Revolutionizing Healthcare Payments with Innovative Financing with Chris Cox, Chief Strategy Officer at iVitaFi

[00:00:02] [SPEAKER_00]: Hey everybody, welcome back to the Outcomes Rocket. I'm so excited to have you back on the

[00:00:08] [SPEAKER_00]: podcast today because I've got an extraordinary guest. We're talking a lot about founder stories.

[00:00:15] [SPEAKER_00]: That is the theme of our podcast now. Since we changed to this new theme, I've been meeting

[00:00:20] [SPEAKER_00]: such great people and one of those great people is Chris Cox. Chris is the Chief Strategy

[00:00:26] [SPEAKER_00]: Officer at iVitaFi. He's an expert on financial services, healthcare and fintech and he leads

[00:00:34] [SPEAKER_00]: product strategy and operations at the company. I'm excited to have him here on the podcast

[00:00:39] [SPEAKER_00]: to talk about the work that they're doing to make healthcare more accessible and to

[00:00:44] [SPEAKER_00]: health systems with their money. So Chris, thanks so much for being on the podcast.

[00:00:50] [SPEAKER_00]: Chris, thanks so.

[00:00:51] [SPEAKER_00]: Chris, being that we're indexing here on the founder story, tell us about you. What

[00:00:56] [SPEAKER_00]: is it that took you from doing what you were doing before and getting into entrepreneurship

[00:01:01] [SPEAKER_00]: and healthcare?

[00:01:02] [SPEAKER_01]: Chris Cox Sure. So I actually started my career in the financial services world, so I'm really

[00:01:07] [SPEAKER_01]: having nothing to do with healthcare and actually started working for a very large

[00:01:11] [SPEAKER_01]: debt buyer and saw just how many people were struggling to pay for credit card bills.

[00:01:18] [SPEAKER_01]: And I did that for a couple of years really running the analytics and ultimately think

[00:01:22] [SPEAKER_01]: by the time I left, I was managing a portfolio that was 40 or 50 billion in size. So just

[00:01:29] [SPEAKER_01]: massive dollars of people who can't afford to pay their bills. I then had an opportunity

[00:01:34] [SPEAKER_01]: to go work for a private investment fund who was making investments into kind of esoteric

[00:01:41] [SPEAKER_01]: industries and that's when I really started to see the healthcare challenges. We were

[00:01:48] [SPEAKER_01]: funding a company who was buying bad debt from hospitals and they were paying like a penny

[00:01:55] [SPEAKER_01]: or two pennies for the bills. And they were just massive files with tons of patients.

[00:02:02] [SPEAKER_01]: I'm thinking, gosh, there has to be a better way. And we got a group of people together

[00:02:07] [SPEAKER_01]: that had experience within this kind of specialty finance section of the industry and we

[00:02:14] [SPEAKER_01]: started digging around. And I was talking with a hospital CFO and I asked him, hey, how

[00:02:20] [SPEAKER_01]: much do you collect on your healthcare bills to patients? And he told me, we're doing

[00:02:24] [SPEAKER_01]: really good, Chris. We're doing about 35% in my job. That's not good. So that's really

[00:02:32] [SPEAKER_01]: where the impetus for the idea started and how we jumped in.

[00:02:35] [SPEAKER_00]: Well, yeah, man, I mean, billions of dollars, you were seeing this and pennies on the

[00:02:41] [SPEAKER_00]: dollar spreadsheets of patients. You're like, what is going on? That's healthcare right

[00:02:47] [SPEAKER_00]: now and it's terrible. And so accessibility is a huge issue. You wanted to do something

[00:02:53] [SPEAKER_00]: about it. And as we think about this, the one question that I did have on the business

[00:02:57] [SPEAKER_00]: is are you guys focused on the cash paying side then? Non-insurance?

[00:03:02] [SPEAKER_01]: Actually, we do both. So oftentimes, and we'll talk about this, I'm sure as

[00:03:07] [SPEAKER_01]: the show goes on, but folks are more and more often in rolling into high deductible

[00:03:13] [SPEAKER_01]: healthcare plans. So when you go to the doctor or the hospital, you're going to have a two,

[00:03:20] [SPEAKER_01]: three, four thousand dollar out of pocket that you'll have to pay for that visit. And

[00:03:26] [SPEAKER_01]: that's with insurance, right? If you don't have insurance, now you're talking to the

[00:03:30] [SPEAKER_01]: tune of potentially tens of thousands of dollars. But we focused really on both

[00:03:35] [SPEAKER_01]: sides of the uninsured, underinsured and the insured.

