OR_Sempre Health_Jeff Spafford: this mp3 audio file was automatically transcribed by Sonix with the best speech-to-text algorithms. This transcript may contain errors.
Rich Prest:
Hello everyone, and welcome to the Sempre Health Outcomes Rocket podcast, where we talk with healthcare leaders on the state of the industry, patient engagement, and technology innovation. I’m your host, Rich Prest, and today, we’re fortunate to be speaking with Jeff Spafford, who’s the CEO of AssistRx. Jeff has had an amazing career in the industry and seems to know everyone, so I think it’s going to be a great discussion today. Jeff, welcome to the podcast today.
Jeff Spafford:
Rich, glad to be here.
Rich Prest:
Yeah, no, glad to have you on, and so just to help our listeners get to know you better, can you maybe share a little bit about maybe, actually, even a dream career when you were growing up, what you wanted to do and then how you ended up with what you’re doing today? Yeah.
Jeff Spafford:
Well, I can tell you that I never dreamed of being a CEO of a healthcare technology organization. That was not on my top ten list, but it’s.
Rich Prest:
Not quite like astronaut or fireman, is it?
Jeff Spafford:
It’s not quite the same, but, so started my career as a economics major undergrad and was fortunate enough to go work for General Electric and went through their financial management program, had amazing opportunities, working in a variety of businesses, then went back to business school, got my MBA and of course came out and did the obligatory management consulting stint.
Rich Prest:
As we all did.
Jeff Spafford:
Exactly, as much as everybody has to. And then from there, I went to, a number of my clients happen to be healthcare organizations, and as you know, healthcare is always undergoing change, and so there’s always plentiful opportunities for consultants within healthcare. And just so happened, one of my clients wanted to hire me, and off I went and spent a majority of my career growing up in the specialty pharmacy distribution channel where I was able to, I was member the different pharmacies that grew out of the space, and then I’ve been the CEO of AssistRx for the last 13 years.
Rich Prest:
Oh, it’s incredible. Yeah, it’s amazing to think back to, specialty has, in many ways not been around for that long, right? It’s almost been in the last 20, 25 years that specialty started and has now become half of the industry, so.
Jeff Spafford:
I like to say that I was in specialty before specialty was a thing.
Rich Prest:
Before it was cool.
Jeff Spafford:
Actually, a home infusion pharmacy that just happened to be handling this new generation of injectable products that no one really wanted to handle at that point, and of course, things took off from there. So it’s been an amazing ride to see an industry grow from nothing to what it’s become today. It’s a classic HBS case study of how businesses and industries form.
Rich Prest:
Yeah, yeah, absolutely. And when you look back over your career, is there a particular accomplishment you’re most proud of?
Jeff Spafford:
Well, you know, one of the great things about being in healthcare is not only, is the business, but the product of what you’re delivering is helping patients and being a specialty pharmacy at the time, you engage directly with patients and you understand the challenges and the frustrations that they’re having. And so being able to help them get access to their therapy is something that is just tremendously fulfilling. It’s something that has driven myself and quite honestly, the entire management team here at AssistRx to do what we do, because it’s, you’re dealing with people that are in desperate need and they have a variety of needs. Not only do they have healthcare issues, but they have financial issues, they have psychosocial issues. And that’s really what makes a specialty pharmacy different than others, is that you’re dealing with a patient in its entirety, and the days that you are helping patients are great days. The days that you can’t help patients are really frustrating.
Rich Prest:
Yeah, yeah, totally agree. I think that’s a really special part. When you get that feedback from the patients and you realize that you’ve made a difference in their lives, it’s really touching, so it’s very cool. And then when you are looking sort of forward, is there something you’d want to be remembered for in terms of changing the industry? Is there something you’re still hoping to hoping to achieve? Yeah.
