Specialized Tech-driven Care for Eating Disorder

Summary

In this episode of Digital Health Transformers, Bryce leads a riveting discussion with Brandon, an experienced entrepreneur reshaping the mental healthcare landscape. Brandon’s journey, from law to co-founding Very Health, showcases his unwavering commitment to innovation.

Reflecting on pivotal moments such as nearly purchasing a restaurant and his involvement with Papa John’s, Brandon highlights his entrepreneurial mindset and dedication to upholding company integrity. Emphasizing the importance of technology in enhancing mental healthcare accessibility, Brandon underscores the need for personalized support and community-building to address treatment gaps.

The conversation explores the challenges of tackling eating disorders and mental health stigma, revealing Brandon’s passion for leveraging digital tools to reach and assist individuals in need. As the dialogue progresses, Bryce and Brandon delve into the transformative potential of virtual care, underscoring technology’s crucial role in enhancing healthcare accessibility and outcomes. With Brandon’s distinct perspective and Bryce’s insightful questions, the episode offers valuable insights into the intersection of entrepreneurship, technology, and mental healthcare transformation.

Key Moments

Introduction

  • Brandon Johnson, co-founder and CEO of Very Health, embarked on a transformative journey from a disadvantaged upbringing in Kentucky to spearheading groundbreaking virtual eating disorder treatment.
  • Motivated by personal experiences and a profound passion for revolutionizing mental healthcare, Johnson’s trajectory is marked by resilience and innovation.

Personal Experience Impact

  • The speaker delves into a poignant narrative surrounding their brother’s battle with alcoholism, navigating the arduous path to recovery.
  • This personal odyssey catalyzed the speaker’s mission to leverage software solutions to aid individuals in recovery and provide vital support for those grappling with eating disorders.

Community Creation

  • Embracing the imperative of fostering a supportive community, the speaker delineates strategies for preventing relapse and promoting recovery.
  • By bridging the chasm between clinical data and mobile app development, the speaker underscores the significance of diligence and commitment in the startup landscape.

Workforce Efficiency

  • Highlighting the detrimental effects of ‘dead weight’ employees, the discourse emphasizes the pivotal role of streamlined workflows and strategic technological partnerships.
  • In regulated markets, finding the right technology ally is paramount, ensuring tailored solutions that optimize efficiency and propel success.

Tool Development

  • Delving into the innovative realm of software development, the discussion centers on the creation of a transformative tool tailored for individuals grappling with eating disorders.
  • This tool facilitates comprehensive tracking of food intake and emotional well-being, offering timely nudges to mitigate harmful behaviors and foster a path towards recovery.

Insurance Challenges

  • Navigate the labyrinthine landscape of insurance challenges, with particular emphasis on reimbursement rates and their impact on Medicaid patients’ access to care.
  • Striking a delicate balance between business sustainability and serving the underprivileged underscores the pivotal role of insurance providers in the healthcare ecosystem.

Tech Support in Healthcare

  • Championing the integration of technology as a cornerstone of healthcare support, the discourse underscores the imperative of user-friendly applications and virtual care solutions.
  • By enhancing accessibility and dismantling stigma, these innovations offer a lifeline for individuals grappling with addiction and mental health issues.

Rise of Virtual Care

  • Witness the seismic shift towards virtual care solutions, propelled by technological advancements and burgeoning market demands.
  • Embracing benefits such as enhanced patient comfort and streamlined communication, the ascendance of virtual care heralds a new era of accessible healthcare services.

Transcript

Bryce 

Yeah, let me go, we’ll go, let me get this first little, we’ll get these first intros out of the way here, and then I’ll hop back over to you. So excuse me while I read. Welcome to Digital Health Transformers, a podcast series.

This podcast explores the dynamic world of healthcare innovation, one conversation at a time. I’m your host, Bryce Barger, and today, we have an all-inspiring guest at the forefront of transforming the healthcare landscape. Today, we have a special guest, Brandon Johnson, co-founder and CEO of Very Health.

Brandon brings an impressive background spanning law, business, and entrepreneurship. He previously served in legal roles at the Johnson Law Firm, WeatherCheck, and Richardson and Richardson. In 2022, Brandon combined his expertise with his passion for transforming mental healthcare by co-founding Very Health.

Very is pioneering in virtual eating disorder treatment, offering compassionate, personalized care from a dedicated team of experts. As CEO of Very, Brandon is leading the company’s mission to close the specialized eating disorder care gap through virtual treatment. His journey and insight provide a unique perspective on innovating this critical area of mental healthcare.

We are excited to have Brandon join us today to discuss his approach to virtual eating disorder treatment and its potential to expand access to this life-changing specialized care. Brandon, welcome to the podcast. We look forward to exploring how virtual care can transform treatment for those struggling with eating disorders.

Thanks for joining us today, Brandon. How are you?

Brandon 

Thanks for having me, Bryce. I’m great, man. That’s a great introduction, more than I deserve.

Bryce 

No, you deserve it. I always love it when I go to the intro and hear the roles that some entrepreneurs and leaders in this tech space have come from because it’s everything. As you’re from the role, we had a past podcast with another attendee, and he started his role working in fast food and grinding and has now become the CEO of a large tech company.

It’s so interesting how it doesn’t matter where you start. It’s about your vision, and it’s about your drive and your will to change the world. So, I’m getting into this first little spiel, but I want to touch on your personal and professional story.

Brandon, I know you’ve had, as we just mentioned, a very diverse career journey, transitioning from legal roles to becoming the co-founder and CEO of Aerie. Could you share your personal experience or moment that motivated you to get into the mental health care field and specialize in eating disorder treatment?

Brandon 

Yes, I can. We’ll try to be as quick as possible, but when you talk about any single point in your life, there are ten reasons why I’m here. But first, I always thought I was a poor kid from Kentucky.

The only way I knew to get out of being a poor kid in Kentucky, and you know, that I would be a doctor for a long time. And where my first job was as a certified nursing assistant, which is the crappiest job in the world, literally. And I made, you know, in a small town in Kentucky, I remember about four weeks working night shift before I was like, well, this healthcare thing is wild.

This is, you know, people dying. You know, it was just, you know, it was very shocking to an 18-year-old young person trying to, you know, think about dedicating their lives to the medical field. And, like, this is what it is, man.

And maybe I don’t want to do this. I took biology when I was a freshman at Western Kentucky University. And I was like, I don’t think I’m going to, I’m not going to do this for seven, eight more years.

I had had some success in high school and had a strong interest in politics and potentially being a lawyer. So, I shifted that way. And then almost bought a restaurant.

And I was so hyped doing proformas. I was like, oh my God, this is what I need to be doing. So I had a quarter-life crisis, so I traveled around and moved to Hilton Head. Then, I moved to South Korea and taught English for a year to expand my horizons on, you know, more than America.

I love America, love it. But I wanted to step outside that echo chamber and experience a different Eastern culture. And then moved to Los Angeles. I moved back to Kentucky. This is a little too slow. So, I moved to Los Angeles before I started law school.

So then, long story short, in law school, I just wanted to do business, and I worked with Papa John’s. I knew John Schneider. I got to help with that. As a young attorney, they gave me a lot of ability to gain access and input.

And that was really cool. I started my law firm and worked and ground through a lot of litigation before I got to do what I wanted: work with businesses and entrepreneurs. So fast forward about four or five years, and my brother, who is handsome, more handsome, way smarter, just a great kid with a great heart.

He struggled with alcoholism. And I mean bad. I mean, bad. You know, he’s in his bedroom, and I love him, and he’s worked for the company now, and he helps us, and he’s on his path. He’s sober now, but it was a very dark time for my tenure, his tenure as my junior. And he’s just, you know, he’s in his room drinking wine and to the point where he’s not, he’s dead to us. He’s dead to our family.

Bryce 

Not the same person.

Brandon 

Different person, interactive. And, you know, came home a couple of times and went back and forth and seeing this pattern of him going from the emergency room upstairs to the psych ward, to the psych unit, out to nothing. Right.

Like he didn’t, you know, there’s no rehab set up, there’s no therapy set up and then relapse. OK. Next, the second time, we have the rehab.

So boom, from emergency room, inpatient, in person to treatment, which is great. And then couldn’t get a therapist after that relapse. The third time, you know, in the emergency room, I was there. I’ll always remember. He came out. I was like, man, I got a police statement.

