Episode 76: Is Some ABA Better Than None? With Answers Now Founder, Jeff Beck

I've always been intrigued by the question: "is a little ABA better than none at all?" Some people/agencies I speak with insist on clinical models that conform exactly to clinical prescriptions and the traditional 2-tiered model of ABA. I totally agree ... as long as families have that option. But what about families in rural areas? Or families of older kiddos who sit on interminable waitlists and can't get services? It feels like they deserve the life-changing power of our science as much as any other family. This conversation with Jeff Beck, co-founder and CEO of Answers Now, helped inform my thinking: with newer technologies, previously unreachable kiddos with autism can now get some form of ABA and that feels worthwhile. Enjoy, kind listener!

Resources:

Answers Now: https://www.getanswersnow.com/

>eff on LinkedIn: https://www.linkedin.com/in/jeffbeck11/

Building Better Businesses in ABA is edited and produced by KJ Herodirt Productions

Intro/outro Music Credit: song "Tailor Made" by Yari and bensound.com

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Transcript

Jonathan: 0:31

My guest today is Jeff Beck. Jeff is a CEO and co-founder of Answers Now. Answers now uses a comprehensive approach to ABA that combines cutting edge technology and evidence-based strategies to help children reach their fullest potential. When not working on access to care, Jeff spends his time running around Richmond, Virginia with his wife and three children. Jeff, welcome to the pod man.

Jeff Beck: 0:53

How you doing? Good to see you.

Jonathan: 0:54

It is great to see you. All right, let's talk about innovation in our field today. I'm pumped for this and, and maybe just to start, tell me about your answers now Journey. Like what were the challenges that you saw in our field and, and how does answers now solve for those challenges?

Jeff Beck: 1:10

Sure. So I think, you know, at the beginning, I want caveat, right? I'm a licensed clinical social worker, not A B C B A. So I, you know, I'm, I've learned about demanding and detecting, but I'm, a little bit of a different ilk. Um, and, but answers now came because I was running community-based programs at a huge nonprofit and Virginia, and next door was the autism school where they, where they did aba. And that's where I met my co-founder Adam Dreyfus, who is an LBA BCBA. And he and I would, Stay after work, talking about ways to try and serve just our populations in general. Kids with autism, adhd, anxiety, how to serve, you know, Medicaid folks, how to get their families involved, parents involved, increase access, and um, we both got really passionate about the science of ABA and what he calls the squishiness of. Kind of CBT DB T in my background. Right? And so we felt like we could use technology to combine the best of both of those worlds, um, by delivering care to as many folks as possible, anybody with an iPhone or an Android, by putting a, B, c, B on the other end with really strong training. So that was the, that was kind of the genesis. I think the, the hardest part in the early days. Was standardizing care because every B C B A came in with kind of their own deal, right? How they like to do it, um, what they thought they could achieve, you know, via mostly text at the time. Um, so coming up with trainings and curriculums and ways to, to support the BCBAs was, was kind of the first thing we focused on. This is four or five years ago, and it's certainly something we continue to focus on today.

Jonathan: 2:40

Well, I think this is powerful, right? And it's, it's amazing just to think how our world's changed in the last three years. And Covid like all of a sudden unlocked this opportunity to provide these services and maybe ways that didn't do it before. But what's interesting to me, Jeff, is that these challenges are not dissimilar to, Challenges that we might find in other parts of healthcare, right? So think about specialists, right? Nephrologists or, OR, or who, whatever specialty serving rural communities. Are there analogs you've seen in the rest of the healthcare world that inform your answers now strategy.

Jeff Beck: 3:09

Without a doubt. I mean, so 20 17, 20 18, I was a talk space therapist, so I'm, I was like, lemme just see what this is kind like. I'm curious, if this can be meaningful and it certainly wasn't for everybody. And, and, you know, working with a newly married couple as a talk therapist is certainly different than providing ABA virtually. But just the general concept of increased care via technology was really interesting to me. So, so I actually was a therapist 20 on Talkspace to see. As a clinician, and I learned a lot through that, that process. And, and my last role before answers now was at HDA, doing value-based care. So when we started answers, now this is obviously all pre pandemic. I wish I could say I had a crystal ball and knew that we were all gonna be sucked into this virtual world. But I thought that there was some level of value-based care concept that existed here with payers to reduce cost, to provide access to care for learners who did not need 30 hours of ABA a week. And in 20 18, 20 19, the prevailing response I got was, you cannot serve a kid with autism without seeing them in person. It is impossible, like you are wildly crazy. And then like roughly March of 20. April, 2020, like in that timeframe, the payers were like, how does it, what do you do again? How does this, how does this work? Um, and so, I mean, it was certainly a tailwind for us and something that I think, um, opened the eyes of the payer. Uh, because I think, unfortunately in healthcare, we're very much beholden to who has the purse string, and in, in this world's the payer.

