Overpayment, unreasonable medical charges, and balance billing continue to occur in the US healthcare system. To help protect patients, health plans, and insurers negatively impacted by these incidents, aequum was formed. Along with educating health plans and plan participants on legislative changes and more, aequum partners with Koehler Fitzgerald LLC, a law firm providing trial and appellate counsel to represent plan participants in the US. To find out more, let’s discuss the topic with aequum CEO Christine Cooper.
Disclosure: Christine Cooper explains in this sponsored interview how aequum protects and provides cost savings to health plans and their participants across the United States.
Interview with CEO Christine Cooper
Thank you for making the time for this interview, Christine.
To start, please tell us a bit about what you do at aequum
I am the CEO of aequum. I spend my time focused on growing aequum’s business, developing additional services for our partners, providing high-quality customer service to our clients (patients receiving medical balance bills), and the general day-to-day activities that keep a business running.
How can aequum help both patients and those who work with health plans?
aequum helps patients and health plans avoid the cost of unnecessary and inappropriate health care by defending patients against unreasonable medical bills. aequum also provides education to both plans and plan participants on legislative changes, health plan design for cost control and avoidance of certain legislative changes, [and] how to understand their health plans, among other educational opportunities.
These are all valuable services. Thinking about the future healthcare industry, how do you see it changing over the next decade?
I anticipate that the healthcare industry will advance in the following ways: patient and provider access to complete medical records; increased use and availability of provider performance metrics, earlier diagnosis innovations, and interventions, greater use of personalized medicine (i.e. using an individual’s genetic profile to guide decisions), continued development of new, innovative treatments, equipment, drugs, and surgical procedures, and increased patient engagement.
How can healthcare coverage potentially improve in the US?
To improve healthcare coverage, it must become more affordable and accessible. Our current system allows many cost increases to be hidden from plan participants in health plans, such as increased premiums, co-payments, deductibles, and coinsurance.
Additionally, the trend is to shrink networks increasing the risk of out-of-network (unexpected) medical bills. A pure reference-based pricing plan that uses a predictable pricing method (such as a percentage of Medicare) allows for real cost control and better coverage for plan participants.
What resources are currently available to patients to defend against overbilling?
aequum, in its partnership with Koehler Fitzgerald LLC (a national law firm), provides legal advocacy services to protect patients from overbilling by defending the bills against the providers. Furthermore, many medical bills contain errors that improperly increase the cost to the patient. Utilizing an appeals process, as well as having a medical bill scrubbed for errors can lower the incidence of overbilling.
Finally, a patient should understand their rights to demand an Advanced Explanation of Benefits that requires a provider to send a good faith estimate of the services to the plan and the plan to provide a breakdown of the true costs to the patient in advance of receiving the services. If understood by the patient, this could be one of the greatest opportunities for the patient to avoid being overbilled.
I am all for prevention education. Switching topics a bit, I’m curious, what helped you reach CEO, given the gender gap in healthcare leadership?
I searched for an innovative firm that would allow me the opportunity to grow and advance. I followed my intuition and joined Koehler Fitzgerald LLC. I put in the work and put myself out there so I would be noticed. I was elevated to equity status, and when aequum was spun off from Koehler Fitzgerald, I was selected to lead it by my partners.
It was important to me to be true to myself throughout the process and, hopefully, gave my partners confidence that I would have the best interests of aequum in mind. I am fortunate to have found a place where I am valued for my abilities and not held back by my gender.
That’s wonderful to hear, and your career path will inspire other females. When faced with challenges as a female CEO, how have you overcome them?
While the healthcare space is male-dominated, it is also a relationship business. The challenge was learning how to communicate with my peers in the space despite my gender. A particular challenge was being heard.
Being myself and putting myself out there over and over again was the best way to start building those relationships. It helps to be an expert in my healthcare niche, as I can now offer value to our partners and those we want to partner with.
How do you balance your career and personal life?
I was once told that the balance cannot be looked at on the daily but should be looked at over the year. This really resonated with me.
There are some days that are dedicated entirely to work and some days that are dedicated entirely to my personal life. Each year I look back to see if I was “balanced.”
I feel balanced when I can focus on work when I am working, my family when I am with family, and my other activities when I am pursuing them. I also appreciate that we go through different phases of life where being balanced may mean working more or focusing more on family or personal endeavors.
I hadn’t thought of balance in that way before. When you are having a low day, how do you reenergize yourself?
If I need reenergizing, I spend quality time with my family away from technology and get out into nature (backpacking, trail running, mountain biking). I find it so important to focus on grounding when life gets chaotic and, for me, that means stepping away from normal life for a few minutes, a day, or sometimes even longer.
Who inspires you, professionally and personally?
Professionally, I was inspired by Ruth Bader Ginsberg. She was dedicated to her work and had one of the most clever legal minds. She could look at an argument and see a way to relate it to her opponents’ arguments to pin them into a corner. She was quiet but so effective. And she broke through so many barriers.
Personally, I am inspired by my daughter. She is 10 years old and fearless. She is always willing to try new things and take risks. I have learned a lot through raising a daughter that doesn’t limit herself or let her gender hold her back.
I have a feeling you inspire your daughter too! Where can we connect with aequum online?
To find out more about protection against unreasonable medical charges, connect with aequum at their website. Their services help patients, health plans, and insurers in the United States.
Is there anything else you want to add, Christine Cooper?
I hope more and more female leaders lift other women up and provide the support and opportunities necessary for their success. By working together, we can continue to close the gender gap.
Thank you for being here, Christine Cooper
This interview spanned a wide range of topics, and I liked how it flowed from helping others to helping oneself. Christine Cooper is helping many people at aequum by advocating on their behalf and educating them to help prevent overbilling and other related healthcare issues. She is also paying attention to her definition of work/life balance and being true to it.
When Christine says in the interview, “we can continue to close the gender gap,” I am all for it! These conversations, I hope, are helping in at least some small way. Step by step, we must get there.
Top photo: Christine Cooper, CEO of aequum. Photo courtesy of Christine.