Nate: [00:00:00] Childhood classmates turned healthcare innovators. Jeff Williams and Dr. Eric Inman are the co-founders of WellBridge Surgical, an Indiana-based surgery center redefining how patients access care by offering upfront, transparent pricing and lowering costs for families. They're tackling one of the toughest challenges in the United States healthcare system while keeping Hoosiers at the heart of their mission.
I'm joined today in studio by both of them. I'm really excited to be, honestly. We're in the presence of royalty: the 1997 Heritage Christian Baseball MVP, Jeff Williams, is in the building. Gentlemen, welcome to the show.
Jeff Williams: Hey, thanks for having us.
Dr. Eric Inman: Thank you.
Nate: I'm really pumped. My first job ever was in the health insurance space at a brokerage. I worked for Apex Benefits. Great place to start a career. Perfect for me. At your desk at eight, we left at five. I learned a lot, a lot of guardrails. Insurance is a very buttoned-up industry, which clearly by what I am and do today, not the right long-term path for me, but the perfect first place to start.
So I know enough about this topic to be dangerous, and I know enough about this topic to know what you guys are doing is gonna make perfect sense. At the end of this episode, everyone's gonna be like, why isn't it like that for everyone? There are obviously a lot of big businesses involved and money that changes hands and the whole thing, but we're gonna unpack that. I'm giving the heads up to listeners: this is going to be an episode that you will be enlightened at the end of.
Jeff Williams: We hope so.
Nate: Before we talk about all the crazy innovative things that you guys are up to today, we have to start with the crazy things you all were doing on the rough and tumble streets of Carmel in elementary school, where you guys first met.
Jeff Williams: Correct. It all goes back to Mrs. Hoffman, fourth grade. Two guys that really loved sports started hanging out through high school and middle school. We played basketball, baseball, all sports together.
Nate: And from there, from fourth grade on, just lifelong friends?
Jeff Williams: Lifelong friends. Never been not friends.
Nate: College comes around. Where do you both end up going?
Jeff Williams: We like to hop around high schools. We like to hop around colleges as well. We checked out a lot of different places, but we were roommates together at Taylor University for one semester.
Nate: Go Trojans.
Jeff Williams: Go Trojans. Then I transferred to Olivet Nazarene in Illinois to play basketball.
Nate: Is that the Panthers? Some type of cat?
Jeff Williams: Tigers.
Nate: Dang it. Tigers. Shout out to Scott Lingle.
Jeff Williams: Scott Lingle and Tyler. He's my boy.
Dr. Eric Inman: I went freshman year to Purdue, sophomore year to Taylor, and then went back to Purdue and graduated there. I stayed there for medical school too. I did the first two years of medical school in West Lafayette as well.
Nate: So lifelong friends. Jeff, you end up graduating from Olivet Nazarene. Eric, you end up at Purdue, med school, the whole route. Where do paths end up crossing again? And where does the idea for WellBridge Surgical come around?
Jeff Williams: My family always spends the Fourth of July with Eric's family. I like to tell the story my way, and then Eric can fill in his side of the story too. We're sitting at his pool, and I was like, look at this place, look at this pool. This is the reason why my health insurance is going up at my printing company.
Nate: How much had it gone up?
Jeff Williams: A significant amount. The original renewal was in the high thirties percent, and then we had to change the plan to get it down.
Nate: That's a big renewal. A big increase.
Jeff Williams: We had a $2,500 deductible and changed it to a $5,000 deductible in order to get the increase down to 23%. I was just really grumpy. What do you do? You take it out on your best friend, who's the doctor. I didn't know who else to blame.
Dr. Eric Inman: He tells me that, and I'm thinking, well, the actual doctors, the physicians, their reimbursement is going down. It has been going down. Every year it goes down. Not even staying the same. Not even taking inflation into account. It goes down regardless. So I'm saying, it's not me. It's not us as physicians. Now I have some ideas on where that money was going, but at that point I'm like, no, it's not us. It must be the hospital, insurance companies, somewhere in between. But I was saying, it's not us.
