Itzik Cohen (Founder and CEO, PayZen)

Can you explain your job to a five-year-old? 

PayZen helps people who are using medical providers to pay their medical bills in a convenient, interest-free way and in a very inclusive way because we say yes to everyone and accept everyone.

We work with medical providers to offer those payment options to their patients. And my job is to make sure that our personnel, the team, are going to always execute our plan based on our values and our mission. Our mission is to bring financial health to healthcare, and our values are to accept everybody who wants to pay their bill—so don't say no to people who are interested in paying their bill. Never charge interest or fees from any patient—so don't make their healthcare more expensive just because they want to break down a payment or to pay it over time. And to continue expanding our solutions to address more and more use cases and make healthcare more accessible and equitable using fintech approaches.

What excites you most about your job?

Reading patient feedback. It is the best part of my day. 

The average healthcare Net Promoter Score in healthcare? Iit's terrible. It's around 20. Our NPS scores are 71. So, that gap amounts to something, and it's because we make it easy. We make it affordable. We make it very simple and transparent. We are trying to be a kind of proactive and show up when you need us.

And so we’re trying to predict where is this friction going to occur. Financial friction is going to occur between the provider and the patient and we address those moments in real time, in a way. People are writing this. Emails. Thank you letters. You know, how they, for example, could not have done the surgery for their kids.

Think about it. This is a horrible time for people. They have to do something. They are very scared. And adding to that worry, a financial worry, is adding more stress to people's lives. And when you take that away from the equation, the focus is on care. Rather than, “Oh, how am I going to pay for it?”

Which trend will change the future of medicine? 

If you look back, the big transition in healthcare, the big IT Innovation in health care up until now was EHR. We're using a lot less paper for clinical lab work intake. A lot of different functions are requiring less paper and depending more on data.

But when you think about it, a lot of the IT or tech investments in healthcare—and from venture capital, by the way—if you look at technology companies, in the last two decades were focused more on the friction between providers and payers. Meaning denial management, pre-authorization, coding automation. Because most of the value and the money that was exchanged was between the provider and the payer. Seems like everybody forgot, nobody noticed that there was a huge shift. 

And now, a lot of friction or financial friction occurs between the provider and the patient. So, there's more of a consumerization trend. I think, the adoption of tools like Epic MyChart, the user interface itself, are taking the industry to a point where you'll have more of an e-commerce look and feel. So your checkout experience, your research experience, your interaction with the provider, everything is becoming a lot more digital, which reminds me more of e-commerce.

And as it relates to us, e-commerce is embedding a lot of different financing tools or payment methods that are supposed to make it easy for the consumer to pay for things. You'll see the same kind of trend where we're going to be embedded in many different checkout solutions, and we're already doing that. 

Looking back, which trends have you missed or underestimated? 

We're a fintech company. The experience of the team is in innovation with financial products and use of data to create unique products that fit a certain use case and become best of breed. But what we didn't appreciate is that affordability extends beyond financial product. 

It's the use of data for automation because, when you think about it, most of the cost in healthcare right now is administrative costs. It's people doing manual work that is not automated. Take that out of healthcare and think of how much more efficient and how much less expensive healthcare would be. So, I think that what I didn't appreciate is how broken the system is, how I knew it was broken, but not to the degree that we found and how much help providers still need.

Which MedTech initiative or startup deserves more attention? 

There are ways for us to extend our technology into prescription drugs. We're not doing much there right now because it's a different type of integration, different type of model than we're operating right now. But I think that prescriptions are becoming so expensive as well.

And we can probably add value in that arena as well.

What's the best advice you've ever received? 

In every stage in my career, I took to heart something different. The first great advice I got when I became CEO for the first time, my mentor gave me the fundamentals of what it means to be a CEO and he told me, “Look, if you do three things only and do them well, you'll be a great CEO.” He said: “Don't run out of money and hire the best people. And make sure they all play nice together according to your vision for the company. So, make sure that everybody's marching in the same direction.” 

I'm getting a lot of advice now that I could consider a lot more useful now that I'm a more experienced CEO. And I think that I would say that the very memorable one actually given to me lately is just stick to fundamentals, first principles. What are you here to do? What are you trying to accomplish? You have a big enough market. Don't try and do too many things because there are hardly any companies that do more than one thing very well. 

We should be really good at solving affordability problems for patients and providers. And that should be our focus, and if you have a big enough market, you don't have to worry about doing anything else. That's what I keep telling my team. Focus. Solve this problem. Don't solve anything else.