He’s crying. He’s like, dude, please take me to the hospital. If I get teared up, I mean, it’s just like, it’s very emotional for me to even talk about being there, flying back from Denver to Kentucky.

But I was like, all right, let’s go. So I took him to the emergency room again, inpatient, and started getting his treatment lined up again. And he went, and he really wanted to change.

And then we had his therapist lined up better, too. So after rehab, he had his therapist, and I’m like, OK, that was hard. But, you know, over time, he’s been sober now for over two, three years.

He’s getting his master’s degree from Elon University and higher education. And from that, I dovetailed that by reading a book by the almanac of Novel Ravikin. Novel Ravikin is an entrepreneur. You know, he’s found an angel’s list and many others. He also talked about how software can change the world. Software can change lives. Software.

So my mission was like at that time, and I had cancer in the past, not just testicular, not the terrible cancer. And I caught it early enough where there was no chemo, no radiation. So I just popped it out, and I will be good.

But that gave me time to sit under and think about how I wanted to help people and help people look more directly than the law. Then you have my brother’s situation. I’m like, oh my gosh.

And then there’s the software side of things as we can, and probably Richard Thayer’s book Nudge, where there are ways that I can take software and help nudge people into the direction of recovery. We can take them from death to their family, to life in their family, from not being able to achieve their dreams to achieving their dreams. And then the last factor is my wife.

She’s my co-founder. She’s an eating disorder psychiatrist. She’s a certified eating disorder specialist. She’s a child psychiatrist, adult psychiatrist, child and adolescent psychiatrist, adult psychiatrist, and pediatrician. So she’s triple board. She’s integrated health in her, in herself.

And I was like, instead of taking the whole world of recovery on, let’s do this, that there is nothing. You have an eating disorder; you go to a higher level of care because you’re finally that bad that someone’s like, you have to go get treatment for anorexia, bulimia, binge eating disorder. And then, after they go get treatment, what do they do?

They go back home. And it’s the same milieu without a therapist who knows what they’re talking about with a doctor who may be telling them to lose weight. It looks like you gained some weight. It would help if you lost like terrible relapses are horrible, very terrible diseases. People die from this. Ten thousand people die per year at minimum.

This is pre-COVID numbers. And there are 10,000 families whose lives are impacted tremendously. Over 5 million people suffer from eating disorders, and only about a million get treatment every year.

Of the million that get treatment, the relapse rate we’ve seen historically is 30 to 40%. Still, there are not very good numbers to either support or deny those numbers. But the few studies that we’ve seen that are ten years old for anorexia specifically it’s like 30 to 40% relapse rate.

So there’s a couple of different things that we can help. One, we can help people once they’re at a higher level of care leave, get back into their lives, and stay in sustained recovery. And two, if we can catch them early before they get too bad, which takes a lot of education, it’s very hard to do.

We can save people quicker. We can get people before they get too bad and need more care. So, we have a dual opportunity in a blue ocean where only a few people have a nationwide program to help people recover.

You have a lot of focus on the IOP and above. So IOP is intensive outpatient, partial hospitalization because the insurance companies have payday rates for those. But once they’re out of there, what do you do, you know, when you don’t have any disorder-informed provider at all? We set up boots-on-the-ground services at first and had to develop a services company. And then we finally, last year, in probably September, launched our community. That’s the first thing we’re trying to start to bridge the gap in treatment.

So, the community has over 200 people, about 25, 30 professionals, and about 200 patients or people who need help. We give them education, peer support, group support from professionals, and meal support from professionals. So now they have access to these things even without being our patients for free. Not only that, but we also give them and connect them to other resources. So we’re big into, like, all right, you have a program, bring it into our community, let people see it, and if they like it, they can go get your program. But give people a home where they can recover; they can go to this community instead of relapsing.

Then, we’ll start bridging the gap between the two. And this is what our whole, this is what this conversation is about, why we’re probably interested in talking to each other, is eventually we’ll take our EMR and our community and our clinical data collection and start narrowing that down into our mobile app or web app or whatever, you know, we’re gonna probably, it doesn’t matter, we can get into the nerdy stuff in a minute. But taking that program makes it a recovery home.

You know, you can come here if you’re in a higher level of care. If you’re too early, we’re talking with many therapists, dieticians, and primary care providers; send them to us now. Instead of waiting three weeks for them to get into psychiatrists or six months in some states, send them to our community today.

Let them start waiting for a crisis. So yeah, it’s a long-winded way of, like, that’s where I came from, poor rural Kentucky, no way out, but doctor, lawyer, married, married a doctor, and then smashing these things together and trying to help people save lives and help people in recovery.

Bryce 

Yeah. And I love that journey. It’s natural; it’s not something where you even really seek it out in a way.

It’s something that, with your brother, presented a challenge and a heartache in your life. And you found a way to help your brother and others. I mean, that’s a beautiful story.

You know, that’s what it’s about. What are some of the unique challenges that you guys face in the specialized healthcare sector? And did your background prepare you for any of that?

Like, having the experiences with your brother, but I would be interested in any of the legal aspects, you know, to help you prepare for what you face in that specialized healthcare sector.

Brandon 

You know, it might. I swim with sharks all the time, right? So if you’re going to be some shark, you must become a shark to be in that water.

And I know how to protect our company. I know how to protect our company from people who say they will do stuff and they don’t. So that’s how we’ve been able to work. One big thing is that people are all excited about startups, and they don’t. They get it and don’t realize how much you have to work.

And you know, there are a lot of sea-level people who forget how to work, and they want to delegate everything. There’s no place in the startup for people who don’t want to do the work. So that’s the one, the biggest thing from a legal perspective.

And then also, like looking at the field, like I do my research and looking at where these big companies have failed, like making an employee, and access to healthcare is our most important thing. And then cutting off their employees, making them independent contractors, and stripping away their healthcare. I’m like, I’m not going to make that mistake.

Bryce 

And then wonder why they lost their employees.

Brandon 

It’s like, wait, I won’t make that mistake. So we’re an independent contractor base. We’re trying to pay people better wages.

We’re trying to listen to providers, but I think only a little of the legal stuff prepared me for that other than the contractual thing, which saves us lots and lots of money because I can do a lot of the work. And then I can be like, Hey, you’re an expert. I’ve done all this work.

Where is this wrong? And instead of being $80,000, the bill is 8,000. And that’s helped us extend it.

Other than that, I’m not; the other thing is I’ve been a founder in the past of legal companies or real estate closing companies. And I run my business on an entrepreneurial operating system. EOS is a book and its traction by Gino Wickman is the book.

I think that has helped me apply that knowledge to this company and help providers and folks along the way. They need to gain business experience executing a very simple business plan. That was part of my entrepreneurial background, and I started another kind of entrepreneurial fund. I’ve not been very good at EOS in the beginning.

I’m much better now. And, you know, it’s taken us about two years to catch our stride. This is our eighth quarterly meeting. And now we’re hitting all of our, we’re tracking along, like setting KPIs, achieving those at a high clip, and doing important work, not just doing work for no reason. So, I feel like it’s a superpower in harnessing your focus. Um, but now I’m outside the realm of what the experience of being a lawyer has helped in this field.

But those are the nuts and bolts that, um, helped me. And that’s how I help other entrepreneurs, too. That’s what I do for other entrepreneurs, other than like exiting and doing private equity or venture capital deals and what stuff like that, but protecting the company and making sure that bad actors are people that maybe they were good actors coming in, but then they, they get to go away without.

Bryce 

Yeah. Yeah. And that’s very important to me. Obviously, being able to set that back to have a strong foundation is key. Right. And then, and then, and then being able to, um, you know, have your wife who’s also in the field, I’m sure is very, is a resource as well to have, be able to bounce things off of her as when it gets into the actual clinical care stuff.

So, that sounds like the team you guys have curated over there is also key. Being able to have that strong foundation, curate a team that is, that you trust, that is, you’ve got his startup base, where it is a full team effort, a hundred percent bought in whether you’re the CEO or whether you’re a sales rep, you know, it’s, it’s, it’s a, it’s a team effort. And when it comes to these startups and being able to share your ideas and push, push, not yourself further, but the whole company forward, as everybody, let’s get the guy.

And it’s almost like pushing a car with no gas until it gets to the gas station and fills that up with gas. And then you, you take off. Right. But the hardest part is getting to the gas station.