Jeff Williams: That was a shocker to me as a business owner. I had no idea. They don't necessarily let you in on why there's an increase. It's just an increase. So then hearing that it's not coming from the professional fees from the docs, and that that's actually being lowered, changed how I looked at it. We had already been chatting about starting a business together, and I said, I think this is what we need to do. We need to do something to help lower healthcare costs in Indiana on a national stage.
Nate: Where does Indiana rank on the cost of healthcare?
Dr. Eric Inman: As far as facility fees go, which is the lion's share of what gets paid for in surgery, Indiana is in the top 10 most costly. And as far as reimbursing surgeons and doctors for professional fees, Indiana is in the bottom 10.
As listeners may or may not know, if you have a gallbladder taken out, you have a few different components. The surgeon gets paid a certain amount. The anesthesiologist gets paid. Assuming you want to be asleep for that gallbladder removal.
Nate: Have you ever had anyone who didn't want to be asleep?
Dr. Eric Inman: Not for a gallbladder. Maybe for a colonoscopy, but not for a gallbladder. Then you have the pathologist and pathology lab, and then you have the facility. The facility is generally around 85% of the total cost of a procedure, sometimes more. Indiana is top 10 in how costly the facility is and bottom 10 in how we reimburse the surgeons and doctors.
Nate: Give us the traditional system. A large percentage of people have health insurance through their employer. Once a company gets big enough, it's a self-funded employer health plan. I need to get my gallbladder taken out. Claims get sent. Insurance is involved. Can you explain the current system and where all these layers of margin are?
Dr. Eric Inman: This is something you don't learn in med school. I've learned it in the past eight years since we started doing this. Insurance was kind of this magical black box. A lot of people think insurance just pays for everything. That's not really true, especially with self-funded employers.
I think 70% or more of people in Indiana who get their health plan through their employer are actually covered by the employer's money up to a certain amount. The employer is paying for all of it up to, say, $200,000 or another threshold. Those self-funded employers are so prevalent around here. It's basically their bank account, but the HR director isn't writing a check for the gallbladder to the doctors and the facility. A third-party administrator, or TPA, administers the plan. The self-funded employer sets up the plan and has the money for it. The TPA administers it.
Nate: I don't think a lot of people know that. If you work at a company over around 100 employees, do a little digging. You're probably on a self-funded plan where there's a top cap, like reinsurance, so they don't get a massive hit. There's a lot of math involved. Actuaries have it figured out.
As you guys dug into the problem, why did you believe this was the right one to tackle? Healthcare is so big. A lot of people have probably had this idea but got lost in execution.
Jeff Williams: I thought it was a good one-two punch. Eric has experience in the ambulatory surgery center, outpatient surgery center side, and how to run one efficiently. I had the business side and understood the pain point of a business owner. My printing company is the buyer for what WellBridge is offering. A self-funded plan is the target audience. I felt like we could always use that company as a guinea pig, which we've done.
Nate: What's the first step when you want to start an outpatient fair-price surgery center?
Jeff Williams: Dr. Google. We Googled it and started trying to figure it out. We found Dr. Keith Smith in Oklahoma City, one of the founders of Surgery Center of Oklahoma. He's like the godfather of transparent-priced surgery centers.
Nate: Not familiar.
Jeff Williams: He's been doing it a lot longer than us. Surgery Center of Oklahoma was the first, and we were the second, at least at that time. We reached out to Dr. Keith and said, hey, we're thinking about doing this.
Dr. Eric Inman: I believe 2009 was the first time they posted their prices, meaning an all-inclusive price bundled together with all those pieces we just talked about.
Nate: So it was like, hey, you can get your gallbladder removed for X dollars. It's crazy because I have no concept of what anything costs in healthcare. All I know is I need to add another zero to what I think makes sense.
Jeff Williams: That's exactly how they plan it.
Nate: It's like going to a fancy steakhouse where there are no prices on the menu. You hope the bill won't bankrupt you. How do you put this into practice, and how do you convince someone to trust you? People often tie price to quality. If my heart transplant costs $6 million, that sounds right. If it costs $1,200, I'm looking somewhere else.
Dr. Eric Inman: It's a good question. Maybe we didn't even fully know when we started it. You have to run into some luck along the way. If you're trying to get high quality, you need somebody who knows the surgeons, who has been in the room with them, and who has had a front row seat to years of different surgeons around the local area. I had that as an anesthesiologist. I had built relationships with surgeons who I would be comfortable recommending to family members or friends, versus some others I probably would shield them from. Building that network of doctors is super helpful.
