Speeding Prescription Process Brings Success To CoverMyMeds

After Columbus health-care technology company CoverMyMeds became the first local startup to be bought for $1 billion, one question kept recurring:

How did they do it?

CEO Matt Scantland said the answer really isn’t all that complex.

“We have a simple formula for success,” he said recently at the company’s Miranova offices. “Start with a big problem and solve it not by disrupting anything but by finding a way that everyone wins.”

And by hiring the best people around, Scantland said.

“We win through our people. That’s just as important as financial considerations for growth.”

Scantland, 38, was born in Columbus to a family of entrepreneurs. His father, Alan Scantland, is a co-founder of CoverMyMeds and was previously an executive at MemberHealth and at Battelle. His brother, Pete Scantland, is CEO of high-profile billboard company Orange Barrel Media.

After graduating from Ohio State University in 2001, Scantland worked at several technology and health-care companies before co-founding CoverMyMeds in 2008 along with his father and Sam Rajan, a pharmacist by training.

The company uses an online approach to help patients get prescription drugs quickly and easily, replacing the old process of phone calls, fax machines and hours or days of waiting.

CoverMyMeds connects more than 50,000 pharmacies, hundreds of thousands of doctors and most health-insurance plans.

The process works like this: When a doctor gives a patient a prescription, it is transferred electronically to the pharmacy. At the same time, it is sent to a health-insurance company for approval, which is often provided within minutes. The seamless system ends with the patient picking up the prescription.

Fruitful partnership

The company’s roots go back to 2005.

“I had started a consulting business, and Sam was actually my best customer,” Scantland said. “He was building a Medicare Part D plan for MemberHealth,” a Cleveland-area company that was selected to provide prescription-drug coverage to senior citizens under the Medicare program.

“I was developing software for MemberHealth, and one of the things we worked on together was the prior-authorization process for prescriptions,” Scantland said.

“We discovered while looking at the process that no matter what we did, a huge number of patients were abandoning their prescriptions. They weren’t switching to something else; they were just getting lost in the process.”

Scantland and Rajan realized that patients were frustrated by a process that was centered on the insurance companies, not on doctors and pharmacies. Patients were saying over and over, “Why won’t they just cover my meds?”

And so a business — and its name — emerged.

Using the CoverMyMeds software, Scantland said, pharmacists can fill more prescriptions, doctors can save time, and insurance plans can save a lot of money. It’s not only because CoverMyMeds makes a process that used to involve phone calls and faxes far more efficient, “but because it can reduce downstream medical spending because patients get their drugs and stay healthy, and don’t end up in a hospital.”

“We weren’t the first company to recognize the problem,” Scantland said. “We were first company that figured out how to solve it at a real scale. But our success as a company has mostly been about taking this big problem and solving it in a way so that all stakeholders in health care can win.”

Read the full story at The Columbus Dispatch.