As the CEO at FourStone Partners, Thomas is responsible for the strategic direction, development, and leadership of the company. He has over 25 years of executive and entrepreneurial experience in the workers’ compensation managed care marketplace.

His constant focus on results, accountability, and practical application have gained Thomas industrywide recognition and established him as a thought-leader in the field. In this interview, Thomas talks to me about his journey in the industry, the challenges he has overcome over the years, and his business plans moving forward.

Starting in the Workers’ Compensation Domain

During his senior year of college, Thomas was offered a job in the claims department at Hanover Insurance Company. The field seemed intriguing and once in it, Thomas began to enjoy his work in the field. As time progressed, he became very committed to the industry and finding ways to improve it in any way possible.

‘That was my first job out of college and I have stayed in the industry ever since.  It has been a great tour.’

Prior to his current role at FourStone Partners, Thomas worked for a company called Healthcare Solutions.  He had a three-year contract with them and had invested some of his own money into that firm.  The firm was ultimately sold to United.

The idea for FourStone Partners was already developing in Thomas’ mind for about 10 years and he decided to move forward on it when his contract came to an end.

‘It was very fortunate that the end of my contract came when it did.   It allowed me to start FourStone and take a chance at an idea that I had been contemplating for a long time.’

Recalling the first account that the firm landed, Thomas states that their first client was also their longest served client. It was a firm that he had done a lot of business with previously. As they had an established relationship, the company reached out to Thomas for help in revenue growth.

Thomas met with the leadership team and the existing rapport worked well in establishing trust to outsource some of the company’s sales efforts. Thomas and his team gained tremendous success on this account, allowing them to better establish their brand.

‘They enabled me to start the company.  I am forever grateful to them for their confidence in me and their willingness to give my firm a chance.’

Current Business Structure and Organization

As the founder of the firm FourStone Partners, Thomas talks to us about coming up with the name of his firm. ‘Stone’ is a tribute to the town called Eddystone in Pennsylvania where Thomas grew up. The town was named after the Eddystone Lighthouse in England.  This is also the reason for the lighthouse logo as well.  The Four at the beginning has always been Thomas’s lucky number and is very meaningful to him.

Regarding the services offered, the company was founded on sales consulting and sales outsourcing platforms. These two aspects still play a prominent role today. The firm also does traditional consulting, product design, go-to-market strategies, and competitive analytics.

The firm has also evolved over the years to also build provider networks for others wherein they contract with medical providers and hospitals on behalf of third parties.

‘We have some of the best talents in the entire industry.  We are better, faster, and more economically efficient than any other solution.’

Over the years, the company has also developed their own products. A company they own does pharmacogenomic testing. That is the science that identifies how individuals uniquely metabolize medication.  This testing helps identify what medications work at what dosage levels prior to taking the medications.  Further, it also helps identify what medications will be ineffective and which will be harmful or toxic.

The company also has a toxicology program and a DME division that focuses on the Gladiator Therapeutics Device, which is a highly innovative technology that accelerates wound healing by up to 68%.

Additionally, they also have hub services here where they can do intake, billing, referral management and business services for others.  In the case of a start-up, FourStone Partners can be the hub services for them and make their business much more economically efficient. The company also does revenue cycle management where they bill on behalf of medical providers in the workers’ compensation space.

‘We have become very diversified over the years and that helped us during COVID because some of our businesses were significantly impacted, but other parts of our businesses pulled us through.’

Reimbursement from the insurance for workers’ comp often takes a lot of time in the industry. Thomas states that this is exactly why companies should outsource their operations to FourStone as the experts there know how to make the process go much more quickly and how to maximize the reimbursement for the provider.

‘It can be a huge challenge to medical professionals if workers’ comp is not the main focus of their practice.  Workers’ comp can be very confusing. We simplify it for the provider and get them paid more and get them paid faster, which is why an outsource solution is a very good idea.’

The firm at present has over 40 employees with several consultants working for them part-time which raises the count to about 50 people. The company has been entirely self-funded from day one.  There are no investors, private equity, venture capital or debt, which allows for decisions to be made quickly and for the firm to remain nimble.

The company has an offshore team in the Philippines and an offshore team in India that perform a variety of support services. The rest of the team is in the United States.

Presently, the company has about fifteen clients in their current portfolio. Their target market has grown over the years as the company has diversified. For their lab business, it’s the insurance companies and TPAs.  For their DME it’s the insurance companies and the TPAs. For revenue cycle management, its medical providers, and for their network development division, it is companies that provide network services in the industry that want to expand their network.  On the consulting side, it would be companies that also target insurance companies and TPAs.

The pricing model at the company is retainer-based.  The firm is paid a retainer each month plus a performance bonus on revenue that they generate for their clients.

Talking about automation, Thomas is a firm believer in automating whatever is possible. He believes the company has provided a lot of innovation in this space with their model and how they bring clients out into the market. They prefer to make everything programmatic in nature.

Standout Moments as a Business Leader

Over his decades of experience in the industry, Thomas has had several standout moments. One was at a company called MedRisk, which turned out to be a huge company in the industry, where he worked with Shelley Boyce.

He states that she was the driver of that entire organization and she encouraged Thomas to be part of that organization from its inception.  That turned out to be a hugely successful company in this space. That was a huge learning opportunity for him and one that Thomas greatly values.

Another standout moment was when he was hired to start the Aetna Workers’ Comp Access Division and built that from 0 to $70 million in five years. That was a wonderful experience.  A woman named Robyn Walsh hired him and later became a mentor who significantly impacted his career.

Starting FourStone Partners nine years ago was a huge milestone and one that Thomas is extremely proud of in his career.

