business,’ and he said, ‘The third thing is, how much do you need to raise?’

Steve: And I said, ‘I think at least 2 million bucks,’ and he said, ‘If you’ll raise a million, and put it in escrow, then I’ll match it.’ But he said, ‘I’m not going to give you any money until you can raise.’

Bart: And that was before you started HealthEquity.

Steve: Yeah, that was in 2002.

Bart: And did you bring some of your own funds to the table as well? I mean, as a surgeon, could you do that? Or were you still paying off med stuff?

Steve: Yeah, trust me, and I certainly did mortgage my house through this whole process, and all of that, and so yes, I put my own money into it. I kind of begged, borrowed, I didn’t steal. I begged, and borrowed from friends, and family, and we were able to raise $1 million, and then at that point David matched the deal, and we started hiring technologists, and sales people, and launched the company formally in November of ’02 and had our first client in September of 2003.

Bart: Okay. So, it took about a year to get your first client. Now, tell us a little bit more about what problem you are actually solving with HealthEquity and the structure that you came up with.

Steve: So the healthcare climate, even that early was clear that consumers, people that were using the services, we call them patients in healthcare, but I like to call them customers, they were going to start seeing a lot more money come out of their pocket for healthcare.

Steve: In higher premiums, that’s how much you pay every month for your insurance, higher deductibles, that’s how much you have to pay. If you have an accident, or you have a baby, you have to pay your deductible, and then copays, and then there’s also something called co-insurance. And so deductibles, copays, co-insurance, premiums, all of these things were going to start getting more, and more for consumers.

Steve: And the reason for that was costs were going up, new technologies, people were living longer, insurance companies, and employers were having to shift more cost to the consumer. That was pretty much standard belief then, even back in early 2001, 2002. So the question was, ‘How would you help the consumer to come up with the money they need to make those payments, perhaps even save some for retirement along the way, but then also make better choices when they go to spend their money?’

Steve: So, it was kind of this tour guide, right? How could you be an expert friend to help those people make good choices?’So at that point, President Bush, his Administration, they were looking at some legislation that would expand a little known account called the medical savings account to allow it to become a health savings account. MSAs, there was just a few Americans that had them, and had them for a few years.

Steve: We went back to Washington D.C. right after we started the company, and we started talking to the legislators, congressmen, senators, and saying, ‘Support this’, and so just right after we kind of got going and had our first customer on board doing management of their medical savings account, the law passed: health savings accounts became law. First time someone could have an HSA, or a health savings account was January one of ’04, and then we were off to the races.

Bart: So you, and your team were actually instrumental in getting the law passed for HSAs?

Steve: Yeah. Well look, I mean, ultimately we never wrote any law, but we talked to a lot of legislators back then.

Bart: Helped them understand the issue.

Steve: Helped them understand the benefit.

Bart: Yeah. Okay. Wow.

Steve: And kind of became the consumer solution here. The other thing we did is we’ve always worked very closely with health plans, and then also employers, because that’s where people get their insurance, and we’ve always said when people start to go to these types of a plans, health savings account plans, they’re going to need help. They’re going to need technology, they’re going to need support, they’re going to need financial services, but sometimes in the middle of the night, they’re going to need someone to talk to.

Bart: Yeah. So I’ve had a HealthEquity, HSA account for, I don’t know, five years, seven years, something like that. So, is that the main business, the main product, or service you provide is these HSA accounts for people all over the country?

Steve: Yeah, most of our revenue right now comes from health savings accounts. We serve about 45,000 employers right now throughout the country.

Bart: Wow.

Steve: Over 4 million families, but more and more people want other types of accounts too. They want a flexible spending account maybe for dental or vision purchases that you can use so you don’t have to use up the money in your HSA. There’s other accounts like a health reimbursement arrangement. Even more and more people need help with Cobra if they’re between jobs.

Steve: Cobra helps you to continue your health insurance. There’s a thing called a commuter reimbursement account that helps you pay for your commuter charges. For example, if you live in New York City, and you want to ride the subway, you can do a commuter reimbursement account.

Bart: Interesting.

Steve: So, there’s all these different types of benefits accounts. Most of them have the feature of being pre-taxed. There’s even a dependent care reimbursement account if you need help with childcare. So, because we’re so strong on HSAs, we’ve been asked to do these other types of accounts, and so we’ve now started to diversify our offering, and we offer many of those types of accounts.

Bart: That’s very cool. So, you really have two customers. You’ve got the end user as well as these companies that are trying to offer this benefit to their end users?

