You can’t bulldoze your way through the healthcare system. I’ve seen people try, and I’ve watched the system win every time. What is true, however, is that lasting change comes from understanding how the system works for real people, and you must build a system that meets their needs.
In my experience, particularly in claims administration, the real challenge isn’t just introducing new technology. It’s keeping pace with an industry that’s evolving faster than most systems can handle. If you’re not intentional about how you innovate, you risk falling behind just as fast as the industry moves forward. We talk a lot about automation in this space, but the real focus should be on who that automation is for. Technology on its own doesn’t solve problems; people do, by using it in ways that make their day-to-day easier and more efficient.
A few years ago, right before I founded IPS, I had a conversation that shaped our entire direction. A client approached us with an opportunity to acquire Podiatry Plan. On paper, it was struggling; manual processes across the board, outdated infrastructure, and bleeding money. But instead of a failing business, I saw a real-world testing ground.
Rather than overhaul everything from the top down, we started small and intentional. We looked at how people were actually processing claims, not how we thought they should be. We spent time with the folks on the ground, listening, observing, and understanding their pain points. That plan laid the groundwork for something bigger: a platform built not just for efficiency, but for usability.
Instead of simply focusing on the tech alone, we aimed to build a system that could flex to the realities of claims administration, without forcing users to conform to rigid, developer-driven logic. As Podiatry Plan stabilized and eventually grew profitable, we took that momentum into our next challenge.
When the owner of East West Administrators was preparing to retire, we had the chance to acquire the company. It wasn’t fully manual, but much of the system was outdated and held together by patches. Again, we didn’t start with the technology. We started with the people, focusing on where the system broke down for users. We modernized it, automated it, and ensured the platform could support complex flows like member reimbursements and HRA processing, needs we’d anticipated from the start.
With the benefit of hindsight, one of the biggest lessons I’ve learned is this: it’s all about the people. You can’t just build something that seems to work; you have to build something that’s flexible enough to work for the people that need it. Customization can be everything. If your platform can’t adapt to real-life use, it becomes obsolete. But if you stay close to the people using it, stay open to feedback, and remain willing to evolve, you give yourself a real chance to build something that lasts. We didn’t set out to change the healthcare system overnight. We started by listening to the people inside it, and that’s made the biggest difference.