Jeff Spafford:
Absolutely, you know, as I mentioned earlier, healthcare is constantly changing and the little area that I focus on, which is helping patients get access to the therapies, is in this transition phase as well. Having been in this industry for so long, I’ve seen it grow and in many ways, it’s become inefficient, it’s slack, it’s become less helpful for patients and for prescribers, and so one of the things that we are really driven to do here at AssistRx is creating that next generation patient support model, one that uses technology to help address some of the barriers to access, one that uses data to help inform our thinking and our decisions so that we can be better at our job, so that we can provide services that are more meaningful, more cost-effective for patients than before. You know, the term reimbursement hub has been coined over the last many years, and in many cases, it was meant to be the quarterback that helped patients shepherd them through this onboarding process and along their journey. And that sounds great, but it’s evolved into sort of a big black hole where patient referrals go into and they’re stuck there for a long, long time. And so being able to improve upon that and being able to create that next-generation model using tech and talent is really what drives us and really is what I have, I want to be able to accomplish before I call it a day.
Rich Prest:
Yeah, and it’s incredible too, right? I think the, back when you started 13 years ago and the thought of, oh, let’s get all of this stuff off paper and into electronic format and I think we’re still on the cusp of, you know, I remember I would always used to say kill the fax and we still haven’t quite done it yet, so.
Jeff Spafford:
…, they say that in healthcare, things take ten times longer than they do in other industries, and I think in many respects that’s true. I am encouraged, having done this now for 13 years, is that I’ve seen this sort of acceleration of adoption of technology, and while we’re not killing the fax quite yet, we’re now having a lot of sort of aligned support in terms of how do we digitally engage with patients, with prescribers, with all the different stakeholders that are involved in that patient journey in a much more meaningful way. And those discussions have grown tremendously over the last couple of years, and I can expect them to continue that way. And so all the hard work that we’ve done over the last many years I think are starting to come to fruition and pay back benefits.
Rich Prest:
Yeah, that’s very cool, very exciting. I think that, it is starting to accelerate in terms of change. So it’s shifting now to sort of the US healthcare overall. What do you think is the key thing that most people don’t understand about US healthcare?
Jeff Spafford:
That it’s broken? Yeah.
Rich Prest:
Actually, I thought it was perfect.
Jeff Spafford:
Right, you know, obviously US healthcare, that’s a big, big bucket, …, you know, from my little corner where I work directly with life science companies, pharmaceutical manufacturers and helping patients get access. I can tell you that I don’t think most people realize what it takes, A, to bring a drug to market, all the costs in R&D and expense to get that drug to market, but B, what has to occur in order to get that drug in the hands of patients. And that has become exponentially more challenging over the last several years, as our system becomes more complex, as our healthcare insurance becomes much more complex, as the financial challenges that patients have in terms of getting their drugs. So it used to be you go to a doctor, they write a prescription, you hand it to a pharmacist at the local retail pharmacy, and they would fill the script. In my world, that doesn’t happen, and there’s a lot more that goes into it, and it’s much more complex than I think most people can appreciate. And I also think that most people don’t really appreciate the cost of these drugs because if they’re getting it at their pharmacy, they’re just paying a co-pay, and in many cases, that co-pay is a small portion of the overall cost of the drug, and that’s changing. As healthcare benefits change and more of the cost burden is borne by that patient, they’re becoming much more astute to what the cost of these drugs are. And so we focus a lot of our time around price transparency and helping patients and prescribers make informed decisions to know, A, what their cost is that they have, but what other programs and services are available to them to help alleviate the burden associated with that. And so there’s a lot going on there, but again, because this is somewhat of a specialized area within the US healthcare system in general, I don’t think there’s a lot of awareness as to the complexity and the challenges that these patients have to face.
Rich Prest:
Yeah, I think you’re exactly right. And I mean, we’re certainly finding at some point that these text messages … from a patient are very clear that it’s the price they pay at the counter, they’re out of pocket is what they think is the cost of the drug. They, you know, it’s very few of them understand how much happened before it actually got to them, and that’s not any fault of this, but it’s just another window into how poor the transparency and visibility is.
Jeff Spafford:
I enjoy seeing your Monday Motivations on LinkedIn, Rich, and I think they’re spot on. You know patients don’t really have an appreciation because, you know, for a lot of these patients, they’ve just been newly diagnosed with a very serious illness or a very serious chronic disease, and they’ve never had to take medications that have been at the same level of cost. So it’s a real eye-opening experience for them, so organizations like Sempre are really helpful in that process.
Rich Prest:
Yeah, thank you. Well, let’s talk into some of the opportunities for fixing all of this. So what are some of the key trends or developments or regulations you’re watching and the impact you think that they could have?