Then you need a surgery center. It's beautiful, it's new, it has the right equipment. You have surgeons ready to do surgery. What else do you need? Patients. If we're going to create an active healthcare consumer environment and get people to come based on price and quality, you have to have an avenue to do that. That's where Jeff comes in. You need a sales engine to show people what you have to offer and why they should choose it.
Nate: The start of this whole thing is pouring a bunch of money into a surgery center.
Jeff Williams: Yeah. We decided to pull the trigger in April of 2020. We all know what was going on then. Great time to start a business, right? Surely we'll be able to get a good deal on real estate.
Nate: At the same time, are you using your network of surgeons and making those scary asks, like, trust us, this is going to be the next big thing?
Dr. Eric Inman: The pitch is that you don't have to stop what you're doing. You can work where you're working right now. We're creating a different referral pathway. We can increase your market share. Patients will come here for lower price but higher quality. If you want to participate with us, we trust you. We like you. I've known you for a while. Come participate and we'll increase your market share while also increasing your professional fee.
Nate: That phrase doesn't equate to most people: lower cost, higher quality. How do you increase the surgeon's professional fee while lowering the total cost?
Dr. Eric Inman: Most surgeons we work with also work at hospitals. Some surgeries must be done in a hospital. Patients who are sicker or certain procedures need to be in the walls of a hospital. Other surgeries can be done in an outpatient setting. The surgeons we work with are independent surgeon groups. These are 1099s, not W-2 hospital employees. It's a new revenue stream for them.
Nate: These are the same doctors who might perform the same surgery down the street at a name-brand Indiana hospital.
Dr. Eric Inman: Sure.
Nate: But if the right factors are there, they can do it at WellBridge for a much lower total price, while their professional fee can be higher.
Dr. Eric Inman: Exactly. We own the bundle. If you have a gallbladder procedure that costs $20,000 at the hospital, with all the pieces of the pie together, our bundled payment might be around $10,000 or a little under. That payment gets paid to us, and we discern how much of that pie goes to the surgeon, the anesthesiologist, and others. We're able to increase the surgeon fee and say, not only will we increase your market share, we'll increase the amount you get paid. We can do that because the total procedure is literally about $10,000 less. It doesn't need to cost that much. It's eye-opening, but it's true.
Nate: Let's talk through the timeline. Healthcare is slow moving. It's complex. There's a lot of trust. You don't want the cheapest option if it means sacrificing quality. April 2020, you get a facility. First step?
Jeff Williams: A building. We had to retrofit it into a four-OR facility. We got under contract in June 2020, bought it in October 2020, gutted it in December 2020, and started building it back up into a four-OR space.
Nate: You're building four ORs in this facility. That's a lot of money. You're all in. Looking back, were there times where you're like, what are we doing here?
Jeff Williams: For me, it's legacy. You're doing something that's really making a difference. You're proving you can make a difference, put money back in people's pockets, and still make money. We're for-profit. We're paying real estate taxes on our surgery center. This is not a nonprofit.
Nate: Why are you able to make it significantly cheaper?
Jeff Williams: There are a lot of unnecessary intermediaries between companies that don't necessarily need to be there when you're dealing with the free market. Knowing exactly what it's going to cost and knowing the quality lets someone make a good healthcare consumer decision. Some of those companies aren't needed anymore. Number two, we own the facility. The facility is a huge piece of the expense of surgery. Maybe you don't need to make those kinds of margins on the facility, or at least we don't.
Dr. Eric Inman: The alternative in Central Indiana is often a hospital-owned hospital or hospital-owned surgery center, which is about twice as expensive as us on average. One reason is the amount of administrative overhead. There is a lot of redundancy and a lot of overhead that we don't have to deal with.
Nate: Hospitals have to solve other problems too. ERs, inpatient care, more complex care. There's still a need for hospitals. But for this specific piece of outpatient surgery, you guys are saying it can be much less expensive.
Dr. Eric Inman: No brain, no heart, no spine is what we like to say. We're multi-specialty, but those are the three areas we don't do.