[00:03:41] [SPEAKER_00]: Understood. Got it. Thank you. Thank you. That's good to know. And so help us understand

[00:03:46] [SPEAKER_00]: how you guys are really helping unlock the revenue cycle for health systems and where

[00:03:53] [SPEAKER_01]: you're adding value. Sure. So if you think about where healthcare, well, I'm going to

[00:03:58] [SPEAKER_01]: take a step back and do a little storytelling. Sure. So if you think back in like the

[00:04:02] [SPEAKER_01]: nineties or early 2000s, around 90% of the financial burden of healthcare was being

[00:04:11] [SPEAKER_01]: shouldered by the payers, the insurance companies, right? Well then something

[00:04:15] [SPEAKER_01]: unique happened. There is the advent of the ACA and the really the popularity of

[00:04:22] [SPEAKER_01]: high deductible healthcare plans really started to take off. And what that did

[00:04:27] [SPEAKER_01]: is it shifted a lot of that financial burden over to the patient. So now we're

[00:04:31] [SPEAKER_01]: seeing about 20 to 30% of the financial burden is supported by that patient. Why

[00:04:36] [SPEAKER_01]: is that important? Well, these hospitals have built all of their systems, their

[00:04:40] [SPEAKER_01]: technology, their talent is focused on the reimbursement of claims by the

[00:04:46] [SPEAKER_01]: payer. And now they're finding that a large portion of the financial burden

[00:04:51] [SPEAKER_01]: is now the patient and you need a totally different strategy and approach

[00:04:54] [SPEAKER_01]: to that. And that's really where we plug ourselves in is helping these providers

[00:05:02] [SPEAKER_01]: in collecting from their patient population in a means that doesn't

[00:05:06] [SPEAKER_01]: frustrate that patient. If you think about the current workflow today, they

[00:05:12] [SPEAKER_01]: spend months and tons of time and people to try and collect this 30 to

[00:05:16] [SPEAKER_01]: 40 cents on the dollar where you plug in us where we're an embedded

[00:05:22] [SPEAKER_01]: financing company seamlessly integrated within the RCM workflow. You can

[00:05:28] [SPEAKER_01]: almost think of us like a payer in some respects. If you enroll the patient

[00:05:32] [SPEAKER_01]: into our program, we cut a check to the hospital for twice that they would

[00:05:38] [SPEAKER_01]: have collected on their own without any of the cost. And that's what we plug

[00:05:41] [SPEAKER_00]: in. Chris, yeah, that makes a lot of sense. And so are you guys so then

[00:05:45] [SPEAKER_00]: your company comes in? So I need to find comes in. Is it part of the

[00:05:49] [SPEAKER_00]: enrollment? Like the patient gets admitted and it's part of the discussion

[00:05:56] [SPEAKER_00]: like, Hey, what are you going to do about your deductible? Well, we have this

[00:06:00] [SPEAKER_00]: plan. Go ahead and sign up. You catch it that early or you catch it further

[00:06:04] [SPEAKER_01]: downstream. We do. And that was actually something that's unique to our

[00:06:07] [SPEAKER_01]: offering. We built our program with free service in mind and being

[00:06:14] [SPEAKER_01]: able to advance the discussion around the balance because I don't know

[00:06:20] [SPEAKER_01]: about your personal experiences with the US health system. We just had a

[00:06:24] [SPEAKER_01]: baby in February and congratulations. Thank you. And you go through this

[00:06:28] [SPEAKER_01]: whole process, no one brings up cost until you get a bill 45 days later.

[00:06:34] [SPEAKER_01]: And it's like, gosh, there's a better way to do this. Bring that

[00:06:37] [SPEAKER_01]: conversation forward and start communicating and setting expectations

[00:06:41] [SPEAKER_01]: so that people understand that they will owe a balance and estimate of how

[00:06:46] [SPEAKER_01]: much it will be. And that's really where we see the vast majority of use

[00:06:51] [SPEAKER_01]: for our program is at that patient access point. So it could be done

[00:06:55] [SPEAKER_01]: as early as scheduling, but we're also we've trained the staff to

[00:06:59] [SPEAKER_01]: offer it at registration. It could be bedside if it's in their

[00:07:03] [SPEAKER_01]: emergency department or post service through their typical billing

[00:07:07] [SPEAKER_01]: or donning statements.