Jonathan: 4:42

It is, uh, payers are, are critical stakeholders in the process and I, you know, one of the things I know when we, you and I first connected, gosh, it's probably almost two years ago now. that I was like so excited about was your pedigree as a, as a licensed clinical social worker. and full disclosure, right at Ascend behavior partners, one of my, my ABA services organization, we are all in on the family mental health and support model. And, and we see the power of it, right? We know that when we get, when one of our L CSWs gets involved during a crisis moment, um, our kiddos are three times more likely. To achieve an intended graduation date than when they don't. So we're, we're bought in. But tell me more about as an L C S W by training, how has that informed your outlook on the ABA field and how you've built answers now services.

Jeff Beck: 5:25

Yeah, I, I think it all goes into B C B A training, right? So when we bring a B, c, B board, they go through a pretty robust onboarding, and training and, you know that you all call it per person environment, right? I, I call that just family involvement roughly, right? Like, let's get the parent here and let's have them be a part of the session. Um, we are billing 97156 almost 20% of the time. That's the parent training code because it is something that we believe very strongly, and that is how, you know, longitudinal change occurs. This, the person who spends 99.9% of the time with the kiddo, right? It's the parent. And so the only way that you're gonna really, in my opinion, See long lasting change is if you have a parent in the house that's kind of carrying the torch. I mean, I saw this as an in-home clinic. I would do seven, eight hours of in-home therapy a week, right? With some of my more intense cases. And my most challenging ones were the ones where the environment was constantly shifting. You know, maybe it was weekends at dad's, weekdays at mom's, whatever it was. Um, if that environment was constantly changing and what I was trying to accomplish as a clinician was not. Happening when I was gone. That's really hard, right? And so how do we use technology to align parents, families, caregivers with what a clinician's trying to achieve? Uh, I'm not saying that's not something that a's done, but as a, from a social worker perspective, that was something that we. We knew early on that, that we could really lean into. the holy grail is coordinated care, right? And you've got pediatricians and psychiatrists and speech, all of'em kind of talking together. I think that's maybe the next iteration, like that's a really challenging proposition. Um, so let's just start with the family first.

Jonathan: 7:03

A Absolutely. I want to. Give our audience like a perspective on how lcsw, just think a little bit differently about our world. So as an example, one way I see it is, Parents might go through divorce. Right. Unfortunately, it's not uncommon. I think BCBAs are not necessarily trained with a set of tools and a toolkit to think about how do you counsel a parent, right? That's outside of scope of practice, if you will. Whereas an LCSW that's part and parcel of like how we're helping. But what would be a specific example you see around how an LCSW might think a little bit differently about the world and then how you've baked that in?

Jeff Beck: 7:35

Yeah, I mean, I think the chasm is much smaller than it seems, right? So I like in our training where we would go there would be how is the change in the parent's behavior due to the divorce, changing the environment for the child. So what parent is happening in your environment? How are you reacting to things? How are you showing up each day? What are the things that you're doing that might be negatively impacting your child's behavior? so that, that's a kind of confluence of the. L C s w a b a world where we, like the lc, s w would meet, I would bring that back to the child regardless, right? Like, I'm there to serve the child, I'm gonna do parent training. It's something, you know, ther's happening in the parent's lives. We can't ignore that. But I'm always gonna gear it back towards how are we serving the client that I'm here to serve together as a a parent clinician. And so it's gonna be very similar and we're just gonna put it in the ABA terms, right around environment and behaviors and consequences and be able to support that parent in, in the ultimate goal of supporting their child.

Jonathan: 8:35

I love that there's, in other words, there's way less daylight between the two disciplines than we would think, right? Yeah, absolutely. Tell me what are the locations that you serve now and, and like, what's the sweet spot of a typical client that you

Jeff Beck: 8:49

Yeah, that's a great question. So I'll go backwards. So, sweet spot for us, our average learner is 10, right? So we're serving the kids who about 50% of our learners have had ABA before, 50% haven't. 90% of'em are in, public education or, not in private day school, right there in general pop school. we're doing about four hours of ABA a week on average. We've got some learners who are doing seven, eight. We've got some learners who are doing two, three. Those are typically older. 13, 16, 19 22. Right there. Only ended a couple hours a week. we have a few younger, younger learners, 2, 3, 4, 5, where, um, that's gonna be primarily parent training, right? It's gonna be very parent led. now some of the four or five, six year olds, they can do it on their own, but for the most part, that's gonna be parent led. So the sweet spot I would say is the eight to 12 year old, doing four or five hours a week. so that's, you know, three to four with a learner, one to two with the parent, or caregiver. But it kind of works. we jokingly call the two, three, four, five year old, the better than nothing plan, right? Like you're on a wait list, you've got six, nine months. There is almost no harm in getting a B, C B A in there coming up with a, you know, treatment plan and getting a little bit of parent training rolling while they wait on the wait list. so that, that's, yeah, our sweet spot is probably the, the eighth toy year old. We accept all major payers across Virginia, Georgia, New Mexico, and Texas Medicaid commercial. And, uh, we actually just started a partnership with Magellan, California, and you and I were talking about this really quickly. I was at the Value Conference, the Behavioral Health Business Value Conference a few weeks ago. And the CEO of Magellan was talking about a, a population of, of kiddos. They just couldn't get served. It was about 50% Spanish speaking, really underserved area. and I was like, we can do it, we can get'em started tomorrow. Um, and I will say within a week we had close to two dozen of those families out, out of about 60, I wanna say they sent over, uh, about two dozen already, single case agreement submitted and getting assessments started. I would say a handful of'em already found in-home or clinic-based care in the other 30 or so. We're still working on getting in touch with. So, Magellan's been a great partner in that they're reaching out to folks for us and, updating phone numbers, right? If we get wrong phone number, it's been disconnected, whatever it's cause that's, you know, that's not. It's not a crazy, concept in the world that we live in. so it's been really, really cool at the end of the day, this is what, what really excites me to be able to get access to care to folks who otherwise wouldn't have had it.