Brandon 

If you have dead weight in your company, it’s like somebody sitting in the car, pointing and laughing at everybody pushing it. They’re adding extra weight. And it’s terrible for a company.

That’s disheartening for other employees. Disheartening. Exactly. Especially of any large equity stake. And it’s like, what if I’m working twice? It doesn’t work. It doesn’t work at all. I give any piece of advice to a general listener. It’s like eliminating the dead weight as much as possible because it is demotivating.

For sure. A hundred percent. The other part is as hard as technology, the technology component of it, like, I’m a lawyer, my wife’s a doctor, and we need to be trained in technology. We’re young enough to adapt, but finding the right tech partner has been challenging. I also have to build a services company in a highly regulated market, which helps me be highly regulated and work around that. But then, trying to do the tech side now, we’ve had to search for the right tech partner.

And it’s not just the technology partner that knows technology; they need to know it. They need to know mental health care. They need to know several components. So we’ve been searching hard for the right party to help us, one with a baseline understanding of psychology and therapy and some of these different things. So we’ve identified a few, but only a few of those folks are out there.

Bryce 

Yeah, for sure. There’s not. And that, that’s a that’s one of the aspects that we, even at OSP, why we try to be so robust and, and, and then, the areas we’ve covered where we say, you know, we’ve covered everything from when I, when I, when I give my sales pitch, I always. I reviewed that first slide; it has us in the areas we’ve covered.

And the people are like, wow, that’s a lot. I’m like, well, it’s, it’s important that I, that I share with you that we’ve covered everything from specifically mental health or home care or psychiatry or dental or, and all these things, because I don’t think people realize how, you know, when it gets into the technology side, it needs to be some, if you’re, if you have a company like Verrier, sometimes it needs to be customized for you to get what you want out of it and to have the efficiency you’re looking for. Some of these out-of-the-box tools you pay a ton for do not fit and must be the right fit. It is a custom approach; you’ve already built your company custom.

What it doesn’t make sense to pull in a box tool, build something that fits your company a hundred percent, that your employees have input in that when the when it’s being built, that you have input in when it’s being built, that you can, don’t have bells and whistles that are not needed. And, yeah, it’s such an important tool. It’s something that I love to focus on whenever when I do sales pitches and talk to startups and other companies where it’s like, hey, don’t be scared by custom.

It’s better. It’s, this is something that is why, you know, my dad always told me, you know, never buy a pair of cheap shoes, right? Because, because one, because one, your feet affect your back, and they affect your entire body.

So you spend money. The whole thing is to spend money on what matters and spend money on important things. Take your time with important things. And that’s such an important thing, and moving along here and getting into that digital health technology and its impact on lifestyle.

You guys are at the forefront of virtual eating disorder treatment. As you mentioned, there’s a little out there. You guys, you know, there’s only a few options.

There are not a lot of options for mental health or for people who come out with addiction and mental health, and not when it comes to specialized disorder care as you guys deal with. And I guess my question is, how do you see kind of the digital healthcare technology transforming the space of mental health and then, particularly like the eating disorders and changing the accessibility and the openness to people to be able to get help when they need it and not kind of face that stigma or they, these, the worries that might keep them from getting the help that you need?

Brandon 

Well, man, the stigma is something that we will have a very hard time with. With the stigma component, making it, you see men’s health advertisements on the television where it’s discreet, like that’s one of the top three advertising things, like discreet, you know, discussion about this. So, like, I do think that there’s an element to that where if you have something that’s accessible on your phone, you’re able, you don’t have to leave to go to a doctor’s office, but you can go and get your treatment in your dorm room or the privacy of your home, makes it more accessible.

But where I see our ability is informing people, you know, we have a screener, we’ve had 20,000 people take a screener, about 19,998 have an eating disorder or have strong indications of eating disorders. We’ve converted very few to patients. So I just, so the beginning of the process is just, you know, you’re not alone.

You have issues, you know, you, you, what you eat, what you don’t eat, if you exercise or not, these all have, you know, play in your, to your mental health every single day. And they cause you concern and maybe undo concern every single day. So how do we get you into a community or a place where you’re safe, get information, and be around people like you or who may have similar thought patterns to you?

And that way, they’re destigmatized, right? You’re in a community where people feel like you, like one of our guys that don’t have an eating disorder, he works for their company, but he ran a 5k, and then he ate like four or five donuts after it was a donut dash and he ate a bunch of donuts. He’s like, dude, I felt terrible about myself.

Like, you know, I felt like I overdid it. And I wrote that it was like a lot of mental weight over eating a few donuts after a donut dash. Like, I’ll crush four donuts.

I don’t, I don’t care. I try to have a balanced diet that includes everything I consume. I try to have that, but it affects so many people.

So the people that have disorders are trying to find them, trying to bring them into a community, and then trying to nudge them, right? Nudge them in the right direction regarding different behavioral health issues. So, a tool we’re going to build or build out will nudge them to track their food.

So, nudge them to check-in. How are you feeling emotionally when you eat? Like, are you having an episode?

Do you feel like you need a binge? Let us know, like step in front of these behaviors that can take you down a slippery slope and instead hopefully build you up into recovery.

Bryce 

Yeah.

Brandon 

So that’s what we are. And then eventually step you into care and treatment if you need it. And if you don’t, that’s great.

We have programs. If you can self-heal, that’s great. And, like the shortages in mental health, there are not a lot of expert providers.

So what you see in the marketplace will be more coaching, but coaches that the expert therapists supervise have a programmatic setup and have the back end on track. Are we doing these things that we say we will be doing? Are we doing them right?

And then I think where AI comes in is like you can have generative AI to be a guy to be. Now, we’ve had issues in the eating disorder space with Tessa, and the National Eating Disorder Association is trying to do away with them. Basically, what happened, what had happened was a rules-based platform.

Then, they took the parameters off and implemented them into a generative AI. They started giving diet and fitness advice. And that’s why you can’t do that with eating disorder patients.

You can’t. And they got crushed for a multitude of things, but that was one of the things still being talked about. This is the 60-minute piece about it last week or two weeks ago.

So, how do we build intelligent generative AI, put limitations on the AI to help people through the process, and give them nudges without giving them terrible advice? And how do we make limitations on that? So that’s what we’re working on right now. Once we build this platform, we get people moving in the right direction and the tools they need.

We spread the word that we have the underlying services, and then we are trying to bridge that gap with coaching, education, free resources, and by answering every phone call. I don’t care if you’re in a state we serve. We’re going to help the best that we can.

We’ll help find you something. And if you’re on Medicare in Wyoming, we may not be able to find you anything, unfortunately, but we will do our best to stay on top of what’s available to help whoever will give us a call. Are you in the state we serve?

Our mission has always been to help a million people. And it doesn’t mean we treat a million people. It means we do whatever we take as an organization to help these people the best that we can. And we can’t help every human being. But those are some ways we’re moving toward trying to bridge this gap in treatment. But there are some big problems that I need to address.

Yeah, insurance. We’ve had great conversations with some great insurance companies. They’re like, yeah, we’ll pay for your platform. Yeah, well, let’s start figuring this out. So, I’m hopeful.

Bryce 

Interest is there.

Brandon 

Interest is there. Yeah. Yeah.

Bryce 

And it should be. I mean, I think, like, if these insurance companies don’t see the vicious cycle that addiction, mental health, eating disorder, all of these patients fall into a lot of the time. It’s a vicious circle that is sometimes never-ending.

And the number of encounters and visits they have in ERs and hospitals is insane. And if we could break, and I know this, it would sound so easy. This is breaking the cycle.

Break the vicious, but it’s like if we could just when they go into an ER if they come out and they do have these things set up with aftercare, where they’re not just being sent right back to the home where there are triggers right there. It’s like you’re preaching all of this. You’re going to sit them through, even impatient.

I come from before I started with OSP, I came from the addiction and mental health world myself, specifically addiction. And in Mississippi, I live in Birmingham, Alabama, and we dealt with Medicaid and Medicare. In Alabama, two hospitals, maybe three state-run hospitals, can accept inpatient Medicare and Medicaid.

The other hospital is in Meridian, Mississippi, right over the border. It’s a 200-bed facility called Alliance Health, and that’s who I worked for. And I was in Alabama, and it was just unbelievable when I would go into UAB and these huge hospitals and say, hey, I can take your Medicaid patients.

