In today’s episode, co-host Carrie Nixon talks with VEDA Data Solutions co-founder and CEO Meghan Gaffney about the impact of “peripheral” healthcare innovations, those platforms and technologies which were not initially designed for healthcare.

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In this episode you’ll discover:

• How a political entrepreneur and an astrophysicist saw an opportunity for healthcare innovation

• Why in-network and out-of-network physician coverage info is so cumbersome to find, use, and update for all parties involved

• What spurred the “no Surprises” Act in Congress and how it changed VEDA Data Solutions’ business

• How COVID impacted data companies like VEDA Data

• How Meghan embraced her Silicon Valley outsider status to attract the right opportunities and employees

Learn more from Carrie and Rebecca: 

Healthcare insights (monthly email) | Telehealth/Virtual Care Mgmt Update (biweekly LinkedIn update)

Website | Carrie on LinkedIn | Rebecca on LinkedIn | NGL on LinkedIn

Learn More Here

Find out more about veda here

Connect with Meghan on LinkedIn and follow veda on LinkedIn

More on the No Surprise Act here.

How to maximize the value of your startup here.

Read the transcript:

Meghan Gaffney (00:00):

Money needs to flow to patient care and the way that we get more money into patient care and the way that we care for almost 400 million people with quality is to reduce the administrative cost as much as we can, and we can use technology to do that.

Speaker 2 (00:15):

You're listening to Decoding Healthcare Innovation with Carrie Nixon and Rebecca Gwilt, A podcast for novel and destructive healthcare business leaders seeking to transform how we receive and experience healthcare.

Carrie Nixon (00:32):

Hi everyone, I'm Carrie Nixon, and I'm here with the latest episode of Decoding Healthcare Innovation, and I'm joined today by me, Meghan Gaffney, the CEO and co-founder of Veda Data. I am really excited to have Meghan as a guest. I've known for her for a number of years now. I think she is an absolute rockstar founder and I'm delighted for her to share a little bit about her journey with Veda. And it's kind of an unusual journey. So often when we think about healthcare innovation we think about something that improves patient care, something like remote patient monitoring technology or a new type of medical device or a pharmaceutical. But there are other kinds of healthcare innovation mechanisms out there that aren't necessarily so intuitive. There are platforms or technologies that maybe in a somewhat peripheral way expand access to care or improve the patient experience. And this is another really important kind of innovation in healthcare. Beta data is the perfect example of that, and as I said, Meghan is one of my favorite founders. So Meghan, I'm going to turn it. First of all, welcome to the show.

Meghan Gaffney (01:50):

Thank you. Thank you so much for having me.

Carrie Nixon (01:52):

Yeah, and as I sort of hinted, you did not come from the healthcare sector. In fact, you have a very interesting story about the genesis of Veda Data that I think our listeners are going to appreciate. So will you share it with us?

Meghan Gaffney (02:06):

Sure yes. I do not come from a healthcare background, but I did have a front row seat to one of the biggest conversations about healthcare that our country has had. And so I worked in the political and policy space here in DC primarily with house members and had a front row seat to the conversations that happened as the ACA was crafted conversations that had representatives from physicians groups and big hospital systems, patient advocacy organizations and health plan executives all coming to try to find solutions to make the healthcare system work better for people and make sure there was enough money in the system to actually care for everyone.

(02:55):

It felt to me at that time as these conversations were happening, people were stepping over piles of money on the floor to solve really big problems that are important and meaningful to solve social determinants of health, but missing the opportunity that automation and technology could provide to bend the cost curve and save money so that the 25 to 30% of our premium dollars that today go to healthcare administration could be reduced and get more money in the system to take care of people, which is where the funds really matter. And so I saw that opportunity and when I met my co-founder, Bob Lindner, he was building tools in the field of astrophysics. He's a radio astronomer. And the genesis of our kind of aha moment as founders was me listening to him talk about speeding up the pace of scientific discovery 10,000 times by teaching machines to do the manual work that grad students and postdocs have been doing, improving the quality of the data they were using in their research and processing it much faster. And I had a light bulb moment and said, that's what healthcare needs. We can bend the cost curve of healthcare, we can get patients better information about who might care for them and where they can access that care, but we can also do it while saving money and putting dollars back into the system so we can get those dollars closer to people and away from paperwork.

Carrie Nixon (04:25):

So how does an astrophysicist and what he did in his sort of prior career fit in to what you all do now at beta?