[00:07:09] [SPEAKER_00]: Got it. Fantastic. Now, it's great to know and it definitely is a great way

[00:07:15] [SPEAKER_00]: for patients to be able to pay for these things and for health systems

[00:07:20] [SPEAKER_00]: to capture that collection upfront. So you mentioned right one of the key

[00:07:25] [SPEAKER_00]: differentiators that you guys do is where you show up in the revenue cycle

[00:07:30] [SPEAKER_00]: process. Anything else you want to highlight as things you guys do

[00:07:33] [SPEAKER_00]: different or better than what's out there?

[00:07:35] [SPEAKER_01]: Sure. No, it's a good question because there's lots of different patient

[00:07:39] [SPEAKER_01]: financing options out there and it actually took me some time to

[00:07:42] [SPEAKER_01]: understand and learn it all. So when you think about patient financing,

[00:07:46] [SPEAKER_01]: it really started with hospitals offering payment plans.

[00:07:50] [SPEAKER_01]: Payment plans have been around forever and they're not going anywhere.

[00:07:54] [SPEAKER_01]: The hospitals don't really love them because they're the pain in the butt

[00:07:57] [SPEAKER_01]: to administer and manage if you're not specifically built to run payment

[00:08:02] [SPEAKER_01]: plans. An example is someone's debit card expires, right? Well, that payment now

[00:08:06] [SPEAKER_01]: broke and now you've got to have someone to call them which now you

[00:08:10] [SPEAKER_01]: have a call center. So you have all these things that you don't really,

[00:08:14] [SPEAKER_01]: they're not purpose built to do that, right? Recourse lenders came around

[00:08:17] [SPEAKER_01]: in the I think the 80s maybe 80s 90s and basically what recourse means

[00:08:22] [SPEAKER_01]: is that the patient takes out a loan through this lender.

[00:08:26] [SPEAKER_01]: The lender will advance the funds to the provider

[00:08:30] [SPEAKER_01]: and so long as the patient makes their payments, everything's kosher.

[00:08:34] [SPEAKER_01]: But if the patient runs into hardship and starts missing payments,

[00:08:38] [SPEAKER_01]: the hospital actually has to hand the money back to the lender

[00:08:43] [SPEAKER_01]: and then the patient experience there is really walkie, right?

[00:08:46] [SPEAKER_01]: Like where does the patient fit into this transaction?

[00:08:51] [SPEAKER_01]: It seems like a bad deal.

[00:08:53] [SPEAKER_01]: Yeah. And if you think about it economically, it's no different than a payment plan

[00:08:56] [SPEAKER_01]: because once you stop, once they stop paying, you have to give back the money that wasn't paid

[00:09:00] [SPEAKER_01]: back. So it's not, it creates friction for the providers.

[00:09:05] [SPEAKER_01]: So what we do is completely non-recourse meaning it's what you typically think of

[00:09:09] [SPEAKER_01]: as a loan, right? We advance the money and if they stop paying, that's for us to eat.

[00:09:15] [SPEAKER_01]: And I think what really makes us unique is that our program is designed for everybody in mind.

[00:09:22] [SPEAKER_01]: So we believe that everybody deserves access to affordable healthcare

[00:09:27] [SPEAKER_01]: and not just the folks with gold-plated American Express cards.

[00:09:31] [SPEAKER_01]: So our approval rates into our program are north of 95%

[00:09:35] [SPEAKER_01]: and we never charge interest. We're a 0% interest company.

[00:09:40] [SPEAKER_01]: Some of our competitors out there will offer promotional 0% interest

[00:09:44] [SPEAKER_01]: and then retroactively charge you interest if you miss a payment.

[00:09:48] [SPEAKER_01]: We don't do any of that. It's truly zero interest.

[00:09:50] [SPEAKER_00]: That's pretty cool. That's pretty differentiated.

[00:09:54] [SPEAKER_00]: So then you guys just doing some rev share with the hospital on it then?

[00:09:58] [SPEAKER_01]: So basically what the hospital do is we'll go in and look at their data and say,

[00:10:01] [SPEAKER_01]: hey, how much are you collecting from your patient population?