Jonathan: 11:13

Yeah. Well congratulations on that Magellan partnership. Um, and I want to come back to something you said, Jeff, on. Around sort of the better than nothing plan, which, you know, say a little bit facetiously, but, but, but it, it is really important and I'm gonna say something a little kind of controversial cuz in my 11 plus years in the field, there have been times where, I've talked to, um, to folks who it's like, hey, you have to have the perfect pristine, a, b a program.

Jeff Beck: 11:38

Sure.

Jonathan: 11:39

Or nothing. And I don't know, I just can't, I I don't buy that. Right. I mean, to be clear. I mean, you all, your BCBAs are providing both the 9 7, 1 53 some direct treatment, right? In addition to providing, um, uh, parent training, the 9 7 1 56. So you're doing both models, but, coming back to your point around engaging parents and helping them be more successful in working with their. Kiddos behaviors and skills acquisition that sure as heck feels like it's better than nothing, doesn't it?

Jeff Beck: 12:07

I would tend to agree. I mean, maybe you're a little more fashion forward. I mean, like, you've got the podcast, you're in the industry, right? I think I was afforded the luxury of a little bit of incompetence as an lcsw. Like, why wouldn't we do this? Aba, the science is incredible. Look at the outcomes. It's, it's algorithmic, it's black and white. It works. Why wouldn't we at least get some of that into a learner's life while they wait? Because that's, that is the underbelly of ABA right now are these wait lists and the difficulty of staffing RBS and great rbs. And that's, that's where the challenge is. So why don't we, why don't we use these incredibly brilliant BCBAs to bridge that gap while these families wait. so it might have been a little bit of ignorance on my part, as an L C S W, but it's worked wonders. I mean, it's, we had a parent survey, sent it out a couple months ago, I think we got about 25 responses and it was, close ended questions and then provide more information if you'd like. Right. So it would be something like, are you, are you less likely to use urgent or emergent services because of the access to your Answers Now not BCBA was, for example, one of the questions, um, and 75% said yes, which is a pretty incredible response. Um, but, but then we said, if you wanna share more, feel free. Right? And so parents would leave these qualitative answers to our quantitative questions and they are life changing. to see the amount of folks who. we're a little skeptical, right? They're like, I wasn't sure, but I'm desperate, right? My pediatrician said, we need aba. We called the three providers. My kid's nine, they're in second grade, and all the providers either have a year long wait list or they need 15 plus hours upfront, and we don't have that. I feel like a bad parent. I found this, figured it was worth a shot and holy smokes, xyz. that's why we continue to do what we do, to see those outcomes. It's, it's pretty cool. Pretty.

Jonathan: 13:51

I'm glad to hear that and the, the feedback from parents I, look, I think this is something that ABA providers just need to. At least open up the periscope a little bit too. Um, open up the aperture because there are payers right now. I mean, Tricare for the last few years has been doing research on parent only models, right? Payers are trying to solve for number one, rural and other underserved populations, right? that they have a responsibility for. and, and number two, they payers recognize how expensive this is and they're gonna do what they do best, which is focus on utilization. So like, it doesn't, it feel important that ABA providers in general, understand, and start to figure out, sure. Maybe the model isn't perfect in certain kinds of circumstances, but how to incrementally keep improving on this.