‘Starting FourStone allowed me to see an entire industry from a variety of different perspectives and I feel like I have learned so much about such a variety of products and services.’ 

Talking about standout moments for the organization, Thomas says that they have helped many small companies expand into national companies and gain national clients and national exposure.  They have helped start13 or 14 companies from scratch.  They have also helped regional companies become national, and small companies become much larger.

‘We have had startups as clients and we have billion-dollar companies as clients. The innovative model that we have brought to this space hasn’t been duplicated, and that is something we are very proud of every single day.’

Overcoming Challenges in this Domain

COVID was one of the challenges with the company having to remodel the way they did business overnight. Thomas says that while they have done a great job with that, it was an interesting situation and certainly a challenge.

In the industry, one of the things that was a really hard challenge to overcome was the concept of outsourcing sales.  People are used to outsourcing IT, legal and other areas of the business, but outsourcing sales was something that took a lot of perseverance.  Convincing people that it was the right thing to do for their company was not an easy task at all.  It turned out to be the right decision for them, but changing the model of how they commercialize their business was an enormous challenge, says Thomas.

Business Plans for the Future

Talking about plans for growing the business, Thomas states that their focus is on growing organically as much as they can.  He will hire additional salespeople to grow the business, but is also contemplating an acquisition.

There are several companies that could contribute to their expansion plans. For instance, a company in the lab business or in the revenue cycle management business. Another option could be a consulting company or a company that does medical management.

‘It would make sense to find an acquisition target that does some of the things that we do or something that we’d like to do that we think we can expand. That’s probably is a 2022 initiative for us.’

Talking about the company’s marketing prospects; Thomas says that they do that in-house.  Their approach is more sales-driven than marketing-driven. Additionally, the company also attends workers’ comp expos and will be attending three of them this year – Vegas, Florida, and RIMS.

‘We don’t find the value in a booth or in just showing up and walking around.  We schedule all of our appointments prior to the event and are very busy from sun up to sun down with prescheduled appointments.’

Top Philosophies and Core Values in Business

The company takes a lot of pride in the culture at FourStone.  Everything they do is based on practical application.  As a consulting firm, as a sales outsourcing firm, they don’t give clients anything based on theory.  Instead, they focus on what actually works and how things actually get done.

One of their core values is to base everything on practical application. Everything is based on reality and on how the world really works.  Another thing that is core to the company is the belief that everybody in the room is the smartest person in the room. It just depends on the subject. Everybody is invited to provide input into either some situation they face or if they are trying to solve a problem for the clients, or any significant decision that needs to be made.

‘At FourStone, it doesn’t matter what your title is, how long you’ve been at the company, or what your seniority level is, the right idea wins regardless of the genesis of that idea, and that has helped us tremendously over the years.’ 

Advice for Newcomers Starting a Career in Workers’ Compensation

This is a career industry. People need to create relationships and those relationships will stay with them through the entirety of their careers. Newcomers getting in should meet as many people as they can. Also, if they behave honorably, are good at what they do and work hard, they will always have a job.

‘People that I have worked with 25 years ago, I’m still working with today and that is not unique in that in our space. Once you’re in it you tend to stay in it.’

Thomas highly advises getting into the workers’ comp industry. He feels that it is filled with intelligent, wonderful people and is a place where people can make many long-term friends and relationships.

Key Benefits of the Services Offered at FourStone Partners

On the consulting side, Thomas states that the key thing is that they are experts in this space and in practical application.  They don’t waste any time on theory or anything theoretical.  They only talk about what works and how it works, and then they execute the plan as they represent the client in the marketplace. Another major benefit is that the company is also economically much more efficient than keeping employees on the payroll.

‘We’re experts in this space. We are better and more economically efficient than anybody in the industry.’ 

On the lab front, the benefits are enormous to the insurance company and the injured worker. Taking medications that are beneficial and nontoxic at dosage levels that are known beforehand ends up allowing recovery much more quickly. It also prevents any adverse reaction to medications, and limits spend on medications that are ineffective.

At DME, Gladiator Therapeutics, is a device that accelerates wound healing, increases circulation, decreases inflammation, and reduces pain.  It also does not require a power source.  The obvious benefits there are accelerated healing times, better outcomes post-surgically, and less pharmaceutical spends because pain is reduced.

Vision for Future of the Industry

Thomas believes that the workers’ compensation industry will continue to innovate and they want to be on the front side of that innovation.  The company wants to bring things like pharmacogenomic testing and Gladiator Therapeutics to the space that are being used more in traditional healthcare but haven’t made their way to this domain yet.

‘Our vision is to innovate by the use of technology and bring some of the products and services that are being used primarily in traditional healthcare into workers’ comp to create better outcomes.  That’s what we’ve done and that’s what we’ll continue to do.’

For companies or professionals looking to remain successful in this domain, Thomas advises bringing innovation and new ideas as well as to create as many relationships that they can create.

He states that people tend to stay in this space, get promoted and get different jobs or they start companies. Having good relationships helps their career because they can learn from everybody.

‘There are a lot of very smart people in our industry. So if somebody is trying to create a new company or a new concept, there are a lot of people that a person can go to for advice and for guidance.’ 

Thomas has also been featured in the CEO monthly magazine and he credits his team and the company for this success.

Leadership Lessons Learned Over the Course of Life

Thomas states that he has been very fortunate to have worked for many great people in his career such as Shelley Boyce at MedRisk, Tom Cox at Concentra, and Robyn Walsh at Aetna.

He has learned valuable lessons from everybody that he has worked for and with, as well as from people that have worked for him.

‘We take a lot of pride here at FourStone at how we behave and how we treat each other and how we treat our clients and constituents.  We believe you should behave honorably and treat people with respect, and we do.’

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