[00:10:04] [SPEAKER_01]: And if it's 30, 40 cents on the dollar, we'll go in and say, hey, we'll give you

[00:10:09] [SPEAKER_01]: 70 cents on the dollar. So you can basically...

[00:10:12] [SPEAKER_01]: So they're winning off the bat.

[00:10:13] [SPEAKER_01]: You're winning off the bat. You have cost reduction from the provider side

[00:10:17] [SPEAKER_01]: because now they don't have to go face after it.

[00:10:18] [SPEAKER_01]: And they know that from the patient's perspective,

[00:10:21] [SPEAKER_01]: they're placing their trust in us to treat their patient

[00:10:25] [SPEAKER_01]: and we're never going to charge an interest or...

[00:10:28] [SPEAKER_01]: I mean, we even pay their leak fees from the bank.

[00:10:31] [SPEAKER_01]: So we are definitely a patient-first company.

[00:10:35] [SPEAKER_00]: Man, that's awesome. I was just assuming...

[00:10:38] [SPEAKER_00]: I was thinking this. I wasn't saying it.

[00:10:41] [SPEAKER_00]: I'm like, okay, cool. They must have some...

[00:10:43] [SPEAKER_00]: I don't know where their interest rates are.

[00:10:45] [SPEAKER_00]: And then you said this. So it's like you're right in my mind.

[00:10:48] [SPEAKER_00]: That's pretty cool, man. And that is a patient-first approach.

[00:10:53] [SPEAKER_00]: And I love it. And the other thing that I love is,

[00:10:56] [SPEAKER_00]: from a provider perspective, you don't have these clawbacks.

[00:11:00] [SPEAKER_00]: Like it's just like a really de-risk thing for the provider.

[00:11:05] [SPEAKER_00]: The pay... It's an access play. I love it.

[00:11:07] [SPEAKER_00]: Yeah.

[00:11:07] [SPEAKER_00]: I love it. Kudos, man. That's awesome.

[00:11:10] [SPEAKER_01]: Thank you. We strive to make it as simple as possible

[00:11:13] [SPEAKER_01]: because when we were serving the market,

[00:11:16] [SPEAKER_01]: trying to understand the financial modeling of some of these recourse providers,

[00:11:22] [SPEAKER_01]: it was really hard to understand how the money movement worked and the pricing mechanics worked.

[00:11:28] [SPEAKER_01]: And I was like, guys, you just need to make this stupid simple.

[00:11:30] [SPEAKER_01]: And that's what we've aimed to do.

[00:11:33] [SPEAKER_00]: That's awesome. Wow. Cool. I love it, man.

[00:11:36] [SPEAKER_00]: Great solution. For anybody listening, if you're in the...

[00:11:40] [SPEAKER_00]: If you're in the Rebs cycle game at a health system, or if you're not and you have a friend that is,

[00:11:46] [SPEAKER_00]: like definitely something you want to share, share this podcast.

[00:11:49] [SPEAKER_00]: Share it with a friend. That's how we get the word out on things like this.

[00:11:54] [SPEAKER_00]: Don't just sit on it. Forward it via text.

[00:11:57] [SPEAKER_00]: We're going to post this on LinkedIn.

[00:11:59] [SPEAKER_00]: Copy people on LinkedIn. Let's have a conversation about this because

[00:12:03] [SPEAKER_00]: it's an important conversation and we need more companies like IVidify

[00:12:07] [SPEAKER_00]: to make access friendly and not trying to make money off of every little thing.

[00:12:13] [SPEAKER_00]: Chris, as you guys have built a company and thinking as entrepreneurs here,

[00:12:17] [SPEAKER_00]: it's not always easy. We face setbacks. Can you think about a setback that you guys experienced

[00:12:23] [SPEAKER_00]: and what you learned from that key learning that's made you guys even better?

[00:12:27] [SPEAKER_01]: I think I'd have to point to the obvious answer here.

[00:12:33] [SPEAKER_01]: We launched our offering in the fall of 2019, which was obviously right before COVID.

[00:12:42] [SPEAKER_01]: And I can promise you, Saul, we did not have global pandemic on our enterprise risk assessment

[00:12:49] [SPEAKER_01]: when we were launching. I know what I'm saying.

[00:12:54] [SPEAKER_00]: That's so short-sighted, Chris.