Jeff Beck: 14:36

Yep. Well, I think to your point, the, the arc of the timeline of covid plays a pretty big role here, in my opinion, because in February of 2020, and I'm making these numbers up, but just gut feel, 80% of BCBAs would've said that model doesn't work. Right. And then a number of those BCBAs were thrust into Zoom face-to-face sessions by their agencies cuz they needed to bill something, right? So the agencies got rid of all the rbs. There was no in-person because of Covid. And any billable hour that was being delivered was from A B C B A. Literally on Zoom with a family. Right, and so BCBA is roughly six months, nine months until we started to get some vaccinations in and consent signed. B RBT started going back out into the, into the homes or clinics started to reopen. But during those six, nine months that 80% of BCBAs who didn't think it could happen, anybody who delivered face-to-face care saw that it could happen. And it can work and it can be really meaningful de depending on the learner, right? Like we're not gonna be able to serve the super aggressive kids. We don't want a three and a half year old, right? We want them in a clinic, we want an home agency to work with them. That's where they're gonna be able to learn quicker. Uh, but again, better than nothing, is kind of our internal tagline for that, that learner. So the population of BCBAs who now think that does work are, has grown, I would say at least to 50% because they did it and they saw it, right? And so then, then the door started to open back up and the owners, and I don't want paint them as this villain, they wanted to get their margins back. And so A, B, C, B A was then voluntold. You're not gonna do Zoom four hours a week anymore. You're gonna send that RBT to the home for 30 hours a week. And the RBS gonna be, Jenny's doing great with four hours and. They're gonna say they don't care and they're the RB t's going back. And so that friction point, that arc of Covid from 2020 to 2021, I think has really opened the eyes of, in our experience, a lot of BCBAs would come to us and say, Hey, this really worked for me in Zoom. And I felt like I have been thinking about if I could take Teach Town and these PDFs that I've created and this PowerPoint, and if I could put it all, I could have a really meaningful virtual session. And we're like, welcome home. You know? And so the number of BCBAs who are kind of thinking that way has certainly increased pretty

Jonathan: 16:43

Sure.

Jeff Beck: 16:43

since pre covid.

Jonathan: 16:45

It would seem like there's another use case here, and I liken ABA sometimes, like it's the Cadillac. It is. I, you know, how passionate I am about the power of our science and the work we do. And you clearly are as well. And let's face it, it's really hard. It can be really hard if you're providing in-home program. your, your home becomes a therapy center, right? 30, 40 hours a week. Um, or you got a two year old got diagnosed, you gotta drop'em off for 40 hours of clinic, whatever, like this is, that's, this is like the Cadillac, right? And my question is like, is there a. The smart car option out there that for parents that, you know what, it's just not gonna work in their life and their lifestyle. How do we continue to iterate and make that smart car, call it like a parent lab, parent training model work? I mean, is that, is that an analog? I don't mean to be the

Jeff Beck: 17:33

No, I think it is. I mean, I think it is. I think it is, uh, it's just, it's not as time intensive, like that's just kind of the best way to put it, what we're doing. I, I do think there are learners that. In a vacuum, if you could take a nine year old and you could give'em, and this might be controversial, you could give'em 30 hours of clinic-based, or you give'em four hours of b CBA a lead. I do think we can hit the same outcome for a specific learner, right? Because we've got parents telling us that their kid is excited about therapy and ABA therapy for the first time, and they've gone through a host of providers. And it's the 9, 10, 11 year old, right? Who, they're the one troubleshooting if they can't hear, right? They're not grabbing mom or dad, they're tech savvy. they're scheduling on their own schedule. They get to own their session. Um, it's predictable for them. It's not some stranger coming in and there's not no turnover rate. our clinician retention rate at one year is over 85%. So like our family knows, their clinician is their clinician. And so that's really meaningful for these kids, to have that predictability. I think that is what allows us to hit really incredible outcomes at a fraction of the time from a dosage perspective.

Jonathan: 18:42

Hmm. Well, I can see listeners now probably thinking, well, I mean, where's the outcomes data and other things. On that, and I'm sure this is early stage right? And I would ask. Where's the outcomes data in the rest of our freaking field, right? these are the challenging conversations we need to be having now as a field, if we want to get out ahead of, for example, payers who are gonna force lower utilization and, and higher light requires more audits. Everything else back on us. We've gotta do our job properly as a field, to push back on that. Well, let me pivot a little bit. I, I'm a huge fan, Jeff, of this book, called The Cold Start Problem, how to Start and Scale Networks. The author is Andrew Chan. In fact, I think he, he worked at Uber. but, it's really funny. he talks about like, The pinpointing the importance of focusing on the hard side of network building, and they even tell this story. This is kind of cool, dude. When Tinder got started, I've never used Tinder. I'm Gen X, I'm way too old, and balls, et cetera. I, but when Tinder got started, I think it got started at ucla. And they're trying to figure out how to increase adoption and there is some party somewhere and the the admission requirement to the party is you gotta sign up for Tinder, right? This when Tinder didn't just like barely exist, minimum viable product is an app. And guess what? They were able to build the entirety of their network around. Getting people to, getting to sign up and go in. And I think as a story is told in the book, you know, it's like the next day you talk to a whole bunch of people to party, but you don't know who they were, you didn't get contact with. Now you got contact info, you can see this anyway, and the rest is history and Tinder took off. But the point is like it's really hard to build, a certain side of your network, and that's where a lot of time has to be invested. So when it comes to answers now, What do you view as the hard side of answers? Now's network. Is it finding clients? Is it BCBAs and other providers, insurance companies, something else?