And they’d be like, what? What are we doing? It’s just like in Alabama; some of these states are a lot further ahead, and they are good on them. In many of these places, Alabama and some in the South are not the case.

Brandon 

The Southeast is a desert, man. I’m from Kentucky, and the Southeast is a desert. It breaks my heart.

It is. There’s only so much that we can do about it other than establish Colorado as a market, get Texas, some of these other markets that are pretty good paying, and then leverage the insurance companies for, and this is not even to your point yet. Still, I’m getting there to leverage some of these insurance companies for a nationwide contract. Then, we can start spreading out in the Southeast. Then, we can try to target specific Medicare. My wife is like, we’re doing Medicare. We’re doing it.

We’re doing it. I’m like, OK, that’s a big task, but it will take us some time to step it up and get that out because the reimbursement rates in some of these places, you can’t pay your experts.

Bryce 

Oh, it’s wild. It’s criminal. And what’s worse is like not that people who have insurance and who can afford premium insurance are not important, but the people who can’t. The people on Medicaid have nothing. Those are the people that, I mean, have no chance if people like Alliance and other companies like yourselves aren’t trying to push these boundaries forward. They’re doomed.

And it’s terrible. It’s sad as a country. And even just as a human being, it’s just like what, you know, it’s just eye-opening.

If you take your step back and pull yourself out right from your head and just look at it from an overhead view, be like, man, are we OK with this as a country?

Brandon 

Yeah. Part of me has to ignore it. And I wouldn’t say I like that.

I mean, admission, but part of me is like, I’m driving this boat, and I’ve got to go to these waters before I can get there. Get to these waters. And, nine out of 10 people, well, cause we started private pay more than nine out of 10, probably at least nine out of 10 couldn’t pay.

Now we’re in insurance. So maybe it’s closer to like, you know, maybe it’s seven out of 10 we can’t treat, or we can’t help, you know, for inquiries from Medicare and Medicaid. But in Colorado specifically, we’re already working on some of those one-off contracts to get in there and establish a foothold.

You know, and to have those relationships, those folks here, particularly as we’re already in insurance, basically all insurance in Colorado, and trying to start to flirt with that and see how that feels, single case agreements and whatnot, see if we have providers that can take. And we also do free work. We work with Project Hill, which basically does scholarships, and they go through the financial part and do a thorough job on financials.

And those are some of the most awesome cases that we have. I don’t want to get into any specifics of the patients, but there are some awesome cases of people from rural towns who are going on to do big things and have this problem. And if we can help them solve this problem, they will be huge benefactors to society. Yeah. So like we, you know, our dieticians have stepped up, our therapists have stepped up and done some, Erin does, she has at least two patients of her 40 that are free, you know, zero dollars. And then, we’re trying to balance that with building a bootstrapped company. Yeah.

Bryce 

Because you, yeah. And it’s not like any of these companies don’t want to help the underprivileged and the, you know, population, but they, but at the same time, you got to run a business, and you can’t lose, you can’t lose Kaylee’s side of that, as you very well know.

Brandon 

Margins in insurance are tough enough with the provider marketing as it is. So, I’m not here to talk about just margins. I mean, but you have to; if the company doesn’t work and it goes out of business, then people are, you’re not helping anybody.

Bryce 

Yeah. You’re not helping anybody or yourself, you know, so moved on to kind of the kind of health tech and resolving eating disorders. What innovative approaches, and maybe this is getting more into what very does and what the process looks like? What innovative approaches or technologies do you use to address the unique challenges eating disorders pose?

Brandon 

We are not very unique this time. The fact that people can do virtual work and we can treat people virtually is good. It’s helpful, right?

It saves people time, saves people. When people are coming to a higher level of care, they need to see a dietician, therapist, psychiatrist, or medical doctor every week for some time. And you take three doctor’s visits where you have to travel, sit, go into, you’re looking at five, six, seven hours a week where you’re trying to reintegrate into your life, but you’ve got to sit in waiting rooms and whatnot.

So that’s one, that’s the most foundational. Second, is developing a community and trying to have a home for people to come to. It’s a small technology lift that can be used in Circle. Eventually, we’ll build our community because it takes little to build one.

And then stack that on top of the EMR. And that’s really where our technology is going to be. It’s a fully integrated place where, even if you’re not a patient, you’re still in the community; you can access these digital behavioral intervention tools. And that’s why we will start bridging the gap between care and the community. These things are things that you can do self-guided, self-helping, and then step to where a coach guides them.

Then, the next step is to get the treatment. So we’re trying to bridge that gap from where I have any disorder, but I do not have, I don’t have anything. I don’t even know if I have any disorder to treat.

And, you know, the first step is to understand. The second step is to learn more about it or get into the community and talk to people about it. And then maybe I’ll try this tool out, or this lesson out, or try this technique out and try to bring them closer to treatment.

That gap is so wide. You take, I mean, outside of money, outside of anything, getting someone from, oh, maybe I have a treatment problem is a far. Yeah.

No one jumps over that. No one jumps from like, may I have a problem with the treatment. People fall into this gap; no matter how far you can jump, you will fall into it.

Bryce 

Yeah.

Brandon 

And you have to put those little parts, the next part, so they can eventually get into treatment, or maybe they self-heal. I mean, some people have stopped drinking, you know, that don’t need, but getting them to the process, I think, is what, and I’m not speaking to the tech, what technical technologies we’re using, but right now we’re using an EMR. We’re using Circle for our community, and wBryce

Yeah, let me go, we’ll go, let me get this first little, we’ll get these first intros out of the way here, and then I’ll hop back over to you. So excuse me while I read. Welcome to Digital Health Transformers, a podcast series.

This podcast explores the dynamic world of healthcare innovation, one conversation at a time. I’m your host, Bryce Barger, and today, we have an all-inspiring guest at the forefront of transforming the healthcare landscape. Today, we have a special guest, Brandon Johnson, co-founder and CEO of Very Health.

Brandon brings an impressive background spanning law, business, and entrepreneurship. He previously served in legal roles at the Johnson Law Firm, WeatherCheck, and Richardson and Richardson. In 2022, Brandon combined his expertise with his passion for transforming mental healthcare by co-founding Very Health.

Very is pioneering in virtual eating disorder treatment, offering compassionate, personalized care from a dedicated team of experts. As CEO of Very, Brandon is leading the company’s mission to close the specialized eating disorder care gap through virtual treatment. His journey and insight provide a unique perspective on innovating this critical area of mental healthcare.

We are excited to have Brandon join us today to discuss his approach to virtual eating disorder treatment and its potential to expand access to this life-changing specialized care. Brandon, welcome to the podcast. We look forward to exploring how virtual care can transform treatment for those struggling with eating disorders. Thanks for joining us today, Brandon. How are you?

Brandon 

Thanks for having me, Bryce. I’m great, man. That’s a great introduction, more than I deserve.

Bryce 

No, you deserve it. I always love it when I go to the intro and hear the roles that some entrepreneurs and leaders in this tech space have come from because it’s everything. As you’re from the role, we had a past podcast with another attendee, and he started his role working in fast food and grinding and has now become the CEO of a large tech company.

It’s so interesting how it doesn’t matter where you start. It’s about your vision, and it’s about your drive and your will to change the world. So, I’m getting into this first little spiel, but I want to touch on your personal and professional story.

Brandon, I know you’ve had, as we just mentioned, a very diverse career journey, transitioning from legal roles to becoming the co-founder and CEO of Aerie. Could you share your personal experience or moment that motivated you to get into the mental health care field and specialize in eating disorder treatment?

Brandon 

Yes, I can. We’ll try to be as quick as possible, but when you talk about any single point in your life, there are ten reasons why I’m here. But first, I always thought I was a poor kid from Kentucky.

The only way I knew to get out of being a poor kid in Kentucky, and you know, that I would be a doctor for a long time. And where my first job was as a certified nursing assistant, which is the crappiest job in the world, literally. And I made, you know, in a small town in Kentucky, I remember about four weeks working night shift before I was like, well, this healthcare thing is wild.

This is, you know, people dying. You know, it was just, you know, it was very shocking to an 18-year-old young person trying to, you know, think about dedicating their lives to the medical field. And, like, this is what it is, man.