Steve: Yeah, language is pretty important around HealthEquity. For example, everyone on our team is referred to as team members or teammates. We’ll slip into little shorter version. We also talk about partners, and so partners would be the large employers, or even smaller employers. In health plans, it’s more of a B2B. We’re selling them B2B, but then our members are the ones that are calling us, sometimes all hours of the night.

Steve: I was talking to one of our member service agents the other day, and she told me that she works the graveyard shift, and every night she has 15 or 20 calls from people that need help understanding this. And so from day one, I remember I walked into our small office above a garage, we didn’t actually start in a garage, we started above a garage, small apartment, and they said, ‘Steve, we’ve got our first customer. When are we’re going to start taking calls?’. I said, ‘Well, better start now,’ and they said, ‘Well, what hours?’ And I said, ‘As a physician, I take calls 24/7, because it keeps people from going to the emergency room.’

Bart: Are you okay with that, 24/7? They’re like, ‘Yeah, sure, I guess.’

Steve: Sure. In fact, they are. One of our co-founders asked me, he said, ‘Well, who do you think is going to call us at two in the morning?’ And I said, ‘I don’t know, Dave, but whoever does call us is going to need us’, and so that’s been one of our industry calling cards is best service.

Steve: You know, we’re a net promoter shop, so we really follow our NPS surveys, and so we want to have great service, great technology. But to your point, we do have lots of interaction. We’ll take well over a couple of million calls this year from consumers.

Bart: From members, for you.

Steve: Yeah. Members.

Bart: Members and partners.

Steve: Yeah, members.

Bart: Very cool. So, every entrepreneurial endeavor is different, and some have big challenges up front, and well, most are probably a lot of challenges up front, but what were those for you?

Steve: I learned very early on. We had someone come on our board, he was a very thoughtful guy who was our chairman, and he said, ‘You know the rule of 24.’ And I said, ‘What’s that?’ And he said, ‘Well, it’s either going to take twice as long, and four times as much money for you to get this thing off the ground, or it’s going to take twice as much money, and four times as long as you think it’s going to take, but it’s going to be one of those variations.’ And so I think any small business, even if it’s a fantastic idea, they need to be able to have the enough capital to make it work.

Steve: So, funding is huge. I mean, I don’t care what your idea is. It takes time; it takes money. And then you’ve got to be lucky in some cases, right? I think back many, many times where had we maybe gone down the left side of the road, versus the right side of the road figuratively, we might have ended up as a different company, maybe owned by somebody else, or maybe we would have put too many of our eggs in one basket with a given partner, and that could have led to not having the success we’ve had.

Bart: Do you feel like your medical training helped you as an entrepreneur?

Steve: You know, I was telling a couple of my colleagues this yesterday, because we had had a couple of busy days on the road, and I said when I was on the pediatric surgery service as a resident, that we had to take call every other night, which meant that we were on for 36 hours, off usually for about 10 hours, back on for 36. It was brutal.

Bart: Yeah, that sounds brutal.

Steve: And we used to joke around that the worst thing about being on call every other night, meaning that you slept at the hospital one night, didn’t sleep the next night, but slept in the next night is when you weren’t at the hospital, you missed half of the good cases.

Steve: So, if there’s one thing that surgical training teaches you is that you have to grind it out. You know, and you have to work hard, period, and so that helped me a lot. I also think that in my world, since the HSA stands for health savings account, it is connected to the healthcare industry, and so being able to go to a hospital system and talk about how this account can be good for their caregivers or people that work for them, including their doctors.

Steve: I’ve had many, many sessions where doctors are asking, ‘Why is an HSA good for me?’ And things like that, and I’m saying, ‘Well, I’m a doctor,’ and so I think being intimately connected to healthcare industry I think has really been good for our business, and so I think for your builders out there, I mean, you can imagine that people may say, ‘Does the domain expertise that I bring to the table, would that help me start my own business?’ I think the answer is absolutely yes.

Bart: Yeah, and did you have relationships in the industry that helped as well?

Steve: Yeah, absolutely. For example, when I was writing our business plan, I was just finishing. I was in my fourth year of my residency, and I needed to do a research paper on what I ended up starting the company on. I gave a talk on it, and so I called up the person that ran the physicians group in Tucson, and asked him if he could give me some information, and he said, ‘Well, I’m not really the right guy, but there’s a guy in my office today that is a consultant for healthcare benefits, and he really knows the space.’