Jeff Beck: 20:28

Yeah, it's a good question. I think it changes. I know it's a bit of a cop out from an answer perspective. I think it changes. we have certainly felt the snowball on the BCBA side. we have started to see our name pop up in Facebook groups and in conversations in a positive light, which is, we have worked really hard to do We spend a lot of time making sure our BCBAs feel taken care of. Uh, and that is on purpose. We, we think there is a real waterfall effect too, if you just take care of the BCBA a and train them and give them free CEUs and give them an opportunity to share. I mean, the p we have a Slack group of over a hundred BCBAs. The power of. Hey, I've never worked with a 12 year old who, is on the spectrum and just told their parents they've got, they battle with anorexia. Has anybody had that before? And to have 2, 3, 4 BCBAs all put their hands up and be like, I can share this with you. Happy to DM you. Whatever it is, it just, it cultivates. That network. And so I think in the early days it was starting the, the b c side. I think that has changed a bit, I think from some of the kind of aforementioned covid tailwinds, but also the size of the network. It just starts to roll downhill as, as it sounds like Tinder did. and then from, you know, the, the client side, I think what we say to our referral sources primarily lands, right? You wanna be able to refer your kiddos to a place that's gonna take care of'em, send you the treatment plan and not turn over. you just don't want that call in six weeks from that parent or that caregiver saying, why did you send me to X, Y, Z? I'm on my third clinician. Like, what in the world? They want to just know that the kid that they care for is taken care of when they leave their doors. And so, um, that is at the end of the day what we. Work very hard to do and, I am not ignorant to the fact that we are doing something very different in a field that's been doing the same thing for 40 to 50 years, and I don't even have the credentials. Like I'm very aware, maybe too much of how much of, a bit of an outsider I may come across as right. I'm grateful that my co-founders in l b Columbia, grad BCBA through and through. but I'm still doing a lot of these podcasts and, uh, if it, you know, he does the NA stuff, right? And I Fun ones with you. But at the end of the day, I just think as long as we take care of the bcps, that will continue to grow as long as we take care of the referral sources that will continue to grow. And then I think the payers, at the end of the day, they want their outcomes. They wanna spend less money. And so those are two things that we're trying to provide to them. Uh, a way to spend less money and, and awesome outcomes. So that's to, like you said, outcomes we're getting, like we personally have some really legitimate outcomes that we're very proud of. We're working on a white paper right now that we're excited to publish by the end of the year. Um, because I didn't understand, the concept that, well, all these kids are so very different. You can't really aggregate outcomes. And to a degree totally, totally get that. But there are also my qualitative outcomes, right? Parent happiness, utilization, you know, words, right? There are things that you can start to aggregate. And those are, that's what we're also working on, for us and for our payers.

Jonathan: 23:28

Well, the grandfather of strategy, um, Michael Porter, who I believe is or was a Harvard Business School professor. You know, he has like the Porter's five forces and frameworks to think about how an organization operates in its environment. and two components of the framework that I found fascinating, are the idea of Competition versus substitutes. So what's an example of that? Think about a car company, right? Who maybe has, you know, Toyota and Subaru are competitors. But as you think about it from the consumer perspective, right? Yes. You could be deciding between wanting to buy a Subaru versus. A Toyota or a substitute could be that you're gonna take light rail to work every day or to get around. So I, I don't know. as you're describing about answers now, do you think of your services as a sort of a substitute from the rest? Aba? Is it more like in line with a b, a? How would you think about that?

Jeff Beck: 24:24

I see it as a graduation, so I'm, I'm trying to come up with the analogy really quickly, but it's the, the kiddo who gets in-home or clinic based from ages three to six, and then in second grade, they start to backside of it, and they had a good experience with a, b, a, but they don't want 30 hours. Then you and I are like, I'm very passionate about the science of ABA and, very amazed at what it can do. And so, um, it doesn't make sense for that nine year old to go back into a clinic for 30 hours a week, nor does it make sense for the clinic to try and rip that kid outta school. Right. So it's more, in my mind, it's more of a, it's more of a graduation. It's a different service. it's like a plane. I don't know. I'm trying to think of something like, it's not, we're not in the car category. and I think part of it is if you look at the diagnostic rates, right? The explosion was about five, six years ago. So those kids were three, now they're nine, and there just isn't a whole lot out there for that nine year old. And that's, that's kind of where we come into play. So that maybe we were an Uber for a person who owns a Subaru if they're out of town, right? Like we're the better than nothing plan. We'll get you around. It's a little more expensive than you want it to be. It might smell funky or whatever. You get to go home to your Subaru at some point in time when you get off the wait list. I don't see it as competitive. I just see it as more options for a family who's lacking them.

Jonathan: 25:46

Oh, I love it You are brilliant, sir. Wait to take that analogy and run with it. And by the way, I channeled the Peter Teal term like competition is for losers, dude. Especially when it comes to serving kiddos with autism. Um, and, and it's your point around like diagnostic rates. At the time of this recording we're, it's late March, right? Um, C D C just came out with

Jeff Beck: 26:04

the new one just came out. Yeah.

