How a Side Hustle Evolved Into One of the Largest HSA Providers

Challenges in healthcare impact every player—payers, HSA providers, and patients. What’s the modern-day answer to rising costs and better care? It’s a complex answer, and Steve Neeleman, Founder & Vice Chairman of HealthEquity, spoke with I Don’t Care host Kevin Stevenson on the topic.

After working for Southwest Airlines, Neeleman graduated from medical school and served as a trauma surgeon. At the same time, he started HealthEquity. “The question was why don’t we treat our customers, patients, the same way we did at Southwest. The notion became consumer-directed healthcare, opening up opportunities for them to make better choices.”

Personal health issues also sparked the ideas around managing health savings accounts (HSAs). He and his daughter faced these, with high out-of-pocket costs. Something that many insured people experience every day.

“HIPAA had a pilot program for HSAs and then extended it. It’s your money, and you don’t pay taxes on it. It functions like a 401K,” Neeleman explained.

Neeleman described the future of HSA providers and healthcare spending, citing its need to connect with centers of excellence. He recalled that after passing his surgical boards, he wasn’t an expert at every surgery because medicine is complicated. “Centers of excellence have completed a procedure many times. If you marry that with consumer-directed healthcare, payers will direct patients there because it saves money, and the quality of care is better.”

Educating patients about health savings account and concepts of navigating their healthcare is part of the equation. Neeleman also speaks to doctors about them. “Doctors are trying to embrace consumerism. They didn’t use to have to be attractive to get patients.”

More Stories Like This:

Transforming How Lower-Middle Market Healthcare Firms are Represented

Which Innovations Are Set to Transform the Medical Device Market?

Regulation F Brings New Regulations to Debt Collection. Here’s How It Impacts Healthcare.

Follow us on social media for the latest updates in B2B!

Image

Latest

finance
Dr. Silver Kung’s Path From $10 Million in Debt to a Multibillion-Dollar Finance Career
May 21, 2026

Global finance is being tested by forces that no balance sheet can fully predict: unstable supply chains, geopolitical shocks, tighter credit conditions and the accelerating rise of AI. In trade finance especially, success depends on more than capital; it requires judgment, discipline and the ability to see risk before it becomes disruption. As automation…

Read More
specialty pharmacy
At the Center of Care: How Specialty Pharmacy Aligns Patients, Providers, and Payers
May 21, 2026

As healthcare costs continue to rise, more patients are finding themselves navigating not just illness, but the growing complexity of paying for treatment. Specialty pharmacy sits right at the center of that challenge—often out of sight, but increasingly essential to how modern care actually works. These high-cost, high-touch therapies now make up more than…

Read More
Language development
Just Thinking… About How Multilingualism and Language Development Belong at the Center of Student Learning
May 20, 2026

For millions of students in America, learning English is only one part of a much larger academic story. A 2024 GAO report found that English learners in U.S. public schools grew from 4.5 million to 5 million students between fall 2010 and fall 2020, and that they speak more than 400 languages. That diversity…

Read More
AI Infrastructure
Simplifying AI Infrastructure: From Data Center to Deployment (Part 1)
May 19, 2026

In this episode of the Flawless Execution podcast, Jeff Hudgins, VP of Global Services at UNICOM Engineering, breaks down the real-world challenges of deploying AI infrastructure at scale. As AI moves from one-off builds to repeatable global deployments, OEMs, ISVs, and enterprises face increasing complexity across design, integration, cooling, logistics, and installation. Jeff discusses how…

Read More