Nate: What was the moment you knew this was going to work?
Jeff Williams: Sometime in 2023. One of the biggest differences in what we do is that we're direct contracting, cutting out middlemen and contracting directly with self-funded plans. At that time, we were maybe up to 25 or 30 accounts, and we started seeing traction from those accounts. That's when I realized, hey, we're going to make it. It's still going to be a long road, but we're going to make it.
As you know from Apex, most renewals are January 1 renewals. As a salesperson at WellBridge, you've got one season to land as much business as you can. I started to see it growing year over year during those renewal seasons.
Nate: Were there any early customers that helped spark more?
Jeff Williams: Early adopters were huge. The Town of Whitestown. Katie Barr was a boss. Haynes International up in Kokomo was an early adopter. Melissa up there is also a boss. You get those going, prove out the model, and then others come on board.
Employers are facing healthcare costs that are getting so outrageous that employees can't handle the cost. The number one reason for bankruptcy in America is medical debt. Businesses care about their employees. How are businesses going to react? WellBridge is one of the few ways they can lower costs.
Nate: What's the benefit for employees?
Jeff Williams: If an employer direct contracts with us and zero-tiers the surgery, the employee pays nothing for surgery at WellBridge because they've been a good healthcare consumer and chose WellBridge. That's a pretty good value proposition. It helps the bottom line of the plan and gets high-quality care to employees.
Dr. Eric Inman: It's a win for the employee because they get a great patient experience, a great quality outcome, and no surgery bill if their plan is zero-tiered. The plan sees savings and a quality outcome. WellBridge gets to do the surgery. It's a win-win-win.
Nate: Let's talk about patient experience. How are you able to provide such a high-quality experience?
Jeff Williams: The bar wasn't set real high to begin with. Everybody has a healthcare story. To be treated like a human instead of a number is what we focus on. From the point someone says they need surgery, we have software called Klara where they're interacting with WellBridge through one point of contact. They're filling out paperwork there too. If you're with an employer that is zero-tiered, all you really have to do the day of surgery is show your ID.
As a patient experience, that matters. How many times have you walked in and had to fill out the same information over and over again? Then when you walk in, WellBridge doesn't smell like a hospital in the lobby. We've got coffee and drinks available for family members. It's bright. It's airy. If you're the patient, you should not be drinking anything before surgery, that's kind of a big deal.
We tried to make it a better experience. Our nurses love on the patients. Between our pre-op and post-op bays, we have drywall instead of curtains for more privacy. Our discharge area lets you leave without walking back through the lobby.
Nate: Why is that a big deal?
Jeff Williams: Nobody wants to walk back through the lobby after they've had surgery, when they're groggy or have bandages on. All those little things add up to a better patient experience.
Dr. Eric Inman: We're really pushing for active healthcare consumerism and free-market outpatient surgery. We have to have a high-quality product or we won't have any patients. We're not relying on surgeons blindly bringing patients from offices. We haven't bought primary care providers and forced referrals. We are free market. We have to have high quality or we won't get patients.
Having experience at a lot of surgery centers and hospitals around town let us take best practices and fine tune them to create better patient experience and higher quality outcomes. You never get to zero percent complications, but you can approach zero more closely by making lots of small decisions the right way.
Nate: The problem you're addressing is very important. Tens of millions of Americans suffer from medical debt or financial hardship. You go in and have no idea what the invoice on the other end will look like. It puts a lot of people in a bad spot. What's the plan for the future of WellBridge?
Jeff Williams: We want to expand. Medical tourism before COVID was people going to some island to get a knee replaced. That got blown up. It's obviously a lot easier to come to Central Indiana to have surgery you know is high quality and you know the price. We've had people come from as far west as Nebraska, from the East Coast, New Jersey, down to Florida, and from Canada. Indiana is still the majority of where our self-funded groups come from, but we are branching into other states. We'd like to put more of these up. We're looking at number two as we speak.
Nate: Give us a sense of where we are today. You took 12 months to build the facility, four ORs, and then built partnerships and trust. Where are we heading into 2026?