Jeff Spafford:
Well, you know, as I mentioned earlier, I feel like we’re in this phase of transitioning to using technology to address a lot of these barriers to access. So historically, when a drug was being commercialized, pharmaceutical companies would hire organizations like my own and we would set up large call centers of people and those people would manage the inbound facts. So they were getting plenty of faxes and they would use the telephone to do a lot of what they had to do, which was to validate what that patient’s benefits were, what that patient’s financial portion was going to be, if there was a prior authorization addressing that and then having to communicate with all the different stakeholders via telephone, well, no one answers their telephone anymore. So that process has just become that much more challenging, and it’s been much more cumbersome. So one of the trends that I’m seeing and we’re squarely behind is using technology to manage a lot of these processes so that you don’t have to have people chasing paper, but rather people can be on the telephones, talking to patients, helping them make better decisions, informing them of what their options are. And I would say that while we’re a technology company, we can get you to the ten-yard line, but it’s that person that has the information that our technology provides them, who’s going to have that conversation with the patient, that’s the person that’s going to be most impactful in helping that patient get on therapy, as well as stay on therapy. And so we’re, we spend a lot of our time and resources looking at what technologies are available, how do we leverage those technologies to address our specific use cases, and so a lot of that’s happening. And, you know, along with that, as we mentioned, patients are becoming much more consumers of healthcare and they’re becoming more aware of the costs of what their healthcare is. And they, then they’re their own, they’re becoming more of their own advocates looking at alternatives, and so you see organizations out there like yours and like others that are really helping patients make better decisions about what their healthcare options are. And so being able to provide simple things like price transparency into what is the true cost of these products, and then couple that with, well, what else is out there? How can you be supportive? Those are things that I think we’re starting to see, and then, of course, the technology-driven delivery models that are popping up all over the place, you know, these digital pharmacies that are leveraging new technologies like telehealth, to be able to get patients access to therapy or even larger organizations like what Amazon Health is investing in, and, you know, Mark Cuban and his Cost Plus Drug company are working to disrupt the status quo, and that’s not easy in healthcare. There’s so much inertia around the status quo that to see organizations, you know, that we all know and respect come into this space to be disruptive, to create a better model is really gratifying. Now with that comes their own challenges, and we’ve seen plenty of organizations come into this space that think that they can fix what’s wrong with healthcare and be challenged. But again, I see the rapid change of pace accelerating, which is really exciting for what we do.
Rich Prest:
Yeah, absolutely, and you guys have been working on some interesting new models too, right, to try to look at how you can bring down the cost of this patient services and support. So I was thinking of something like CoAssist, for example, is maybe an interesting model you want to share a little bit about with the audience?
Jeff Spafford:
Yeah, you know, CoAssist is really an opportunity for us to leverage the current infrastructure that exists to really facilitate and make the onboarding process efficient. So in one of the key drivers of what, in our business, what we want to do is we want to be able to connect with all the various EHRs that are out there today, because everyone knows that when they walk into the physician office they’re in, the physicians are in the EHR and they don’t want to have to necessarily drop the paper, or swivel to another system. And so CoAssist has been able to take advantage of that current connectivity that we have so that we’re plugging our patient services into virtually every single EHR that’s out there. And so that’s, all the prescriber has to do is simply e-prescribe that medication, it comes into our CoAssist environment, we can then run our e-services against it. So doing things like advanced benefits verification, electronically determine what that coverage patient’s coverage is, coordinating any type of EPA or electronic prior authorization or financial assistance, all of these things that historically have taken people and paper to do, we’re now able to do in a matter of seconds with our e-services. And then helping that patient make an informed decision, where are they best serviced? You know, one of the hypotheses that we hear about or that we think about a lot is that, they say that for 40% of the medications that are out there today, patients are better off paying cash for, or using their healthcare insurance benefits. And so you see organizations like GoodRx really focused on helping manage that, right? And this CoAssist model is a different version of that because in, say, the GoodRx model, you’re relying on that patient going to the pharmacy counter and presenting a coupon and having that conversation with the pharmacist about, well, what’s my insurance coverage? Here’s a coupon, what am I better off, right? And so by virtue of our technology solutions, we can do that all electronically so that when we do go to the, proactively to the patient, we can inform them that, here they are better off using their insurance, or here they’re better off using cash. If they’re wanting to use cash, we can work with them on that. They want to use a pharmacy of choice, we’ll triage that prescription to the pharmacy of choice. So really automating that process so that it’s more seamless to the prescriber and really being more proactive in helping the patient. So CoAssist is very exciting for us, there’s a number of different use cases we have, and so a lot of the pharmaceutical companies that we’re working with today are leveraging CoAssist to really act as their essentially digital front door, and that allows to all their patient support services that they’ve been offering. And so it’s really that funnel point, because of the connectivity of that it has into each and every EHR out there, it really simplifies that patient onboarding process. And then once it comes in at our front door, we can then make sure that that patient is getting access to the support services that they need most.