Meghan Gaffney (04:36):

So I'll give you a really simple example. Big telescopes like the ones you might have seen, if you've seen the movie contact that's the VLA telescope, right? It's actually data that people in his field work on. Every car that drives by when they have a spark plug that fires or somebody nearby making a call on their iPhone or microwaving a hot pocket for their kids is blowing huge holes in the data coming off the telescope. It's really imperfect, it's messy, and every telescope's data streaming in a different format. Surprisingly, it looks a lot like the data that we see in healthcare that's

Carrie Nixon (05:13):

Very messy, right?

Meghan Gaffney (05:14):

Yeah, very messy. Some of it's missing. People are busy when they're handing things into an emr, right? They maybe forget to do fill in a few dropdowns. Maybe that claim was entered totally incorrectly because there were spelling errors or keys. And so the technology to fix those data sets is actually very similar.

Carrie Nixon (05:35):

It's amazing ideas that come into the healthcare sector from a completely different industry that have a real role to play. Very, very, very interesting. So talk to us a little bit exact about exactly what your initial product offering does and who your customers are.

Meghan Gaffney (05:54):

Sure. Yeah. We work primarily with health plans today. And if you can imagine there is a really high-paced game of telephone happening between providers and health plans every day, new providers are joining a practice. Maybe somebody's now participating in telemedicine that didn't before, and the interchange of that data back and forth about who's in network and where they practice things that seem quite simple, it's a very complex process to get the information from the provider into the health plan correctly. Right now, what's sitting in between those two are a bunch of people staring at the information from the provider on one screen and hand keying it into health plan data systems downstream. What it means for patients is that it can take up to several weeks to get updated information about where they can seek care. So if a big hospital system rolls out a new telemedicine program, this is great for patients and it's covered by their health plan, there can be a six week lag when that patient goes to the website to try to find a telemedicine provider. And it looks like there are none there, even though that care is available. So we speed that process up and use AI and machine learning systems to automate the conversation that happens through the data between the provider and the health plan. So what took maybe six weeks before can now happen in under 24 hours. It helps the health plan get compliant, but it also gets the right information to the patient as quickly as possible.

Carrie Nixon (07:33):

And that's really important. You described one situation where there may be providers in network that a patient doesn't yet know about, but conversely, I've personally had this experience, you go to look up a particular type of physician that's located nearby that is supposedly covered under your healthcare plan. You get to the office, you know, make the appointment and you get to the office and they go, oh, I'm sorry, we don't take your insurance. And you go, what? Right? Are you hearing that as well?

Meghan Gaffney (08:09):

Yeah, I think we've all had that happen, and there's a lot of blame in the conversation now about whose fault that is. Is the provider giving the wrong information to the health plan? Is the health plan not updating the information fast enough? But it's actually a lot more complicated than that when you have so many touchpoints on the data from one end to the other, and it takes so long to get it updated even when everybody is trying the best to get it right for the patient. At the end of the day, it's really not possible until you improve the technology.

(08:46):

I think about this as an investment in infrastructure with my old policy hat on. We all invest in roads and bridges. Everyone likes to see their potholes get filled on the street, but as a country and as a healthcare system, we haven't invested enough money in the infrastructure that makes data flow well and the system work well for patients. And so that's really where we focus as a company is can we fill those potholes and get the data moving faster with better quality so that folks don't end up with a surprise bill at the end of the day.

Carrie Nixon (09:18):

Yeah, that's a great analogy, Meghan especially with today's conversation around infrastructure and I think makes a lot of sense. So you mentioned patients not getting surprised by a bill. This has become a hot button issue over the past several years where a patient has gone and gotten care somewhere in particular if they've gone to an ER or maybe an urgent care, and it was the only place that was available for care, and it may have even been for something minor, strep throat, something like that, whatever. And the visit to the ER ends up being an absolutely astronomical amount that the individual may be completely unable to pay for. So I know this phenomenon got a lot of press, and eventually it has resulted in the no surprises act that was passed by Congress. This act has had implications for Veda. Can you talk a little bit about that?

Meghan Gaffney (10:35):

I mean, it's funny that you mentioned the legislative impetus and how it changed our business because I jokingly had calls from friends that asked, did you pay someone on the hill to write this piece of legislation for you? This is exactly what you've been trying to change in the industry for the past few years. And it makes sense because it's something that patients understand, ev, they're trying to do the right thing, they're looking to see what their insurance covers, they're trying to access care in the right way, but when the data's wrong, they can't make a good decision. They can't really make any decision, right, as a consumer because they don't have the inputs to do that. And so from Veda's perspective, we are able to solve for two of the requirements in the No Surprises Act, both that benefit patients, providers, and the health plan.