Steve: He put me in touch with a guy named Paul, and then Paul gave me some insight, and so that kind of helped me start from the thoughts. So, there’s no question that relationships are incredibly important, and so some people will say to me, ‘Well, I’m 22 years old, I have this absolute zeal to go start a business, but I also have an opportunity to work in industry for a while, what should I do?’ I’d say go work in industry. You know, do the other thing as your side hustle, but there’s nothing that can replace the types of relationships and learning you can have by working for big, sophisticated, fantastic companies.

Bart: And you can maybe hire people with that industry knowledge, or relationships, or things like that, but yeah, if you have that yourself, that’s fantastic, a great advantage. So, you were there 17 years, tell us about your current role, and kind of the evolution of your leadership, and where it’s come.

Steve: So I was the founder, the CEO up until 2014. I brought a fantastic guy on that loves running the business, brilliant guy. He had started a company of his own. It’s actually a competitor in our space.

Bart: Okay.

Steve: More to come on that in just a second, and he had started couple of years before I did. He’s an economist, and I got to a point where I really wanted to continue practicing medicine for a little bit, but the company was getting so big that I was going to have to make a tough choice. And the board came to me and said, ‘What if we brought someone on to help you run the business? His name is John Kessler.’

Steve: John’s a brilliant guy, and John, and I sat down and had a big, long breakfast one day and talked about it, and he said he would come on a little bit as a trial initially. He came on as our executive chairman of the board to see how it would go, and we kind of ran neck and neck and helped each other out, and over time I transitioned a lot of the operational parts of the business, and so he became effectively our COO, plus he was really running most of the executive functions.

Steve: I was still the CEO in title. In 2014, we decided to take a stab at this public offering deal, and so the bankers came to us and said, ‘Look, it’s a little bit confusing, because who’s actually running the business?’ And I said, ‘Look, I really see myself as more of the founder of the business.’ And so at that point, John became the CEO at the end of ’14, sorry, at the end of ’13, early ’14, and then in July of 2014 we went public. And then I practiced for about another year, and then I phased out of my surgical practice.

Bart: Now, were you practicing surgery the whole time that you built this company?

Steve: Yeah. Yeah.

Bart: Wow, so you really did know how to grind?

Steve: Yes, it was a grind. It was plenty of weekends at the hospital and plenty of weekdays on the road out selling, and so where I sit now is I’m on the executive team. I’m on the board. My formal title is founder and vice chairman which puts me in a position where I have this kind of interesting perspective of being both on the board and also being on the executive team.

Steve: John and I are partners in running the business. We still spend a lot of time talking to investors together. Our CFO is fantastic. We’ve now brought on a chief operating officer to help John, and so I find myself to be most effective in continuing to tell the HealthEquity story. I think most founders will acknowledge that they really do need to try and be the best salesperson in the company.

Steve: Now, does that mean they need to be the most technical salesperson, the best at responding to an RFP, the best at asking for the business, and all that? No, I don’t think so. But I do think they need to be the one that really thinks about the business and why is it changing people’s lives? How can it help their team members lives? How can it help their customers’ lives, their partners in our case, their members in our case, and then certainly how can it be great for shareholders too?

Bart: Yeah, that’s really interesting. I think a founder’s story, there’s a certain amount of truth that is just demonstrated through the fact that you actually created this company to solve a problem, and then there’s also the experience that you have with all of the different members and partners that you’ve worked with over time that just goes to emphasize the fact that you’ve been in this to win it for a long time, and win it for your partners and members.

Steve: All of our constituents.

Bart: All of those things bring trust and credibility.

Steve: You know, I’ll give you a brief example. So, last week we had a case where our salesperson had been working it and been doing a fantastic job, but it was between us and a big name brand competitor, and he called me up and said, ‘Steve, can you please fly to Dallas and meet with these guys and gals and just tell them the story?’

Steve: So I went there, and again, he had it all set up. He had done everything he should have, but they just needed that little bit of a nudge. And not long after I went to the finalist meeting and told the story, I got a call from the person that runs benefits for this company, and they said, ‘Look, it meant a lot for you to come and tell your founder story, and we’re going to go with you.’

Steve: So again, I think we might’ve won the business anyway. I’m not sure, but also, I’m happy that our salespeople feel like that they have confidence in me, that if they really need me to come in, and I’m happy to help them, and it’s not just for winning new business, but we’ve got some fantastic partners out there. We have over 140 health plans. We have, I mentioned 45,000 employers.