And maybe I don’t want to do this. I took biology when I was a freshman at Western Kentucky University. And I was like, I don’t think I’m going to, I’m not going to do this for seven, eight more years.

I had had some success in high school and had a strong interest in politics and potentially being a lawyer. So, I shifted that way. And then almost bought a restaurant.

And I was so hyped doing proformas. I was like, oh my God, this is what I need to be doing. So I had a quarter-life crisis, so I traveled around and moved to Hilton Head. Then, I moved to South Korea and taught English for a year to expand my horizons on, you know, more than America.

I love America, love it. But I wanted to step outside that echo chamber and experience a different Eastern culture. And then moved to Los Angeles.

I moved back to Kentucky. This is a little too slow. So, I moved to Los Angeles before I started law school.

So then, long story short, in law school, I just wanted to do business, and I worked with Papa John’s. I knew John Schneider. I got to help with that. As a young attorney, they gave me a lot of ability to gain access and input.

And that was really cool. I started my law firm and worked and ground through a lot of litigation before I got to do what I wanted: work with businesses and entrepreneurs. So fast forward about four or five years, and my brother, who is handsome, more handsome, way smarter, just a great kid with a great heart.

He struggled with alcoholism. And I mean bad. I mean, bad.

You know, he’s in his bedroom, and I love him, and he’s worked for the company now, and he helps us, and he’s on his path. He’s sober now, but it was a very dark time for my tenure, his tenure as my junior. And he’s just, you know, he’s in his room drinking wine and to the point where he’s not, he’s dead to us.

He’s dead to our family.

Bryce 

Not the same person.

Brandon 

Different person, interactive. And, you know, came home a couple of times and went back and forth and seeing this pattern of him going from the emergency room upstairs to the psych ward, to the psych unit, out to nothing. Right.

Like he didn’t, you know, there’s no rehab set up, there’s no therapy set up and then relapse. OK. Next, the second time, we have the rehab.

So boom, from emergency room, inpatient, in person to treatment, which is great. And then couldn’t get a therapist after that relapse. The third time, you know, in the emergency room, I was there.

I’ll always remember. He came out. I was like, man, I got a police statement. He’s crying. He’s like, dude, please take me to the hospital. If I get teared up, I mean, it’s just like, it’s very emotional for me to even talk about being there, flying back from Denver to Kentucky.

But I was like, all right, let’s go. So I took him to the emergency room again, inpatient, and started getting his treatment lined up again. And he went, and he really wanted to change.

And then we had his therapist lined up better, too. So after rehab, he had his therapist, and I’m like, OK, that was hard. But, you know, over time, he’s been sober now for over two, three years.

He’s getting his master’s degree from Elon University and higher education. And from that, I dovetailed that by reading a book by the almanac of Novel Ravikin. Novel Ravikin is an entrepreneur. You know, he’s found an angel’s list and many others.

He also talked about how software can change the world. Software can change lives. Software.

So my mission was like at that time, and I had cancer in the past, not just testicular, not the terrible cancer. And I caught it early enough where there was no chemo, no radiation. So I just popped it out, and I will be good.

But that gave me time to sit under and think about how I wanted to help people and help people look more directly than the law. Then you have my brother’s situation. I’m like, oh my gosh.

And then there’s the software side of things as we can, and probably Richard Thayer’s book Nudge, where there are ways that I can take software and help nudge people into the direction of recovery. We can take them from death to their family, to life in their family, from not being able to achieve their dreams to achieving their dreams. And then the last factor is my wife.

She’s my co-founder. She’s an eating disorder psychiatrist. She’s a certified eating disorder specialist.

She’s a child psychiatrist, adult psychiatrist, child and adolescent psychiatrist, adult psychiatrist, and pediatrician. So she’s triple board. She’s integrated health in her, in herself.

And I was like, instead of taking the whole world of recovery on, let’s do this, that there is nothing. You have an eating disorder; you go to a higher level of care because you’re finally that bad that someone’s like, you have to go get treatment for anorexia, bulimia, binge eating disorder. And then, after they go get treatment, what do they do?

They go back home. And it’s the same milieu without a therapist who knows what they’re talking about with a doctor who may be telling them to lose weight. It looks like you gained some weight.

It would help if you lost like terrible relapses are horrible, very terrible diseases. People die from this. Ten thousand people die per year at minimum.

This is pre-COVID numbers. And there are 10,000 families whose lives are impacted tremendously. Over 5 million people suffer from eating disorders, and only about a million get treatment every year.

Of the million that get treatment, the relapse rate we’ve seen historically is 30 to 40%. Still, there are not very good numbers to either support or deny those numbers. But the few studies that we’ve seen that are ten years old for anorexia specifically it’s like 30 to 40% relapse rate.

So there’s a couple of different things that we can help. One, we can help people once they’re at a higher level of care leave, get back into their lives, and stay in sustained recovery. And two, if we can catch them early before they get too bad, which takes a lot of education, it’s very hard to do.

We can save people quicker. We can get people before they get too bad and need more care. So, we have a dual opportunity in a blue ocean where only a few people have a nationwide program to help people recover.

You have a lot of focus on the IOP and above. So IOP is intensive outpatient, partial hospitalization because the insurance companies have payday rates for those. But once they’re out of there, what do you do, you know, when you don’t have any disorder-informed provider at all?

We set up boots-on-the-ground services at first and had to develop a services company. And then we finally, last year, in probably September, launched our community. That’s the first thing we’re trying to start to bridge the gap in treatment.

So, the community has over 200 people, about 25, 30 professionals, and about 200 patients or people who need help. We give them education, peer support, group support from professionals, and meal support from professionals. So now they have access to these things even without being our patients for free.

Not only that, but we also give them and connect them to other resources. So we’re big into, like, all right, you have a program, bring it into our community, let people see it, and if they like it, they can go get your program. But give people a home where they can recover; they can go to this community instead of relapsing.

Then, we’ll start bridging the gap between the two. And this is what our whole, this is what this conversation is about, why we’re probably interested in talking to each other, is eventually we’ll take our EMR and our community and our clinical data collection and start narrowing that down into our mobile app or web app or whatever, you know, we’re gonna probably, it doesn’t matter, we can get into the nerdy stuff in a minute. But taking that program makes it a recovery home.

You know, you can come here if you’re in a higher level of care. If you’re too early, we’re talking with many therapists, dieticians, and primary care providers; send them to us now. Instead of waiting three weeks for them to get into psychiatrists or six months in some states, send them to our community today.

Let them start waiting for a crisis. So yeah, it’s a long-winded way of, like, that’s where I came from, poor rural Kentucky, no way out, but doctor, lawyer, married, married a doctor, and then smashing these things together and trying to help people save lives and help people in recovery.

Bryce 

Yeah. And I love that journey. It’s natural; it’s not something where you even really seek it out in a way.

It’s something that, with your brother, presented a challenge and a heartache in your life. And you found a way to help your brother and others. I mean, that’s a beautiful story.

You know, that’s what it’s about. What are some of the unique challenges that you guys face in the specialized healthcare sector? And did your background prepare you for any of that?

Like, having the experiences with your brother, but I would be interested in any of the legal aspects, you know, to help you prepare for what you face in that specialized healthcare sector.

Brandon 

You know, it might. I swim with sharks all the time, right? So if you’re going to be some shark, you must become a shark to be in that water.

And I know how to protect our company. I know how to protect our company from people who say they will do stuff and they don’t. So that’s how we’ve been able to work. One big thing is that people are all excited about startups, and they don’t. They get it and don’t realize how much you have to work.

And you know, there are a lot of sea-level people who forget how to work, and they want to delegate everything. There’s no place in the startup for people who don’t want to do the work. So that’s the one, the biggest thing from a legal perspective.

And then also, like looking at the field, like I do my research and looking at where these big companies have failed, like making an employee, and access to healthcare is our most important thing. And then cutting off their employees, making them independent contractors, and stripping away their healthcare. I’m like, I’m not going to make that mistake.

Bryce 

And then wonder why they lost their employees.

Brandon 

It’s like, wait, I won’t make that mistake. So we’re an independent contractor base. We’re trying to pay people better wages.

We’re trying to listen to providers, but I think only a little of the legal stuff prepared me for that other than the contractual thing, which saves us lots and lots of money because I can do a lot of the work. And then I can be like, Hey, you’re an expert. I’ve done all this work.

