Portfolio Insights – Verisys

Issue 11, Mar. 2024

Introducing the Leverage Health Portfolio Insights Series

As the industry’s only Venture Catalyst, Leverage Health is dedicated to propelling transformative solutions and pioneering advancements. In our ongoing quest to illuminate the trailblazers shaping the future of healthcare, we proudly present the Leverage Health Portfolio Insights Series.

Throughout this exclusive series of interviews, we have the privilege of delving into the minds of visionaries who are driving change, disrupting norms, and championing progress within our dynamic portfolio. From revolutionary technologies to groundbreaking care delivery models, each conversation offers a glimpse into the strategies, insights, and experiences of leaders at the forefront of healthcare innovation.

Join us as we uncover the stories behind the solutions that are redefining the landscape of healthcare, one breakthrough at a time. Welcome to the Leverage Health Portfolio Insights Series – where inspiration meets impact, and where the future of healthcare begins.

Richard Lungen (Leverage Health)

Hello Charlie. First question: when did you become CEO of Verisys, and you can you explain the process from then to now?

Charlie Falcone (Verisys)

Hello Richard and thank you for the opportunity to be here today. That’s a good question actually as Verisys is the combination of two companies:  one dating back to the early 2000’s and the other dating back to 2014. The first is legacy Verisys from the early 2000s and the other is Aperture Health from 2014 after it was spun out of United Health Group’s Optum Division. I became CEO of Aperture in 2014 and remained on as CEO after the companies came together in 2021. We are now one company under the name Verisys.

Richard Lungen

Thank you. That leads us to the next question. What is the gap in healthcare and what is the problem that Verisys solves?

Charlie Falcone

Verisys has a broad set of data solutions that serve a number of different customer segments and use cases across the healthcare industry. The use cases for our data fall into two distinct areas. The first is for human capital or workforce management, and the second is for governance, risk and compliance purposes.

On the human capital management side, for really any entity in the heathcare industry a background check is typically a pre-hire requirement. For this use case, you can think of the healthcare industry as a very large set of entities that includes hospitals, physician groups, health insurance carriers, pharmacies, PBMs, life science and device companies, background screeners and more. Background checks are generally thought of as only criminal history checks.

However, in the healthcare industry, an additional component of that pre-hire background check and ongoing monitoring process is to ensure that any clinical person have a license, proper education, etcetera, but also that any non-clinician individual is not excluded or sanctioned by a federal or state organization that would preclude them from working at an entity in the industry. Our data is used to ensure those clinical and non-clinical individuals and entities meet necessary requirements.

On the governance, risk and compliance side of the business, you can think about physicians that admit patients to a hospital or a physician or other clinician that is part of a network for a health insurance carrier. In this case, it’s a more robust check of credentials, to make sure that that clinician is qualified to participate with the health plan or to treat patients. Our data is used to ensure those clinical individuals and entities meet necessary requirements.

Richard Lungen

What is Verisys’ unique approach and market differentiation? Is it technology? Is it proprietary assets? Anything that feels relevant.

Charlie Falcone

Our differentiator in the industry is our data asset. Verisys was founded to combat fraud in the healthcare industry and built the industry’s most robust compliance data asset called FACIS.

FACIS stands for Fraud Abuse Control Information System. The FACIS data asset goes back decades, and historical data is maintained and updated constantly to ensure our customers can receive nearly real time updates on individual clinicians, as well as non-clinician individuals and entities.  FACIS ingests and organizes data from thousands of different data sources which eliminates lags or inaccuracies from any single data source.  With FACIS, Verisys provides the industry with the most comprehensive look at adverse events that would prohibit or restrict an individual or entity from being hired or seeing patients inappropriately.  Adverse events include many items including license actions, sanctions, exclusions, debarments and many other obvious and not so obvious infractions or red flags. Our technology allows us to move actionable data to our customers via APIs in bulk or individual element format.

We collect, update and maintain FACIS data on over 8 million individuals and entities. The size, breadth, accuracy and timeliness of our FACIS data, along with the ability to use it for many different use cases and is what clearly differentiates Verisys from others in the industry.

Richard Lungen

What is ahead for Verisys in 2024 and beyond?

Charlie Falcone

Verisys has a very focused vision to help solve data gaps and fragmentation in the industry that lead to inefficiencies in patient care and cost. We will continue to invest into our FACIS data asset to make it available to more segments of the industry and to make it more expansive so it can continue to be the industry’s premier data resource for human capital management, governance, risk and compliance. In addition, we are beginning to serve other use cases at the point of care and in payments and revenue cycle management. Going forward, we will continue to expand FACIS as more individuals and entities come into the industry andto ensure that FACIS remains the most accurate and reliance data source in the industry.  Also, we will continue to push toward making our data available real-time or perpetual versus transactional with respect to those eight million+ and growing individuals that we monitor on a regular basis.