Ask Paytient co-founder and CEO Brian Whorley about 2024 and he’ll use superlatives like “explosive growth” and “watershed moments” to describe both the Columbia-based company he founded, Paytient, and the state of healthcare access and affordability in the U.S. 

“It’s a weighty responsibility,” he said. “The mission of our company is to improve how people access and afford care. It’s incredibly motivating.”  

Most Americans have health insurance today, but increasingly high deductibles mean far too many Americans face the painful choice between physical and financial health if they get sick or injured.  

Paytient is now offered alongside ACA marketplace plans and as an employee benefit through its partnerships with payers like Anthem, local employers like EquipmentShare, Boone Health, and Commerce Bank as well as its collaboration with the Missouri Chamber of Commerce that makes a Paytient card available to employees of over 4,000 small businesses with Chamber Benefit Plan coverage. 

Paytient is also now partnering with Medicare and the Missouri Chamber of Commerce — with more than 4,000 small businesses across the state — and is now an added benefit of multiple commercial health insurance plans and Health Savings Account (HSA) plans.   

Whorley added, “They are bundling Paytient into their plans.”  

Whorley noted that in 2025, Columbia-based Paytient will be part of nearly twenty-five million Americans’ health plans. The Paytient team also recently celebrated the launch of the first-ever Medicare Prescription Payment Plan, a new program that will expand access and improve affordability for Medicare Part D beneficiaries, including older adults and those living with disabilities.  

That also means a significant increase in Paytient’s employment total and payroll, which are not publicly disclosed because Paytient is a private company.  

“We have committed to hiring a whole bunch of folks,” Whorley noted. Paytient positions itself as a company with local roots and global growth, though Whorley said he is “always championing Columbia as an amazing place to live, work, and play.” The company’s headquarters is located off Endeavor Avenue, near Father Tolton Catholic High School in south Columbia.  

And that means, Whorley said, more Americans will be getting health care because Paytient has created a way to ease the affordability burden that often dissuades individuals from seeking care, even if they are insured.  

“There is a relationship between clinical care and income — the ability to pay or a person’s financial capacity — and outcomes,” he explained. The connection between health and wealth is just one indicator of the social determinants of health, a metric that is often used to determine why people in one ZIP code are healthier than people in another or even adjoining ZIP code. And when “out of pocket” costs are simply out of reach, studies show that many people will either delay or not seek care.  

“We’re not in the position to change the price people will pay, but the ability of people to pay the price. We’re helping to create a healthier health system.” 

Brian Whorley

“If my doctor tells me to take this prescription and I don’t take this prescription — I don’t pick it up or I’m not adherent to the dosage — there’s a much higher chance I’m going to end up back in the hospital. And that costs all of us even more.”  

The new partnership with Medicare Part D prescription drug plans, which is now a legal requirement for every Part D plan, will further smooth out the cost by allowing payment over time.  

“The insurer is essentially going to float your out-of-pocket payment,” Whorley added. “It is the designed intent of this program to make health care more accessible, equitable, and affordable. People still pay their share, but they have the ability to pay that over time.”  

The JAMANetwork reports that as many as 20 percent of Medicare beneficiaries are skipping doses or not filling prescriptions because they cannot afford the out-of-pocket cost. The same dynamic happens in the commercial market where 40 percent of workplace insured Americans report deferring care due to cost.  

That report is featured on Paytient’s website, with the following conclusion: Here’s the incredible thing: when patients have the power to redesign the timeline of their out-of-pocket payments with no interest or fees, healthier care seeking patterns emerge.   

“In other words, time to pay demolishes the psychological and practical cost barriers that keep people from seeking care. Today, this shift in behavior will be made possible for the first time in Medicare.  

Founded in 2018, Paytient now has the data to back up that analysis. In a January 2024 survey of Paytient cardholders, 54 percent reported getting care they would have delayed or skipped without Paytient’s payment solution.  

Accessing care when it is needed rather than delaying treatment also means less chronic conditions that drive up the cost of care — and shorten lifespans. When affordability is not out of reach, people use their health insurance more often, they stay with the plan, and the health insurer retains more clients.  

“That’s a good thing for the insurers,” Whorley said. “We’re not in the position to change the price people will pay, but the ability of people to pay the price. We’re helping to create a healthier health system.”  

Paytient cardholders choose their own payment plans over twelve months with no interest or fee. Paytient assumes the risk if payments are not made.  

“Every time you swipe the card, you pick your own payment plan,” Whorley said. Cardholders also choose their own payment source, whether connecting an HSA with pre-tax dollars, a bank account, or a debit card. “We’re essentially giving you confidence in that moment of uncertainty, and a sense of affordability.”  

The cost is built into premiums paid by the employers.  

Whorley said Paytient is in “rare air” among the some 4,800 venture-backed companies that were formed in 2018 and 2019.  

“There might be fifty where we are at this level — the top 1 percent,” he added. “Rare air, so to speak.”  

That “explosive growth” is also confirmation that Whorley’s vision for Paytient hit the mark.  

“The world is changing in the way that we thought it would,” he said. “I would like to think we are an influencer of that.”  

Whorley previously worked for Boone Health as director of business development and strategic planning when the hospital and health system were managed by BJC Healthcare.  

“Paytient wouldn’t exist if I hadn’t worked at Boone Hospital Center,” he said. “It’s an incredible place – mission driven. Every single day we woke up thinking about how we could improve the health of the people in the community we serve.’  

That same thinking has forged Whorley’s path with Paytient.  

“There’s been lots of innovation around new treatments — the expanding of the curative and therapeutic envelope,” he said. “There hasn’t been enough innovation around the pricing and payment in health care. That’s what we’re doing to create a healthier health system.” 

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IN A NUTSHELL 

How Paytient works for:  

Employers  

Employees receive a Paytient card they can use to pay out-of-pocket expenses for medical, dental, vision, pharmacy, behavioral health, and veterinary care.  

Cardholders swipe their card at the point of care and split their balance into easy-to-manage payments automatically deducted from future paychecks or another linked payment method.  

Insurers  

Once approved, members receive a Paytient card with their health plan that empowers them to pay out-of-pocket healthcare expenses. In a crowded market, Paytient helps insurers differentiate their offering to attract and retain more members.  

Health Systems  

Health systems can subsidize the cost of the Paytient card for local employers who want to offer it to their teams. Employees can use the card to get care with the health system’s facilities and physician groups, which helps attract more commercially-insured patients.