Where is this wrong? And instead of being $80,000, the bill is 8,000. And that’s helped us extend it.

Other than that, I’m not; the other thing is I’ve been a founder in the past of legal companies or real estate closing companies. And I run my business on an entrepreneurial operating system. EOS is a book and its traction by Gino Wickman is the book.

I think that has helped me apply that knowledge to this company and help providers and folks along the way. They need to gain business experience executing a very simple business plan. That was part of my entrepreneurial background, and I started another kind of entrepreneurial fund. I’ve not been very good at EOS in the beginning.

I’m much better now. And, you know, it’s taken us about two years to catch our stride. This is our eighth quarterly meeting.

And now we’re hitting all of our, we’re tracking along, like setting KPIs, achieving those at a high clip, and doing important work, not just doing work for no reason. So, I feel like it’s a superpower in harnessing your focus. Um, but now I’m outside the realm of what the experience of being a lawyer has helped in this field.

But those are the nuts and bolts that, um, helped me. And that’s how I help other entrepreneurs, too. That’s what I do for other entrepreneurs, other than like exiting and doing private equity or venture capital deals and what stuff like that, but protecting the company and making sure that bad actors are people that maybe they were good actors coming in, but then they, they get to go away without.

Bryce 

Yeah. Yeah. And that’s very important to me.

Obviously, being able to set that back to have a strong foundation is key. Right. And then, and then, and then being able to, um, you know, have your wife who’s also in the field, I’m sure is very, is a resource as well to have, be able to bounce things off of her as when it gets into the actual clinical care stuff.

So, that sounds like the team you guys have curated over there is also key. Being able to have that strong foundation, curate a team that is, that you trust, that is, you’ve got his startup base, where it is a full team effort, a hundred percent bought in whether you’re the CEO or whether you’re a sales rep, you know, it’s, it’s, it’s a, it’s a team effort. And when it comes to these startups and being able to share your ideas and push, push, not yourself further, but the whole company forward, as everybody, let’s get the guy.

And it’s almost like pushing a car with no gas until it gets to the gas station and fills that up with gas. And then you, you take off. Right.

But the hardest part is getting to the gas station.

Brandon 

If you have dead weight in your company, it’s like somebody sitting in the car, pointing and laughing at everybody pushing it. They’re adding extra weight. And it’s terrible for a company.

That’s disheartening for other employees. Disheartening. Exactly.

Especially of any large equity stake. And it’s like, what if I’m working twice? It doesn’t work.

It doesn’t work at all. I give any piece of advice to a general listener. It’s like eliminating the dead weight as much as possible because it is demotivating.

For sure. A hundred percent. The other part is as hard as technology, the technology component of it, like, I’m a lawyer, my wife’s a doctor, and we need to be trained in technology.

We’re young enough to adapt, but finding the right tech partner has been challenging. I also have to build a services company in a highly regulated market, which helps me be highly regulated and work around that. But then, trying to do the tech side now, we’ve had to search for the right tech partner.

And it’s not just the technology partner that knows technology; they need to know it. They need to know mental health care. They need to know several components.

So we’ve been searching hard for the right party to help us, one with a baseline understanding of psychology and therapy and some of these different things. So we’ve identified a few, but only a few of those folks are out there.

Bryce 

Yeah, for sure. There’s not. And that, that’s a that’s one of the aspects that we, even at OSP, why we try to be so robust and, and, and then, the areas we’ve covered where we say, you know, we’ve covered everything from when I, when I, when I give my sales pitch, I always. I reviewed that first slide; it has us in the areas we’ve covered.

And the people are like, wow, that’s a lot. I’m like, well, it’s, it’s important that I, that I share with you that we’ve covered everything from specifically mental health or home care or psychiatry or dental or, and all these things, because I don’t think people realize how, you know, when it gets into the technology side, it needs to be some, if you’re, if you have a company like Verrier, sometimes it needs to be customized for you to get what you want out of it and to have the efficiency you’re looking for. Some of these out-of-the-box tools you pay a ton for do not fit and must be the right fit. It is a custom approach; you’ve already built your company custom.

What it doesn’t make sense to pull in a box tool, build something that fits your company a hundred percent, that your employees have input in that when the when it’s being built, that you have input in when it’s being built, that you can, don’t have bells and whistles that are not needed. And, yeah, it’s such an important tool. It’s something that I love to focus on whenever when I do sales pitches and talk to startups and other companies where it’s like, hey, don’t be scared by custom.

It’s better. It’s, this is something that is why, you know, my dad always told me, you know, never buy a pair of cheap shoes, right? Because, because one, because one, your feet affect your back, and they affect your entire body.

So you spend money. The whole thing is to spend money on what matters and spend money on important things. Take your time with important things. And that’s such an important thing, and moving along here and getting into that digital health technology and its impact on lifestyle.

You guys are at the forefront of virtual eating disorder treatment. As you mentioned, there’s a little out there. You guys, you know, there’s only a few options.

There are not a lot of options for mental health or for people who come out with addiction and mental health, and not when it comes to specialized disorder care as you guys deal with. And I guess my question is, how do you see kind of the digital healthcare technology transforming the space of mental health and then, particularly like the eating disorders and changing the accessibility and the openness to people to be able to get help when they need it and not kind of face that stigma or they, these, the worries that might keep them from getting the help that you need?

Brandon 

Well, man, the stigma is something that we will have a very hard time with. With the stigma component, making it, you see men’s health advertisements on the television where it’s discreet, like that’s one of the top three advertising things, like discreet, you know, discussion about this. So, like, I do think that there’s an element to that where if you have something that’s accessible on your phone, you’re able, you don’t have to leave to go to a doctor’s office, but you can go and get your treatment in your dorm room or the privacy of your home, makes it more accessible.

But where I see our ability is informing people, you know, we have a screener, we’ve had 20,000 people take a screener, about 19,998 have an eating disorder or have strong indications of eating disorders. We’ve converted very few to patients. So I just, so the beginning of the process is just, you know, you’re not alone.

You have issues, you know, you, you, what you eat, what you don’t eat, if you exercise or not, these all have, you know, play in your, to your mental health every single day. And they cause you concern and maybe undo concern every single day. So how do we get you into a community or a place where you’re safe, get information, and be around people like you or who may have similar thought patterns to you?

And that way, they’re destigmatized, right? You’re in a community where people feel like you, like one of our guys that don’t have an eating disorder, he works for their company, but he ran a 5k, and then he ate like four or five donuts after it was a donut dash and he ate a bunch of donuts. He’s like, dude, I felt terrible about myself.

Like, you know, I felt like I overdid it. And I wrote that it was like a lot of mental weight over eating a few donuts after a donut dash. Like, I’ll crush four donuts.

I don’t, I don’t care. I try to have a balanced diet that includes everything I consume. I try to have that, but it affects so many people.

So the people that have disorders are trying to find them, trying to bring them into a community, and then trying to nudge them, right? Nudge them in the right direction regarding different behavioral health issues. So, a tool we’re going to build or build out will nudge them to track their food.

So, nudge them to check-in. How are you feeling emotionally when you eat? Like, are you having an episode?

Do you feel like you need a binge? Let us know, like step in front of these behaviors that can take you down a slippery slope and instead hopefully build you up into recovery.

Bryce 

Yeah.

Brandon 

So that’s what we are. And then eventually step you into care and treatment if you need it. And if you don’t, that’s great.

We have programs. If you can self-heal, that’s great. And, like the shortages in mental health, there are not a lot of expert providers.

So what you see in the marketplace will be more coaching, but coaches that the expert therapists supervise have a programmatic setup and have the back end on track. Are we doing these things that we say we will be doing? Are we doing them right?

And then I think where AI comes in is like you can have generative AI to be a guy to be. Now, we’ve had issues in the eating disorder space with Tessa, and the National Eating Disorder Association is trying to do away with them. Basically, what happened, what had happened was a rules-based platform.

Then, they took the parameters off and implemented them into a generative AI. They started giving diet and fitness advice. And that’s why you can’t do that with eating disorder patients.

You can’t. And they got crushed for a multitude of things, but that was one of the things still being talked about. This is the 60-minute piece about it last week or two weeks ago.

So, how do we build intelligent generative AI, put limitations on the AI to help people through the process, and give them nudges without giving them terrible advice? And how do we make limitations on that? So that’s what we’re working on right now. Once we build this platform, we get people moving in the right direction and the tools they need.