Jonathan: 26:06

One in 36. Right? So look, we're, there are more and more and more kiddos that need it to be served, and we've gotta continue to innovate to figure that out. Hey, can I ask you though about your business partner, um, who's a licensed behavior analyst. Tell me about kind of some of the conversations that, that y'all have. do you butt heads right, on clinical stuff or is it like, tell me about your partnership.

Jeff Beck: 26:27

I, I mean, I think the amazing thing was that we, we just kind of clicked, we both saw the space of, a family that could be served using technology, and I think that was what was really exciting to the two of us, is that we obviously have very different backgrounds and different education and different thoughts on behavior change. but he immediately. Immediately, Jonathan, to your point about how some BCBAs want their ABA to be pristine and they don't like to think outside of the box. He immediately wanted to think outside of the box. He was like, one minute of ABA is better than zero minutes of ABA for any kid. Right? And so having that fundamentally drove us to what if we did this? What if we did that? what if we built a sticker chart in the platform? What if we did the carbon card sort in the platform? Or what if it was just for adults? Or what if it was just for two year olds? You know? Like, what if we did. you know, eye tracking and affect tracking and, and um, you know, some things we've decided to prioritize and some things we've decided to deprioritize. But I think fundamentally we both agreed that a little bit of ABA is always better than no aba and that's been our true north ever since

Jonathan: 27:34

Wow. Wow. So tell me, I mean, you all been working together for what, a few years now?

Jeff Beck: 27:38

2016. So we are certainly not snake oil salesman. Yeah. Like we've been around for a little while. Yeah.

Jonathan: 27:44

like seven years in counting. Tell me, is there a specific strategy that you all use to like, to really make sure your partnership is as effective as it can be for your mission, your team, and your kiddos?

Jeff Beck: 27:57

man, that's a good question. He, he's the a, b true north, right? So I, this probably isn't surprising, I'm the excitable, you know, some strategy driven entrepreneur, right? He's the B cba and so you know what dot his opinion. Far heavier than in the other B C B A that I know just because of, I know his experience and his lived experience and, um, I have never seen anybody practice with a child the way that he can. I think, uh, there's a story that I tell, the nonprofit. We both worked. I was this huge campus and I was walking across the campus and there's this big playground and there's a kid out there, 6, 7, 8. Having a, you know, physical upset with two, three texts with the pads, you know, everyone's seen it, right. and they just can't calm him down. And Adam, I mean, I swear, looked like a Jedi night, just kind of slowly walked out of the school and knelt over and like slowly touched the kid's shoulder and looked away and looked back at him and took step two steps back and did, touched him again and literally 30 to 45 seconds later, the two of them were just kinda locked arm in arm calmly walking back into the school. And I was like, holy. Smokes, right. And so I went to him, he was like, what was that? He's like, that's aba. And ever since then, I've just been hooked on how do we get that into more family's lives? and so anything about, anything when it comes to aba, he's my go-to guy.

Jonathan: 29:23

Oh man, brother, I call ABA the force all the time because you're literally changing behavior without, like having reshaping the environment. It's unbelievable.

Jeff Beck: 29:32

was just standing there. I mean, you know, I had been spit on and cursed and TV thrown on my foot. I've done it all in the in-home environment, right? I just watched that happen and I was just blown away. Um, so I haven't turned back since.

Jonathan: 29:46

Wow. So Jeff, I know in, in any entrepreneurial endeavor and certainly in, in building and growing an a, b, a organization dedicated to quality, um, as you and Adam have, uh, not everything is roses, right? What are some of the major challenges you faced?

Jeff Beck: 30:03

I think scheduling, I mean, just right outta the gate. this is not a question I was prepared to answer my knee jerk response. It's just scheduling, you know, it's just getting our two-sided marketplace on the same page at the same time to be able to. Perform that behavior change, at scale, that becomes really hard. You know, when we're serving hundreds of families doing thousands of hours of therapy a month, we're doing everything we can to streamline that process. so scheduling, I would say is, is right now the thorniest. Uh, another one, a plug for you I would say is revenue cycle management. I didn't get into this because. I love to track billables or ar, right? And so I don't think many clinicians do. Uh, fortunately we've hired people way smarter than I am at this kind of stuff to ensure we actually get paid by the payers. But it's still really hard, right? It's still something you've gotta keep your eye on at all times and wait on hold, and. Call back and call back and call back. Um, so, uh, yeah, that's, that's another one. You know, I think the, the paperwork collection, whether it's diagnostic paperwork or the right insurance paperwork, all the kind of red tapey stuff that anyone who's working in or on business in the field, they're all experiencing the same kind of stuff.

Jonathan: 31:16

Well said. Um, well, I'm gonna pivot again here cuz you and I a, again, as the time of recording, it's opening day for the baseball season. You and I share a mutual passion for baseball. You actually. You played in college, I think. I think you still have, like me, I've always got my bat and my glove and a ball in the back of my car so that I can have a catch at any time. Dude, what's the, what's similarity between like baseball and our A field?