(11:27):

It's really a win-win when you get it right on the legislative side. They've said, okay, you need the information to be audited every 90 days. The information that's on your health plan website that you're showing to consumers, we need to know that you're checking it and making sure the data's right. That just makes sense that they should be doing that. But it's a manual process today, and it takes a lot of effort to get through all of that data. We provide an automated solution solution that's able to do that audit in under 24 hours so that health plans can keep a good eye on the quality of the information they have out in the public sphere. The second is really a regulation towards the same goal, better data quality, making sure things are up to date. So that part of the regulation requires that health plans update provider data that they receive from providers within 48 hours of receipt.

(12:22):

That seems fairly easy, but when you get a large roster from a huge hospital like Georgetown here in DC or maybe even larger like Montefiore in New York, that's a lot of manual work to get that into downstream systems. We provide a drag and drop automated tool that allows health plans to ingest that information, process it, identify what updates need to be made and update their system all in one workflow. And we guarantee that we can do it within 24 hours. So again, benefits to everyone down the line, patients get the information they need, providers get paid correctly and on time, and health plans are able to be in compliant. So we really see it as a tool that benefits the entire ecosystem.

Carrie Nixon (13:11):

Yeah, absolutely. And so Veda really helps health plans to be able to meet their requirements and the result is better access, better information, better care for all.

Meghan Gaffney (13:22):

Right? Yep, that's right.

Carrie Nixon (13:24):

Excellent. So when I talk to clients and clients of digital health companies or life sciences companies, they often talk about how covid has impacted their business or their market. And a lot of the times they're doing patient care. Now you're not focused on patient care itself. So I'm wondering whether covid had an impact on Veda as a healthcare company?

Meghan Gaffney (13:57):

I think Covid impacted all of us for Veda and for folks that are in the healthcare data space and the kind of pure data plays within healthcare, it's really fundamentally changed the ecosystem that we work within probably forever. There's more information flowing today than there was two years ago. On a daily basis, you have data points around health and safety measures for things like nursing homes and long-term care facilities. At the height of the first wave of the pandemic, we started to pull in information about things like, do these long-term care facilities have adequate PPE and testing supplies? And we were able to aggregate those and put them out into our platform for our customers. We see new data points coming online that are really important in ways that they weren't before tracking who provides telemedicine and in what locations they're able to provide that type of care where testing facilities are located and where someone can get a vaccine that is covered by their health plan. All of those different data points just expand the footprint of that game of telephone that we talked about happening at the beginning of the call. And so the need for automation is even greater.

Carrie Nixon (15:21):

Yeah, no, that makes sense. Again, sort of not intuitive, but makes absolute sense. The need to get vast amounts of rapidly changing information accurately out to the public right down your alley,

Meghan Gaffney (15:35):

And more important now than ever.

Carrie Nixon (15:36):

Yeah, absolutely. Absolutely. So what is in the future for Veda? Are you thinking about other types of product offerings given the power that your technology brings?

Meghan Gaffney (15:49):

Yeah, a trillion dollar problem in the industry isn't solved through one use case. So we have a lot left to do. I fundamentally started this company because I think that money needs to flow to patient care and the way that we get more money into patient care, and the way that we care for almost 400 million people with quality is to reduce the administrative cost as much as we can. And we can use technology to do that. So data will continue to look for opportunities to introduce automation that help save money and improve data quality. We're looking forward into challenges around claims automation and Medicaid eligibility, places where there are a lot of people working really hard, but they need technology tools to be able to move quickly and get information through the system so that folks can access their Medicaid benefits or make sure that the provider is paid accurately and on time. So those are the types of problems that we're looking at and we're just getting started.

Carrie Nixon (16:58):

I can't wait to hear more about them. Real quickly, I know you have you've undergone some efforts at fundraising a number of times. I'm sure you feel like you're constantly fundraising to continue to support the evolution of Veda and its product lines. Can you tell do you have any sort of tips or tricks or best practices or stories, war stories from fundraising that you can share with our audience that innovators in the space experience?

Meghan Gaffney (17:28):

There are definitely plenty of war stories and advice to share. I will say this, I mean, when I talk to other female founders or any founder that isn't from the mold that the kind of valley created years ago there's an advantage when the book wasn't written for you, and that's that you don't have to follow the rules because the rules weren't made for you anyway. And so I've always looked at positioning my company and creating a company that I believe in that reflects my values and the things that I'm passionate about. And I've assembled a team and product offerings that are really unique, and it flows from that ability to not feel constrained by the way things are supposed to be done. And I'll give you kind of two examples of that. So the first interesting thing that I encountered where I realized that the rules really don't apply to me, it was kind of a sticky situation, literally.