We spread the word that we have the underlying services, and then we are trying to bridge that gap with coaching, education, free resources, and by answering every phone call. I don’t care if you’re in a state we serve. We’re going to help the best that we can.

We’ll help find you something. And if you’re on Medicare in Wyoming, we may not be able to find you anything, unfortunately, but we will do our best to stay on top of what’s available to help whoever will give us a call. Are you in the state we serve?

Our mission has always been to help a million people. And it doesn’t mean we treat a million people. It means we do whatever we take as an organization to help these people the best that we can. And we can’t help every human being. But those are some ways we’re moving toward trying to bridge this gap in treatment. But there are some big problems that I need to address.

Yeah, insurance. We’ve had great conversations with some great insurance companies. They’re like, yeah, we’ll pay for your platform.

Yeah, well, let’s start figuring this out. So, I’m hopeful.

Bryce 

Interest is there.

Brandon 

Interest is there. Yeah. Yeah.

Bryce 

And it should be. I mean, I think, like, if these insurance companies don’t see the vicious cycle that addiction, mental health, eating disorder, all of these patients fall into a lot of the time. It’s a vicious circle that is sometimes never-ending.

And the number of encounters and visits they have in ERs and hospitals is insane. And if we could break, and I know this, it would sound so easy. This is breaking the cycle.

Break the vicious, but it’s like if we could just when they go into an ER if they come out and they do have these things set up with aftercare, where they’re not just being sent right back to the home where there are triggers right there. It’s like you’re preaching all of this. You’re going to sit them through, even impatient.

I come from before I started with OSP, I came from the addiction and mental health world myself, specifically addiction. And in Mississippi, I live in Birmingham, Alabama, and we dealt with Medicaid and Medicare. In Alabama, two hospitals, maybe three state-run hospitals, can accept inpatient Medicare and Medicaid.

The other hospital is in Meridian, Mississippi, right over the border. It’s a 200-bed facility called Alliance Health, and that’s who I worked for. And I was in Alabama, and it was just unbelievable when I would go into UAB and these huge hospitals and say, hey, I can take your Medicaid patients.

And they’d be like, what? What are we doing? It’s just like in Alabama; some of these states are a lot further ahead, and they are good on them.

In many of these places, Alabama and some in the South are not the case.

Brandon 

The Southeast is a desert, man. I’m from Kentucky, and the Southeast is a desert. It breaks my heart.

It is. There’s only so much that we can do about it other than establish Colorado as a market, get Texas, some of these other markets that are pretty good paying, and then leverage the insurance companies for, and this is not even to your point yet. Still, I’m getting there to leverage some of these insurance companies for a nationwide contract. Then, we can start spreading out in the Southeast.

Then, we can try to target specific Medicare. My wife is like, we’re doing Medicare. We’re doing it.

We’re doing it. I’m like, OK, that’s a big task, but it will take us some time to step it up and get that out because the reimbursement rates in some of these places, you can’t pay your experts.

Bryce 

Oh, it’s wild. It’s criminal. And what’s worse is like not that people who have insurance and who can afford premium insurance are not important, but the people who can’t. The people on Medicaid have nothing. Those are the people that, I mean, have no chance if people like Alliance and other companies like yourselves aren’t trying to push these boundaries forward. They’re doomed.

And it’s terrible. It’s sad as a country. And even just as a human being, it’s just like what, you know, it’s just eye-opening.

If you take your step back and pull yourself out right from your head and just look at it from an overhead view, be like, man, are we OK with this as a country?

Brandon 

Yeah. Part of me has to ignore it. And I wouldn’t say I like that.

I mean, admission, but part of me is like, I’m driving this boat, and I’ve got to go to these waters before I can get there. Get to these waters. And, nine out of 10 people, well, cause we started private pay more than nine out of 10, probably at least nine out of 10 couldn’t pay.

Now we’re in insurance. So maybe it’s closer to like, you know, maybe it’s seven out of 10 we can’t treat, or we can’t help, you know, for inquiries from Medicare and Medicaid. But in Colorado specifically, we’re already working on some of those one-off contracts to get in there and establish a foothold.

You know, and to have those relationships, those folks here, particularly as we’re already in insurance, basically all insurance in Colorado, and trying to start to flirt with that and see how that feels, single case agreements and whatnot, see if we have providers that can take. And we also do free work. We work with Project Hill, which basically does scholarships, and they go through the financial part and do a thorough job on financials.

And those are some of the most awesome cases that we have. I don’t want to get into any specifics of the patients, but there are some awesome cases of people from rural towns who are going on to do big things and have this problem. And if we can help them solve this problem, they will be huge benefactors to society.

Yeah. So like we, you know, our dieticians have stepped up, our therapists have stepped up and done some, Erin does, she has at least two patients of her 40 that are free, you know, zero dollars. And then, we’re trying to balance that with building a bootstrapped company.

Yeah.

Bryce 

Because you, yeah. And it’s not like any of these companies don’t want to help the underprivileged and the, you know, population, but they, but at the same time, you got to run a business, and you can’t lose, you can’t lose Kaylee’s side of that, as you very well know.

Brandon 

Margins in insurance are tough enough with the provider marketing as it is. So, I’m not here to talk about just margins. I mean, but you have to; if the company doesn’t work and it goes out of business, then people are, you’re not helping anybody.

Bryce 

Yeah. You’re not helping anybody or yourself, you know, so moved on to kind of the kind of health tech and resolving eating disorders. What innovative approaches, and maybe this is getting more into what very does and what the process looks like? What innovative approaches or technologies do you use to address the unique challenges eating disorders pose?

Brandon 

We are not very unique this time. The fact that people can do virtual work and we can treat people virtually is good. It’s helpful, right?

It saves people time, saves people. When people are coming to a higher level of care, they need to see a dietician, therapist, psychiatrist, or medical doctor every week for some time. And you take three doctor’s visits where you have to travel, sit, go into, you’re looking at five, six, seven hours a week where you’re trying to reintegrate into your life, but you’ve got to sit in waiting rooms and whatnot.

So that’s one, that’s the most foundational. Second, is developing a community and trying to have a home for people to come to. It’s a small technology lift that can be used in Circle. Eventually, we’ll build our community because it takes little to build one.

And then stack that on top of the EMR. And that’s really where our technology is going to be. It’s a fully integrated place where, even if you’re not a patient, you’re still in the community; you can access these digital behavioral intervention tools. And that’s why we will start bridging the gap between care and the community. These things are things that you can do self-guided, self-helping, and then step to where a coach guides them.

Then, the next step is to get the treatment. So we’re trying to bridge that gap from where I have any disorder, but I do not have, I don’t have anything. I don’t even know if I have any disorder to treat.

And, you know, the first step is to understand. The second step is to learn more about it or get into the community and talk to people about it. And then maybe I’ll try this tool out, or this lesson out, or try this technique out and try to bring them closer to treatment.

That gap is so wide. You take, I mean, outside of money, outside of anything, getting someone from, oh, maybe I have a treatment problem is a far. Yeah.

No one jumps over that. No one jumps from like, may I have a problem with the treatment. People fall into this gap; no matter how far you can jump, you will fall into it.

Bryce 

Yeah.

Brandon 

And you have to put those little parts, the next part, so they can eventually get into treatment, or maybe they self-heal. I mean, some people have stopped drinking, you know, that don’t need, but getting them to the process, I think, is what, and I’m not speaking to the tech, what technical technologies we’re using, but right now we’re using an EMR. We’re using Circle for our community, and we’re using a data collection company and provider communication company called Sequel. I think our product is smashing those together and putting good guardrails on what these folks should be doing.

Sorry, putting good guardrails on how to help nudge people, you know, marketing, whether it’s the emails or the messaging within the community. So that’s what we’re focused on: helping cut from, oh my God, maybe I have a problem with treatment, or something closer to them not having a problem. And technology, I mean, people are dying for community.

People are dying to be part of something. People are alone. People are, you know, loneliness kills more than anything else.

And I’m not trying to avoid your question about specific tech. I named the technologies we’re using.

Bryce 

Yeah, no.

Brandon 

But I’m planning on and want to make this, throwing in the generative AI, helping the chat quicker, and getting people to respond more quickly. I need help. What if it’s 6 p.m. on a Saturday night, when many of these people are thinking about these problems when they have time, after work, after their kids are in bed? We had a couple thousand dollars in our budget for our screener tool. And we need more Google on the budget for the ads between 12 and 2 in the morning. They would get that early in the morning because people are late.

