Photo by Chris Casella

In Good Company

Matt Scantland has an Uber-sized problem to solve. But he needs your help.

“No one’s really talking about it, but every day we’re seeing thousands of patients who aren’t getting the drug they need to be healthy because this process is just too hard.”

CoverMyMeds, co-founded by Scantland, set out to challenge the status quo in how insurance companies approve prescription medication. Insurance companies require prior authorization—essentially a permission slip—for medications to be given to patients. If it hasn’t been pre-approved, it takes extra work from the caregivers (doctors and pharmacists) to make sure patients get the medicine they require. The cost of that extra work (calls, forms, faxes, appeals) is between $23 and $31 billion annually.

“We had really, legitimately tried to avoid the prescription abandonment problem and weren’t able to get it done. We said, ‘Maybe this isn’t a problem that any one insurance company can solve on their own.”

“From the perspective of a doctor who needs to participate in the process, our beautiful application is just one of a dozen that that doctor needs to navigate; each with their own password and workflow and everything. Let’s approach this from a different angle. Let’s do something that’s provider centric rather than insurance plan-centric.”

“[CoverMyMeds co-founder] Sam [Rajan] and I got together, and we knew we wanted to solve this massive problem … every day we’re seeing thousands of patients that aren’t getting the drug they need to be healthy because this process is just too hard.”

“A couple of days before we started CoverMyMeds, at the time it was probably Yahoo! discussion boards, and there were hundreds of patients saying, ‘Why won’t they just cover my meds?’ And so we registered CoverMyMeds and we got started right away.”

It’s a big problem with big rewards. Since its founding in 2008, CoverMyMeds has at least doubled in revenue and employee count every year.

Scantland sat down with (614) to talk about the way he identifies business problems, the tools needed to solve them, and what’s next for CoverMyMeds.

Diagnosis

“I think you’re looking for problems where no one is winning. That’s different than problems where someone is winning and someone is losing. Cable TV right? Cable TV companies are just fine. Why does their customer service stink? Because they have a 100 percent marketshare. It doesn’t have to be better.”

“Those problems are very hard to solve for someone that’s just starting out. The problems that can be solved are where no one’s happy. Something that I point to that most people would be familiar with is Uber. The first time I rode in an Uber, what was so remarkable wasn’t just how much better the experience for me as a rider was, it was actually how much better it was to be a driver … they could have very easily said, ‘Let’s have an app that hails taxis.’ But they didn’t stop there—they solved the whole problem. They found something that no one was happy with and they solved it. To me, those are the problems that are easier.

The second criteria that you’re looking for: is it a big problem? My first attempt at being a product company really never became a great company because it just wasn’t a big enough problem.”

Prescription

“[We have] a very clear dedication to getting amazing people working at CoverMyMeds—helping them understand our mission and then getting out of their way. We decided with our consulting business we weren’t going to be the best place for technical people to work because we were on this treadmill. We became a product company really explicitly to do that. We want to be the best place for ambitious people to work … ambition to take care of patients and build something amazing.”

“I think it starts with a mission that matters to people. We’re helping patients get the drugs they need to be healthy. At the end of the day, there are lots of big technology products. There are very few that will make that big of a difference in people’s lives in terms of them being healthy. I think people believe in that mission.”

“The second is that really talented people want to work with other really talented people. And so we started strong and we’re getting stronger. When you come here, you see people that are excited about the mission, happy to be here and you say, ‘That’s the kind of room I want to be in. Those are people that I am going to learn something from.’ Great people kind of set up a flywheel that tends to create more success.

“Another thing is that we’ve optimized the company for the employees, not for managers. There’s this philosophy we have that the person that’s closest to the problem knows best—not least. And so they make the decisions.”

“The last piece that I think is important to being a great place to work: running the company in a way that generally demonstrates to [employees] that they’re the most important thing we have going for us. And there isn’t any one thing. Some day, the most evil corporations in the world will have pool tables and kegerators, like we have. That’s cheap and easy to fake. What you can’t fake is the thousand decisions that you make every year that collectively demonstrate that employees are the most important thing we have. It’s the times when we could have crammed a decision down the company without talking to people and didn’t. It’s the times when we could save money by not being generous with our benefits. Eventually, people learn that we care about them.”

Adverse Reactions

“There’s never a perfect person for a company. There’s a perfect person for a particular stage in time for the company.”

“There’s this learning theory where you start out as unconsciously incompetent and then consciously competent and then unconsciously competent. And what propels you through that learning cycle is awareness. While we’re not always going to be good about it, what we try to do is have awareness and say we’re going to be in learning mode and there’s no one here that’s always right, including me.”

“Occasionally, people either aren’t interested in becoming competent in what the role has become, and they move on. But it’s actually happened pretty infrequently because the good thing about learning a new role is you’re advancing through your career and learning something new and it’s generally pretty fun.”

The Cure

“What you get here, in terms of employees, is people that I think truly care and are willing to make a commitment to an organization’s success. Our retention rate is unbelievable: For all intents and purposes, a 100 percent.”

“I think a lot of times people in Columbus have a perception of what you can and can’t do here. It’s a negative fantasy to believe that you can’t build something impressive in Columbus … there’s no reason that you can’t address a national market from Columbus.”

I think it’s impostor syndrome—this deep-seated anxiety that ‘I am not good enough.’ What I have learned, as I’ve gotten older, is that there’s usually more than one right answer and there’s usually not a silver bullet. You start to realize that you matter and that you can do this in Columbus or anywhere.”

Follow-Up Care

“Life expectancy from 100 years ago has doubled. That’s an amazing technological progress in core healthcare. What we haven’t done is figure out how we’re going to pay for this. How can we provide this stuff to everyone? That intersection of how we balance the trade–off between efficacy and cause is a core healthcare problem. We think we’re in the driver’s seat to do that for prescription medications. We have a lot of things going on that are fundamentally reimagining this so that doctors are practicing more medicine, insurance companies are paying—helping the right patient get on the right drug at the right time.”

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