(18:35):

So I was at a very large pitch event. It was about 30 different founders from seed stage companies who were coming to pitch to investors and local incubators all different types of technology. I was really excited to make the cut. And as a part of the program, you got an hour of pitch coaching, which I was really excited about. I needed help. I had never done this before. And the feedback I got at first was good. There were some slides that weren't very clear. I needed to make some edits on the way that I was presenting the market size. And then I got a comment that said, the business case is great, but you, I'm having some trouble with your credibility. And here I thought I'm, oh, great, I'm not from healthcare, I don't know what I'm talking about. And he said, no, it's the pitch and cadence of your voice.

(19:34):

And I said, well oh good. What would you like me to do about that? I can't speak in a deeper voice. I can't. This is just who I am. And then the day of the event, as I was going to the stage to speak, one of the investors who I was hoping to get their attention and get them excited about Veda handed me their sandwich crust on the way to the stage because he thought I was part of the wait staff. Oh, and I, yeah, and I put it in the trash can and I wiped my hands on my black dress, and I walked up to the stage and I gave my presentation with the pitch and actual cadence of my voice because this is who I am. And I was really down the rest of the day. But what happened was that there were a few other women in the room who saw that interaction and they didn't see the interaction in the pitch coaching, but I was approached by people who got it and could see how I handled that situation. And those were the people that I needed to surround myself with. So I would say that for other founders, people will see you for the strengths that you have, even if those aren't obvious to kind of status quo supporters. And as investment communities get more diverse, the ability for founders to be noticed for their strengths,

Carrie Nixon (21:02):

Those women had been there, they'd been there as well. Yeah, that's right. Yeah, that's a pretty striking example. For the record, I like the pitch and cadence of your voice. Just FYI.

Meghan Gaffney (21:14):

I appreciate that. I like yours too.

Carrie Nixon (21:16):

Sorry. Thanks. I don't like my own.

Meghan Gaffney (21:19):

<laugh>,

Carrie Nixon (21:20):

Why I'm on a podcast. That's why I don't listen to myself.

Meghan Gaffney (21:22):

Yeah, that's great. The second example is simpler and it's a simple decision that we made. We're a healthcare company. I have always said that means that our employees shouldn't have to worry about their healthcare. So from the very beginning, we've covered a hundred percent of premiums for our staff and their entire family. And there were some investors who said, that was just not something that I should be doing. We shouldn't be spending our money there. That's not the right thing to do. But what I found was that when we started to get and retain the best staff in the industry and people were really excited to come and work here, the investors started to understand because they would tell them, part of the reason I'm here is for the mission, but part of the reason I'm here is for the benefits. And so I would encourage founders to make choices within their own set of values as well, because you attract great people to come and work on your team.

Carrie Nixon (22:17):

Making choices within your own set of values, I think is key. It is fundamental and I think that's a great piece of advice. I will ask you if there is any other piece of advice you'd like to leave folks with, or if you want to close there, that's fine too.

Meghan Gaffney (22:36):

I would say there's so much more room for innovation in healthcare. There's so much love to be done, and regardless of if you've been in this industry for your whole career or if it's a new interest and you're kind of dabbling in healthcare from the outside, there's so much space for innovation and it's such an exciting time to do that that I would encourage folks to get off the set headlines and start the business that you've been thinking about. If you're sitting inside a big company today, kind of dreaming about being an entrepreneur, now's the right time to do it.

Carrie Nixon (23:10):

I'll just echo that a hundred percent. A hundred percent. Sometimes coming with that outside perspective, not having been entrenched in the healthcare industry, it means, again, you don't have to do things the way they've always been done. Cause you don't even necessarily know that and you don't have, and there aren't the same expectations of you. It doesn't mean you shouldn't educate yourself, and you've always been super good at that but it does mean it's wide open. Come on in and make some change, right?

Meghan Gaffney (23:40):

That's right. Absolutely.

Carrie Nixon (23:41):

Awesome. Thank you so much, Meghan, for being with us. You can find information about beta data and about Meghan in our show notes, and we will look forward to seeing you, all of you hearing all you being with all of you listeners at the next episode of Decoding Healthcare Innovation. Thank you.