Jeff Williams: We have about 90 Indiana businesses signed up, which equals about 100,000 Hoosier lives that can get a free surgery through WellBridge. We've hit profitability. We were on the Fast 25 this year. I think we were number six. Last year we did about $5.3 million top line, and this year we hope to almost double that. We'll keep reaching out to Hoosier businesses and surrounding states as well.
Nate: What kind of business owners need to think about incorporating this into their strategy?
Jeff Williams: If you're the CFO or head of HR at a self-funded plan and you're looking for ways to lower healthcare costs, we are about 20% of the spend. We're saving about 50% on that 20%. Outpatient surgery is roughly 20% of a total self-funded plan. This can cut that piece down significantly. In a lot of cases, when we do cost studies for plans, the savings are in the millions.
Nate: A big part of this from the employer side is pain. Changing insurance cards, open enrollment, all that stuff. You could come in with the greatest idea ever and HR might still think the juice isn't worth the squeeze.
Dr. Eric Inman: One good thing about WellBridge is you don't have to stop whatever else you're doing. You won't achieve savings if employees don't utilize the extra benefit, but you're not losing your normal option. You can still go wherever you want. But if you go to WellBridge, maybe you don't owe that $3,000 out of pocket.
Nate: Let's put it in practical terms. I work for an employer that has a normal health plan and has the zero-tier with WellBridge. I'm on a high-deductible plan with a $3,000 deductible and maybe a $10,000 out-of-pocket max. If I go to a traditional hospital system, I'll hit my deductible and maybe owe more. My employer covers the rest. Or, if my employer has zero-tiered WellBridge, I pay $0. I could potentially get the same surgeon from down the street, and my employer might have a 50% reduction.
Dr. Eric Inman: That literally happened last week. Somebody said, I'm scheduled for this surgery here, but I just found out my benefit is zero out-of-pocket if I go to WellBridge with the same surgeon because that surgeon works with us too.
Nate: The same exact surgeon just comes to WellBridge Surgical, performs the same outpatient surgery, the employee pays zero, and the employer saves money.
Jeff Williams: You got it.
Nate: Is the hardest part signing up businesses, or educating employees that this is not discount surgery?
Jeff Williams: It's a two-step process. We give employers monthly content they can push out to employees to help with education. There can be resistance around travel, like not wanting to drive down from Northern Indiana or up from Southern Indiana. Some employers provide a travel benefit, cover travel expenses, a hotel, and on top of that the surgery is free. Anything to incentivize good healthcare consumerism.
In 2022, education was the big thing. People were like, what do you do again? You're in printing and now you're doing surgeries? Overcoming that was not for the faint of heart.
Nate: From swag to surgery.
Jeff Williams: I like that.
Nate: Gentlemen, learning more about the story and what you're doing, it takes serious risk tolerance to go all in on innovating such a complex legacy business. Healthcare is not easy to understand even if you're in it every day. A lot of providers go into it because they want to make a difference. Then they realize hospitals are businesses too. Simplifying the outpatient experience, providing excellent care at a fair price, and still making a fair profit is a commendable mission.
Jeff Williams: Thanks for having us on.
Nate: We need to round it out by talking all things Indiana. This question is brought to you by our friends at J.C. Hart. They're a leader in creating enjoyable living experiences at apartment communities all across Indiana and beyond. Check them out at homeisjchart.com. Jeff, why do you call Indiana home?
Jeff Williams: I never knew growing up that Hoosier hospitality was a real phrase, but it is real. Once you start traveling to other states and doing business in other states, you realize Indiana has a great group of people and a great business environment. If you want to get out of Indiana for the weekend, we have a great airport with direct connections, and you can always make your way back. It's a great state. I think it's the best state in the union.
Nate: Eric, why do you call Indiana home?
Dr. Eric Inman: I could never live anywhere that doesn't have all four seasons. I love the four seasons. I think it's a great place to raise kids. We have three kids. I like running a lot, and around Central Indiana there are not many hills. I don't like running hills, so we've got a lot of flat land to run around.
Nate: Amen. I just did 31 miles through Eagle Creek while training for a Zion crossing. We originally had rim-to-rim-to-rim at the Grand Canyon, but the North Rim is on fire, so we pivoted. We did 31 miles through Eagle Creek, 1,500 feet of elevation, and 1,500 feet feels like a mountain in Indiana.