Steve: So, that’s where I spend a lot of my time. The other thing is that in kind of a weird Back to the Future moment it became public, and we’re in the middle of this process that we are now seeking to acquire another public company that was started by John Kessler, our CEO. So, the company he started a couple of years before we started ours, he had left, come to run our company with me for the last 10 years, and now we’ve put a bid in to acquire them.

Bart: Just recently.

Steve: Yeah.

Bart: Oh, that’s exciting.

Steve: And they’re a big company, and they do a great job.

Bart: So, many of our builders are running businesses that are much smaller than HealthEquity, nowhere near a $4.8 billion market cap at this point. At this point is the key term there, because some of them are looking to try to grow that big. But in the early stages, there’s often a transition that needs to be made. It sounds like you were kind of looking to grow something fairly big from the beginning, is that true?

Steve: Yeah. Oh yeah. I mean, we’ve always had a pretty ambitious mission statement. We think we’re going to help save healthcare in the United States, and in order to do that, you’ve got to connect with a lot of folks out there.

Bart: What were some of the challenges early on as you were just growing it from 10 team members or so to 100, 200? What were some of the challenges there?

Steve: Well, I remember, I mean, when we had probably a couple thousand members that we were looking after, a couple thousand families, and we were down in Tucson. We knew we’d need to scale the business, and I love Tucson. Three my kids were born there, practiced medicine there for a long time. But it wasn’t the type of business environment that would allow us to really scale, and we needed to find a place where we could get more technologists, where we could get more professional business folks, and so we had to move the company. That’s why we came to Utah.

Steve: So, one of the things was just where can you find a good environment to take care of your people? You know, there was a transition. There was a time when kind of the founders were all very involved with the business, and yet you felt like you needed to bring in people that had actually ran businesses before, and every time you bring somebody else in, your span of influence needs to shrink, and that’s hard. It was really hard for some people feeling like I’m giving away all of my authority, and all of my power, and all that stuff.

Steve: For me, it was always, ‘Look, whatever we can do to grow this business to take care of more customers, more members, et cetera, the better.’ And so I was pretty fine with giving up my span of control, if that made sense, but that’s hard for people.

Bart: Absolutely. So, you’ve credited combining efficiency technology and customer service as being instrumental to your success, and you’ve kind of mentioned at least the customer service piece, but how can smaller businesses utilize this model when they think about growing their business to stay?

Steve: Well, I think of technology being this fantastic enabler to remove friction that people have. I mean, we all benefit now from products. What we did early, early on as a very tiny business was we said, ‘What would make it easier for the consumer to kind of go down this experience?’ And one of the things that occurred to us was, ‘Boy, it’d be really nice that when they enroll in their health plan, that allows them to have that HSA health savings account, why not integrate the enrollment?’

Steve: So, on one website, or on one piece of paper, when they’re enrolling in their health plan, that they’re also enrolling in the HSA, and so we did integrated enrollment. Everyone thought that was crazy. It’s like, ‘Well, just have a separate piece of paper for them to fill out,’ and we said, ‘We don’t want to do that. We want to make it simpler.’

Steve: So, we invested heavily in integrated enrollment, and then we said, ‘Well, once we’ve made that link, we’ve connected you Bart, your health savings account with your health plan, now we can do some other things. For example, when you go and seek care, we can integrate on your claim feed, and after the claim is ready to be processed and paid, it can show up in your portal.’

Steve: So, we had integrated enrollment led to integrated claims, and then we did integrated investments. And now we do integrated wellness programs, and things like that. So even as a tiny little business, we were doing things to make it easier for the consumer to create more efficiency, and we’re still working on that every single day.

Steve: I mean, last week I had several calls with hospital systems, because now we’re generating so many claims that we’re facilitating payment on out of people’s accounts that we can either mail them a check, which in my mind is terribly inefficient, terribly expensive, it is fraught with things like fraud where people can steal checks, and things like that, or we can wire them the money. You know, use technology. And so to me it’s always remove the friction, make it easier for all this to work, and typically if you can remove friction from a business using technology, you’re going to save a lot of money.

Bart: Yeah. I mean, it’s better for everybody, right?

Steve: Yep.

Bart: Yeah. So, if you could go back, are there any things that you would actually change about your journey?