Rich Prest:
Oh, that’s very cool. And I’m assuming, too, if you’re able to suck some clinical and demographic information out of the EHR, then you’re not having to fill out one of these service requests forms, and then getting into this issue of having to then go back to everybody and try to get the missing information.
Jeff Spafford:
And that’s 100% correct, and that’s the wonderful thing because the challenge in our space historically has been that you have this one-page enrollment form where you need to collect all the information about that patient demographics, maybe comorbidity, maybe other medications that they may be on, and it’s a real battle to try to collect as much information without alienating the prescriber, and so a lot of times you get spent and you sacrifice a lot of information. And Rich, we’re in a data-intensive business, and the more information we know about you, the patient, the better off we can be in helping to support you in your needs. And so by now, having connectivity into the EHR, not only are we getting that basic demographic information, but we can have access to a whole host of other clinical information that really helps inform our thinking to make sure that we’re providing you the right services that meet your needs, not just the needs of everybody.
Rich Prest:
No, it’s very cool. Yeah, definitely, and that then starts to get past that point at which scribbling on a piece of paper and faxing it to the specialty pharmacy is superior to actually just pressing the button and sucking that.
Jeff Spafford:
And maybe then we’ll finally be able to kill the fax.
Rich Prest:
Yay! Yeah, that would be very cool. Awesome, well, it definitely says, like, an opportunity that you’re excited about. Are there any other opportunities you see in the industry? I know there’s been a lot of talk about AI, and I’m kind of curious whether you see a role for AI in the call centers in terms of helping with some of the customer interaction and bringing down the cost of that.
Jeff Spafford:
I certainly do. I think that, as I just mentioned, we’re in this data-rich business, and the challenge is we’re just scratching the surface and how we use data to make decisions. And part of that, you know, we are challenging, even though we’re, lots of data out there, we’re challenged in terms of how we can use that data and for what purposes we can use that data. But we need to work through that because of the fact that if we don’t, then it becomes a very inefficient model where we’re offering everybody the same services, whether you’re going to be responsive to them or not. And so I always joke that we need to become much more like Amazon because when you shop on Amazon, they know Rich Prest, they know what Rich has historically bought, they know what Rich likes and what he’s been looking at. So they offer you products that are really of interest to you, right? And while that’s obviously being used for a marketing perspective, what I want to know is when I get a referral from Rich Prest, what are his challenges? What have been historically his other, so that when I’m working with Rich Prest, I can help him be, you know, be much, I can improve his chances of getting access to therapy, but I also can help him stay on therapy because I know that he has these other challenges that we’re going to address along with that, and that’s where I feel like this industry has to go. We have all these individual stakeholders working on behalf of the patient to help them be successful and have that successful outcome, but they’re working in a silo. And part of what we want to do here at AssistRx is bring everybody together so they have that common vision of what that patient status is so they’re working together more in a proactive nature than just working in a silo. That’s part of what has driven the costs up for healthcare today, everyone works in silos, you can see it when you go to the doctor’s office. You go to the doctor’s office, you fill out the same paperwork, and then you go to a different doctor’s office, still, the same paperwork and they don’t really share information, and that has to change if we’re truly going to try to change the cost curve. And so part of, a lot of what we’re doing here at AssistRx, is investing in creating that data infrastructure to be able to bring together all these disparate data sets to help inform our thinking as to how we can intervene proactively and help that patient. We’re not interested in becoming a data aggregator because I view them as sort of scorekeepers. They’re off to the side, they’re keeping score of how everyone’s doing, but they’re really not impacting the outcome. And what I want to do is be using that data so that we’re not, that we’re impacting or improving upon that, those patient outcomes. And we can measure that and then we can go back and determine to the actions we take, actually move the needle, or do we need to take different actions so that we can better improve ourselves. So that’s where I think AI and machine learning can really be impactful because we’re now working with a number of different data partners and bringing in huge sums of data to help really create those patient profiles that will help inform our thinking, and that’s where I think AI and machine learning are going to be a game changer in what we do.