I love it. We have some rapid fire questions. What's your first memory of meeting each other at College Wood Elementary?
Jeff Williams: The lunchroom. We liked to put grapes down where people entered the lunchroom and see if people would step on them.
Dr. Eric Inman: Those fifth graders were the only ones eating after us, and we thought it was hilarious if a fifth grader would step on the grapes. I probably still find it hilarious.
Nate: What is a hidden talent most people might not know?
Dr. Eric Inman: I fell off a cliff once and didn't die, so I used to think I was really good at falling without getting hurt.
Nate: Wait, how tall was this cliff?
Dr. Eric Inman: I probably fell maybe 25 feet. It was when Purdue was in the Rose Bowl. We were in Palm Springs climbing around, and I fell. All I did was cut up my head and face.
Nate: Did you still go to the game?
Dr. Eric Inman: I believe it was after the game. It's a little fuzzy. We had to go to the Palm Springs hospital and get X-rays.
Nate: Jeff, any hidden talent?
Jeff Williams: Eric knows me too well. The chicken breeding is pretty good.
Nate: State fair champ?
Jeff Williams: 1993 and 1997. I also know a lot about donuts. My first job was at Maplehurst Bakeries out in Brownsburg. I worked there for one year making donuts. I know a lot about Bavarian filling. I know a lot about raspberry filling.
Nate: I love a raspberry-filled donut.
Jeff Williams: I could have hooked you up back in the day.
Nate: These are the same three questions we ask every guest. Jeff, what's something the world needs to know about Indiana?
Jeff Williams: The Indiana Dunes. People need to know we have coastline here.
Nate: Coastline, baby.
Jeff Williams: Most people don't even know where to find Indiana on a map.
Nate: Eric, what do more people need to know about Indiana?
Dr. Eric Inman: I don't think people appreciate how nice of a family place Indiana is. It's a great place to raise a family.
Nate: What is a hidden gem in Indiana?
Dr. Eric Inman: Brown County State Park and the areas down there, including Hoosier National Forest. I'd like to know more about that and explore it more myself.
Nate: Brown County is a mountain biking mecca. Jeff, what's a hidden gem in Indiana?
Jeff Williams: Friendship, Indiana. It's in Southern Indiana and I don't think many people have heard about it. It's a really cool spot.
Nate: Friendship, Indiana is an unincorporated community in Ripley County, down by Batesville. It has the Friendship Flea Market for nine days in June and September. Its saying is, come as a stranger, leave as a friend. That's really good.
Final question. This is how we get recommendations for future guests and learn about cool people making huge impacts across the state. Who's a Hoosier we need to keep on our radar, someone doing big things?
Jeff Williams: Have you had Andrea Siler on yet? She's doing big things. She's a veteran working in construction and just killing it.
Nate: What company?
Jeff Williams: GroundBreakers. It's a company with big trucks that suck stuff out of sewer systems for utilities. She's like the local version of that. So you could say her company sucks.
Nate: I love it. Gentlemen, it was a pleasure to have you in the studio today. Thank you for talking about the amazing things you're doing with WellBridge Surgical. Taking a massive risk, especially when it took around 24 months to see traction, takes real guts. Entrepreneurship is scary in general. Going after healthcare, which is complex, old-school, and confusing for the average person, is a different level. I'm grateful to have people like you solving complex problems and trying to create a better experience for Hoosiers.
If employers want to talk about options for their health plan, or if individuals want to explore outpatient surgery, how can they connect with you?
Jeff Williams: You can connect with me at jeffw@wellbridgesurgical.com.
Dr. Eric Inman: I'm erici@wellbridgesurgical.com. Jeff is probably the one you should aim for.
Nate: Who are the right people who should reach out?
Jeff Williams: CFOs of self-funded plans, HR directors of self-funded plans. Reach out, shoot me an email, and I would love to give you a tour of the facility and show you what we have going on.
Dr. Eric Inman: And anybody who wants to have a high-quality experience, high-quality outcomes, and maybe save some money in the meantime.
Nate: Gentlemen, thanks for coming on the show. Congrats on all your success. Keep up the good work and we'll talk soon.
Jeff Williams: Thank you.
Dr. Eric Inman: Thank you.