Jeff Beck: 31:42

Biggest similarity between baseball. I think they're both innovating at a rapid pace. Baseball for the first time ever, uh, as a pitch clock, it's 15 seconds. That's brand new. Um, they have banned the shift, which is a huge rule. so these are some sweeping changes that have happened in the Nation's pastime, uh, that are taking effect for the first time today. Uh, and I think the same thing goes for, the field of aba. I was at that conference and, um, one of the CEOs, the CEO of Cortico, was talking about their approach to value-based care, and it's innovative and it's really awesome. Um, I'm rooting for them to continue to do what they're doing. I, again, I just don't. This might, again, I might continue to be, missing the ball here, but I just don't see it as competition. Like the more people working on the right things and focusing on outcomes for this population. I think it's the diagnosis rate continues go to, continues to go up. Uh, I think the pie will continue to grow as long as we all continue to focus on outcomes. It's. I know that sounds, it's not hyperbole, like I just think make the world better for the kiddos you're serving. so yeah, I think that, off the cuff, I would say they're both innovating.

Jonathan: 32:57

I love it. as a longtime baseball fan, I have, uh, I, I can talk out of both sides of my mouth on something like a pitch clock, right? Like I, yes, I, we gotta shorten the game, right? And gotta make it more approachable for, the next generations that have nine second attention fans. But then there's another part of me that says to you, this is our, this is not called a sport. This is called our national pastime. It's played in a park, not in a stadium. It's played in a ballpark. And so I don't know how I feel entirely about the, the pitch clock, but, um, you know, the other thing I'll throw out there. Tell me your thoughts on this. Um, look, baseball is so much like this. Wonder what pitcher and. And the batter, right? And yet, and same as aba, it's like a, clinician and the kiddo. And yet at baseball you got this entire team behind you that you need to be successful, right. That you gotta rely on. Same thing, right? There's this entire team behind a clinician that, that you gotta rely on to be successful to serve a care. Yeah. So I think, um, oh God. I mean, I could, I could go on forever about that, but I think there are more similarities than people.

Jeff Beck: 33:57

Yeah. Yeah. there's a lot of strategy involved and the environment dictates what you're gonna do. And, um, yeah, I, I think, I think you're spot on there.

Jonathan: 34:10

Well, so if, what's one thing every ABA business owner should start doing and one thing they should stop doing?

Jeff Beck: 34:16

Mm. One thing they should start doing, um, Oh man. Um, if they're not already, I would say track outcomes that you can aggregate across your population. Uh, it's probably not a shocking answer. Um, stop doing, um, over prescribing. Not every kid should get 30 hours a week if they just cuz they can. It's easy for me to say, but that's my, that's one person's perspective.

Jonathan: 34:54

Oh man. This is not a cookie cutter science, right? It is highly individualized. I absolutely agree. and the idea of tracking outcomes even with all the scuttle bot about and disagreements around it, something you said earlier is, is really important. Start doing, um, Norm referenced assessments that are easy and are gonna give you some insights into, for example, the quality of your relationship with the families. And whether it's a parent satisfaction score or an NPS net promoter score, or like a parenting stress index, right? Are we actually helping to make parents' lives? Are we helping to reduce their stress levels over time? Like, these are all things that can be done, without having to build coalitions around outcomes. And. What, um,

Jeff Beck: 35:39

Exactly. That's exactly right.

Jonathan: 35:41

well, Jeff, where can people find you online?

Jeff Beck: 35:44

Yeah, so, uh, Jeff Beck 11, uh, back to back slash JeffBeck11 for LinkedIn. And then our website is getanswersnow.com. I love the field. You've had some of my investors mentors, friends on your podcast. so any, anybody listening, feel free to just contact me directly if you have a thought, disagree, agree question and just jeff@getanswersnow.com

Jonathan: 36:10

I love it and you can always drop a link in the show notes. we are on YouTube recording video, so come check us out. and yeah, let us know what you think about this conversation. So, Jeff, are you ready for the hot take rapid fire questions, dude.

Jeff Beck: 36:23

yeah. Let's do it. Let's do it.

Jonathan: 36:25

All right, you're on your deathbed. What's the one thing you wanna be remembered for?

Jeff Beck: 36:28

I know this is very, Um, fortune cookie ish of an answer, but just that he lived life to the fullest. Like that's just, you know, we've got a larger family than we used to. We've got twin one and a half year olds and a four and a half year old, and we're taking'em all to Barcelona in a couple months and um, that is gonna be a time, right? It's gonna be a time in an airport. It's gonna be a time on a plane. I mean, there are gonna be plenty of tears. Plenty of, uh, deep breaths, but, uh, we're gonna do it cuz we want to, we wanna try and do everything we can with these kids and with ourselves. And so that's my long-winded answer of just squeezing as much as you can outta life.