Rich Prest:
Yeah, very cool. If you can get that longitudinal view of the patient, each patient, then you can tailor the care for each of those patients and that’s pretty cool, and that should improve outcomes. Nice, well, definitely, this has been great. I’m just curious if you’ve got any advice for folks starting out in the industry, what you’d recommend as a path for them? Yeah.
Jeff Spafford:
You know, that’s a great question. In fact, I get asked that question a lot and I think one of the things I look back upon in my own career is that what has been very, very helpful is that you sort of, you get engaged at the ground level and you learn your business at the ground level, and over time, you understand you have good experiences, you have bad experiences. I’ve worked with companies that have been hugely successful and I’ve worked with companies that have been big failures, right? And sometimes you learn more by being on the failure side than you do on the success side. Some of the things I see in this industry is that you got people who come in from the outside, you know, where you’re at in Silicon Valley, that’s always people coming in and saying, you know what, I’m going to fix what’s wrong with healthcare. And they’re challenged because they don’t really understand the complexity of the healthcare system. And so they may have great technology solutions, but, A, they don’t know how to talk the talk, if you will, with the people that are in there today. And if, and because of that, they’re not going to get the adoption that they need in order to truly be disruptive. One of the areas where I think we were different is, as I mentioned, we spent 20 years, we dealt with patients, we knew what physicians were facing, the frustrations they were having, we knew that needs that life science companies had, and then we went out and created the technology solutions based on that experience and understanding. And that, I think, has truly been a game changer in terms of why we’ve been successful when others have failed. And so my encouragement with someone coming into this is, you know, focus less on the technology, focus more on understanding the process, the needs, the nuances, the needs of each stakeholder. And once you have a good understanding of that, then you’re going to be able to create solutions that are really meaningful, really disruptive, and are going to be successful.
Rich Prest:
Yeah, I think that’s a great point. And certainly, through that process, you’re probably going to encounter problems that you’re going to then go out and want to solve, but now you know it’s an actual real problem rather than a solution looking for a problem.
Jeff Spafford:
I mean, one of the reasons I got into healthcare was because at the time it was a 3 trillion dollar industry, mainly run by people that did not have a business background …, and so I knew there had to be opportunities there in this industry. And to your point, you can’t shake a stick without identifying opportunities to improve care, to improve efficiencies, which ultimately the outcome. And you couple that with the fact that at the end of the day when you’re successful, you’re actually helping patients. You’re helping improve their quality of life, and that’s hugely important and that’s hugely fulfilling. So there’s, I don’t think there’s any other industry like that where you can be so successful, but yet, no, at the end of the day, you’re doing good.
Rich Prest:
Yeah, absolutely, it’s wonderful. Where, if folks want to find and connect with you online, what would you recommend?
Jeff Spafford:
Well, I am a CEO of a tech company, I don’t really do social media other than LinkedIn. So LinkedIn is probably the best way to get to me. Yeah, I do that. And certainly, AssistRx as an organization has a social media presence. We’re on all the main socials. We have our own page, web page, and, and I would encourage people to connect to us through them. And we’re always interested in working with people that share our passion about taking care of patients, improving their lives, that have a vision of solving these problems via tech and talent, So I would encourage people to reach out and I’d love to have a conversation.
Rich Prest:
Awesome, now, well, thank you so much, Jeff. It’s been a real pleasure to catch up and I certainly hope for our audience that, thank you so much for tuning in, and hope you guys got something out of this episode as well, I know I did. And if you did, please don’t forget to review Sempre Health podcast on your favorite streaming service, it really helps others to find and enjoy the show. So thank you, everybody. See you on the next one!
Jeff Spafford:
Thank you, Rich.
Rich Prest:
Thank you.
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