They feel bad about themselves. They’ve just binged. They’ve just purged.

They’ve just done something that’s triggered them. So being able to be more responsive to people, getting them quicker, and supporting them faster are all things that are very important to us. What tools or technology will we use?

It’s going to be just a myriad of those together.

Bryce 

Yeah. And now, as you guys are innovating those technologies as well, those are only going to become more. And I see you guys having, like you guys are, you already mentioned, you guys will have your platform, community, and application.

I see that you have everything in your future of the very app. It’s all-inclusive that you can click on your phone and go right there and have a perfect workflow of, do I have an eating disorder? To, as you mentioned, hey, I need treatment tomorrow.

How do I get it? Like, I need treatment right now.

Brandon 

The technology side is getting easier and easier. The technology with the it’s getting easier and easier. Now, what’s challenging is creating a good app or a usable app.

So we’ll spend a lot of time on that, too. The user experience, making sure that you went to the doctor’s office before, fill out two pages with a PIN every time. So, we want to eliminate some of that stuff to make it easy.

Every block for an eating disorder patient is going to fall off, and a tremendous amount of people are going to fall. Every block is like Velcro. If somebody is running and you have a block, they’re just going to stop in their tracks and not go any further. So making it easier to use as a slide and user experience.

And those are some of the things that we’re focused on.

Bryce 

Yeah. Yeah. And what’s cool about that too is like once it’s like it, all of this, like it can be transformed to all of these mental health issues.

It doesn’t have to be in the future. I was very continued to grow. I mean, you guys could expand to all mental disorders and addiction.

You can do; the options are endless for you guys, which I see when you guys get this technology and the technology comes together because it’s such a, I think when people think virtual care, virtual is starting to become kind of like my, like a second nature to us a little bit. But when it comes to our care, when you do it, like I did, I go to therapy. And, you know, with these companies, like better help, and some of these that have come out where you can talk to your therapist, you have a Zoom call with her.

You talk to him right out there on your phone, and you have FaceTime with your therapist instead of having to get up or pull your insecurities together, get dressed, drive somewhere, sit in a waiting room, sit in a room with other people. And they get in the thing and spill your guts to somebody. It’s very emotional.

Get back out and then have to drive yourself back home. It’s like, I don’t think people realize how different an experience it is to go into your office or to go into your bedroom where you’re safe. You feel comfortable and talk about some of the most important and the hardest things you’re dealing with in your life. Some people don’t realize how big of a deal virtual care is, especially in dealing with stigmas, which we discussed trying to overcome.

It’s a huge way to overcome that stigma of where you don’t need, you know what? I understand that you’re just dealing with this a lot right now. Don’t even worry about you don’t need to go out.

Just go to your room and get your cell phone, which we all have. We’re all obsessed with them. And let’s talk.

Let’s do it right here. Just me and you. And it’s such a disarming disarmament to people who are very wound-tight when you’re dealing with the stress of an eating disorder or addiction or mental health.

And it’s I love the approach of the virtual care approach and the 24 seven access. And it’s like, hey, come to me when ready. You know, I don’t need to force it on you.

But we’re here. Whenever you’re ready, you come to me. We’re always here.

Whenever you’re ready, hop on. Very. We’re gotcha. Or, hey, call us. You know, I love that aspect of it. And I cannot wait.

Brandon 

Yeah, I have over here. I do it because I’m getting goosebumps about, like, I work in numbers as my head works in numbers, like assessing my family makes fun of me all the time. They’re like, I’m like, there’s an 87 percent chance probability of that.

This is how my head works. I work in POTAS, and I moved to Korea. I was broke when I started teaching there. So I wasn’t drinking.

I was kicking butt at poker all the time, POTAS, and playing conservatively and just smashing people. But I say all that to be like, this is how I process things. And I agree with you 100 percent. People are like, oh, but you lose things in virtual. You know, you. OK.

All right. Well, I’ll give you, across the table, maybe you get five percent or seven percent or nine percent more. But eventually, we’ll have technologies that pick up on perceptions that when you’re looking down or looking away, you’re not even good.

We’re going to be better than even in person. A lot of times, because technology is going to help us, like reading body language and different things like that, we’re going to be able to apply it to videos. And that’s going to be a hugely beneficial thing for providers.

And then what are you talking about, golly? How much harder is it for human beings dealing with this issue to do all these things? Thirty percent harder. So, I was like, no-brainer, five percent less versus 30 percent harder.

OK, this is a no-brainer. We got to do it virtually. And that’s what the market’s going to do.

That is where the market is shifting because it’s a better product. And people, I still think that I say all that, too. My major point when you were talking was that we’re still talking about what virtual is good. Some people are still talking about that.

That’s just as much of a topic of conversation, especially at the federal payer level. Federal payers are very much pushing for virtual. And the insurance companies will get rolled on that, which will benefit health care.

I think healthcare parity is for sure. I lost my train of thought, but. The problem or the additional problems from the patients is what we’re trying to solve.

And the other thing.

Bryce 

Yeah. And the other thing is that. Some people are thinking about when you hear these the people who have been in this in the mental health space for years and years and years, 30, 40 plus years, right, is you’re dealing with a different generation, which this might seem very like, duh.

Right. But you’re dealing with a generation now, my generation, who had techno. We are, we are, we are technology sound.

I might not lose a thing between this meeting if we had it or if I was sitting in your kitchen with you, Brandon. Right. Like because why?

Because we’re very much used to it.

Brandon 

You’re in your spot. You gain because of that. You know, there’s no you gain 10, 20 percent on your ability to be because you’re comfortable in your setting in your environment.

Bryce 

It’s also second nature for us to have a conversation or have a FaceTime or a Zoom meeting where it wasn’t that technology wasn’t around back then to where people there was that learning curve or that transition or that kind of thing. Evolution is a little bit more now. It’s technology, so you think about it, and I would be very interested. Nowadays, you can do almost everything, including running your business, on your cell phone.

Right. Like and like, short of a few things, maybe. But for the most part, you could go to the beach on your beach and run your business from your phone to do your day from your phone.

And it’s like, why are we not taking advantage of that? Because we think we’re going to lose two to five percent in eye-to-eye contact or our facial cues, or that doesn’t make sense. And like you’re saying, where we’re OK, we might lose five percent, but you’re ahead in 30 percent because the person is comfortable and will open up to you and share what they feel instead of closing down.

Brandon 

You’re seeing seismic shifts, man. People don’t realize it like you have. But if you look, pull back, as if the U.S. is half the world’s healthcare spending. OK, digital. The U.S. spends one-third of the world’s healthcare spending. That is a big delta.

And people who do not have access. So, yes, I don’t care if it’s virtual. I don’t; I need access.

And the people are speaking. The markets are moving. The markets move slower than the people.

And that’s why we will be at the forefront of that.

Bryce 

Yeah, 100 percent. That’s well said. That’s well said.

Well, Brandon, thank you so much for joining us today. It was a pleasure to explore and learn more about what you guys are doing and what you guys are doing in the future. Your insights into kind of the transformative power of virtual care are eye-opening.

And it’s interesting to me because as somebody who we deal with, with direct solutions and deal with this, it’s always I always love talking and getting kind of perspectives like this from CEOs and from founders like yourself where you see what kind of the thought process from the business side of it as well. I love that. And what are your views on closing the gap and specialized disorders and care through virtual?

And it’s a vibrant perspective that I think many people should give it a chance. If you are struggling with something or are unsure about it, give it a shot because you might surprise yourself. And it’s not going to hurt anything.

Brandon 

I don’t want to get better. You know, you might get better. That’s right.

Bryce 

To get better. I love that. Yeah.

So, thank you again, Brandon. It is a real pleasure talking to you. I look forward to staying connected with you and seeing what you guys do in the future.

Thanks, Bryce. Appreciate you, man. Thanks.

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About the Guest

Author

Brandon Johnson linkedin

Brandon Johnson, CEO of VERY, spearheads a pioneering virtual eating recovery platform, uniting patients and providers globally. With 15 years as an entrepreneur and a background in law, he champions startups and businesses, guiding them through legal intricacies. His passion lies in fostering communities and leveraging AI for holistic care.

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