Jonathan: 37:06

I love it, Jeff. I had a buddy tell you like, suck the marrow out the bone of life. It's,

Jeff Beck: 37:15

I'm not as intense as your Tony Robbins friend, but it's maybe minor league version of that.

Jonathan: 37:22

I love it, dude. Hey, what's your most important self-care practice?

Jeff Beck: 37:26

Exercise every day.

Jonathan: 37:29

What

Jeff Beck: 37:29

Even if it's, yeah, I mean, so it depends If I can, if I can carve about 45 minutes, I'll, I'll do like an intense hit workout or head over to the gym and lift weights. If I've got 20 minutes and a baby, I mean, he's gonna be in my arms and we're gonna be doing squats and lunges, and I'm gonna be doing burpees over him, and we're just gonna go until we sweat and then we're gonna. Um, so those are the two ends of the spectrum. I'd say if I can, if I can carve out an hour, I'd love to just, you know, listen to music and lift weights. If it's, I've got 19 minutes before the morning shower with a kid, and then that's what we're gonna do.

Jonathan: 38:01

Oh, I love it, dude. That's like the reverse Murphy's law of like time and exercise. You just make it happen whatever time you have.

Jeff Beck: 38:08

it happen. Then whatever we got is what we're.

Jonathan: 38:11

Do you still play baseball or softball?

Jeff Beck: 38:13

I don't, I retired, love the cleats basically when I had my first kid, the softball cleats. Um, but I have been attending my four and a half year old's t-ball practices the last couple of days. So he just got started. Uh, so we'll see.

Jonathan: 38:26

Yeah, buddy. I'm a coach on my, or the assistant coach on, on my 12 year old's team, but I still play Maid of October. We have two different seasons of, uh, my co-ed, my, my old man co-ed softball. I'll tell you what, I still look forward to those days.

Jeff Beck: 38:41

Oh yeah, when? When, when my littles get bigger, I mean, I'll pick it back up. I loved it. I will say though, Softball was incredibly frustrating because when you'd strike out on like a, you know, two seam, 92 mile hour fast ball, you're like, that guy's awesome. Wow. He's awesome. Right? That was a great pitch. But then when you like foul tip and strike out in softball, it's like pretty degrading. So, uh, it, uh, was not mentally prepared for the self-loathing, uh, cuz there's no hat tip to the pitcher of the softball. Like, that's not, it's just, that's a me problem at that point.

Jonathan: 39:15

Oh my God. You're hysterical, dude. I'll bet you have a favorite song or music genre.

Jeff Beck: 39:21

Ooh, class Rock. This is a Woodstock poster. My dad was 15, um, and my grandfather chasing down on the highway and was like, you're not gonna Woodstock. Get back, get back in the car. So I've got the ticket, I've got the, you can see it. That's the ticket, the not get used at Woodstock. Um, and then I grew up in classic rock. So my dad was a classic rock morning show host for 20 years, and my first concert was Cheap Trick. And I've just, I've always loved classic rock.

Jonathan: 39:44

No way. Gee. Yeah. Surrender dude. Like one of my favorite class rock songs of all time. I love that, that poster for our listeners, three Days of Peace and Music. Do, does your dad have PTs? D being that close to Woodstock and yet not

Jeff Beck: 39:58

it was not a happy story. He said, I get it. I was 15. Probably shouldn't have been at Woodstock in retrospect. Uh, yeah. Yeah. So that's, that's rumors. I dunno if you can see, uh, that's the Rumors album, which is like one of the top in my mind, rock albums of all time. Big fan of Fleetwood Mac.

Jonathan: 40:18

Uh, never going back again. Favorite Fleetwood Max song, dude. So like, oh,

Jeff Beck: 40:22

a lot of good ones. The

Jonathan: 40:23

ous, what's one thing you tell your 18 year old self?

Jeff Beck: 40:28

The dots will connect. It's, there's a jobs quote out there, something like that. But I remember thinking, why am I doing this? Especially, uh, I was working two jobs going through licensure for lc, s w and I was questioning do I even wanna be a therapist? And, um, I'm glad I went through it and got through it cuz it, that lived experience leads to the next lived experience. And so I think that's just keep going. The dots will eventually connect.

Jonathan: 40:54

The dots will connect beautifully said, all right, you can only wear one style of footwear. What would it be?

Jeff Beck: 41:01

Tennis Shoes. Yeah, that's an easy one. Right? What do you want? Is there another choice? Crocs, maybe. I guess they're in.

Jonathan: 41:08

Maybe Crocs. I mean, I hear Birkenstocks are like back in again. I don't know if I was in nineties, in high school and college and Berks were all the rage. But I mean tens, you can't go wrong. Right.

Jeff Beck: 41:19

Yeah. Yeah.

Jonathan: 41:21

Well, hey Jeff, this has been an absolute pleasure. Thank you, man, for sharing your wisdom and telling us about answers now.

Jeff Beck: 41:26

No, I enjoyed it. Thanks so much for having me.