Steve: Yeah, I would do a better job, and this is something I learned. I heard this several times, and yet it’s almost counter to this entrepreneurial zeal, especially if you’re talking to investors and stuff. You know, you got to sell them on your great idea. You’ve got to sell on how much money they’re going to make, your shareholders, and all that stuff. And so the whole kind of under promise, and over deliver, which is so trite, I would do a better job of it as a young entrepreneur, because we had investors that came in, and they really believed we were going to have growth of X, and when you end up having growth of X minus 50%, they’re dissatisfied, and yet if you can just beat their projections by a little bit, they’ll love you.

Steve: So, I think that’s not only to your investors, and shareholders, but I think also to your team. I think setting expectations, for example, for your salespeople that you’re not sure they can hit is not good.

Bart: Yeah, that’s a tough balance.

Steve: Yeah. So, you have to do it, and yet you have to build to sell them, and ultimately, I think if you miss numbers, and things like that, it leads to needing to go out and get funding sooner than you thought, or needing to lay people off and things like that, which is really tough. We’ve had one kind of necessary reduction in force where we had to lay some folks off. I still remember.

Bart: That’s super tough.

Steve: Oh, it was terrible. June 4, 2008. I still have those people’s names on a list and in my desk. And so that type of thing can be avoided generally if you can set appropriate expectations, and for example, if a business leader is working with a sales team, or even holding themselves accountable for sales as they always should, set more reasonable numbers, hit them, and then kind of get the flywheel going at that point.

Bart: I think that’s really good, and you said it’s a trite phrase, ‘Under promise and over deliver.’ But I think it’s one of the best guidelines for business.

Steve: I mean, I should have learned that better, because I would always do that. When I was in the medicine field, I always tell my wife, she said, ‘When are you going to be home?’ And even if I thought I could be home at like 7:00 PM, I’d always tell her like nine, and then if I got home at eight, she loved me. If I had told her, ‘Oh, I’m going to go home at seven,’ and I got home at eight, she would hate me.

Bart: Or even 7:15.

Steve: Yeah, exactly. So, I think it’s a pretty universal truth. If you can under promise and over deliver, people will love you.

Bart: Last question for you, what’s next?

Steve: I do stay a little bit connected with the medical community because of my work, and I got a little bit of a passion to think about how we can do better with end-of-life care. I think we need to do a better job of helping people navigate the last few years of their life. How do you kind of touch that plane down gently? America, we do a really bad job of it. You know, too many ICU visits, too many people die in ICU, too many people don’t die at home.

Steve: So, that’s a little bit of a side passion to me; it still keeps me connected to the healthcare field. But that being said, my full-time day job right now is to get HealthEquity and our industry to a point where I truly believe this, and this is really important your builders to understand this, and this is why I think the mission is so important is that if over 50% of Americans were in an HSA . . .

Steve: Now, right now it’s 25% of Americans that are in commercial insurance. We’re working on an initiative to get HSAs into Medicare. There’s some states that are doing it from Medicaid, which is people of lower income. Tri-Care, these are vets from military, they should have HSAs. But if we could get 50% of Americans in a health savings accounts, I believe that then we’re starting to approach our mission of saving healthcare in the United States, because big, large populations that do that see their healthcare cost trends that are almost about the same as normal inflation.

Steve: So think about it like this. You started talking about how this is such a big headliner issue. Nobody’s talking about milk reform, how we have to reform the cost of milk and bread in this country. And that’s because milk and bread tend to trend at about a 2 to 3% normal inflation, and everyone is okay paying 2 to 3% more next year than they paid this year for the milk and bread. But they’re not okay with healthcare because it’s trending at 7 or 8 or 9%.

Steve: And yet for our customers that have gone kind of full HSA, and they’re big enough customers to have real numbers, their trend is in the low single digits. And so that’s what keeps me going. We’re going to save this thing, but we just need more and more Americans to adopt HSAs, more employers to adopt them, and we think we do the best of any of our competitors.

Bart: Well, I’m very hopeful that that kind of improvement can continue to be made by companies like HealthEquity in that space. So Steve, thanks so much for taking the time to talk with us today.

Steve: And I thank you. Appreciate it.

Bart: So I’ve benefited, as I mentioned from HealthEquity’s easy to use HSA account for years, and it’s amazing to learn the story behind it as well as the fact that they’re adding new products and services. Builders, you can learn more from Steve by visiting builttostay.com and downloading our additional content piece there. Show notes and links to HealthEquity will also be online.

Bart: Hey builders, we want to hear from you. If you have a story about your business, reach out at builttostay.com. If you haven’t yet, sign up for our email list for access to the show notes and downloadable handouts.

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