[00:12:56] [SPEAKER_01]: Awful. So COVID was interesting because it gave us an opportunity to be introspective

[00:13:05] [SPEAKER_01]: because our thesis, our go-to-market thesis was to go and call on these hospital CFOs

[00:13:11] [SPEAKER_01]: and VPs of revenue cycle within hospitals but realize that they were a little preoccupied.

[00:13:16] [SPEAKER_01]: So we took that as an opportunity to focus inward and be hyper focused on our product

[00:13:23] [SPEAKER_01]: and making sure that the user experience was as seamless as possible, understanding that there

[00:13:29] [SPEAKER_01]: was so much noise and friction in the world. We wanted this to be as easy as paying for an Uber,

[00:13:36] [SPEAKER_01]: right? When you don't even think about it when you whip out your phone to pay for an Uber,

[00:13:40] [SPEAKER_01]: it's that seamless. That was what we had in mind for embedding the financing program

[00:13:47] [SPEAKER_01]: within the workflow of the revenue cycle. Additionally, we expanded our scope and started

[00:13:55] [SPEAKER_01]: focusing on ancillary health care services too outside of hospitals because there's a lot

[00:14:00] [SPEAKER_01]: of health care being done outside of hospitals. And as a result of those two things, we've seen

[00:14:07] [SPEAKER_01]: triple digit growth every year since. So it's been an interesting ride for sure.

[00:14:13] [SPEAKER_00]: And when you do the right thing, you solve the right problems in the right way, you're solving

[00:14:20] [SPEAKER_00]: problems for all of the stakeholders in that value chain. You're going to grow. And I think this is

[00:14:27] [SPEAKER_00]: an important message that we all should be thinking about is what's that network that you're

[00:14:34] [SPEAKER_00]: working in and are you providing value? This idea of every organism in the ecosystem has a role

[00:14:41] [SPEAKER_00]: in the minute that they don't serve a purpose, they get extinct. So you guys are like symbiotic

[00:14:48] [SPEAKER_00]: man with all of the organisms and you're having success triple digit growth. Congratulations.

[00:14:53] [SPEAKER_00]: I love hearing these types of growth stories. Chris, my pleasure. Look, leave us with the

[00:14:59] [SPEAKER_00]: closing thought. What do you want us to be thinking about? And for anybody listening to

[00:15:04] [SPEAKER_00]: this that you want to connect with that you want to learn more about you and I vitify

[00:15:09] [SPEAKER_00]: where can they find you? So take away and where can they find you?

[00:15:13] [SPEAKER_01]: Sure. So I think I'll leave the audience with kind of my thoughts on where the industry is going,

[00:15:22] [SPEAKER_01]: which is I think the fancy or the trendy answer would be like, oh, it's AI, right? Because AI

[00:15:27] [SPEAKER_01]: is now the flashy buzzword for, it's the answer to every question. I actually don't

[00:15:32] [SPEAKER_01]: think healthcare is ready for AI yet. And there's more of a digital transformation that's

[00:15:37] [SPEAKER_01]: needed. And the story that I like to tell, I was traveling for work a few years ago. I found myself

[00:15:44] [SPEAKER_01]: in Denver, Colorado. And I was, it was one of those, I was on a campaign, right? You wake up

[00:15:50] [SPEAKER_01]: in the morning, you don't know which state you're in. And I'm checking into the hotel,

[00:15:54] [SPEAKER_01]: it was a Marriott property and I see Kayla at the front desk and she's nice, but not overly

[00:16:00] [SPEAKER_01]: nice. I get checked in. You could tell she may not have been having a good day.

[00:16:03] [SPEAKER_01]: I get up to my room, I take out my car and I let myself in the room and my phone paints.

[00:16:09] [SPEAKER_01]: It looks like I had a text message and I look at it and it's Kayla. And she's saying, hey,

[00:16:15] [SPEAKER_01]: I hope you have a great stay. Please text me if you have any questions. We're happy to have you

[00:16:21] [SPEAKER_01]: with a little smiley face. And I'm like, oh my gosh, it's so kind. And it hit me.

[00:16:25] [SPEAKER_01]: What was it? Kayla, she's having a bad day. Like this was all automated, right?

[00:16:29] [SPEAKER_01]: It was all automated to say the register at the front, insert their name. And as soon as I swipe

[00:16:36] [SPEAKER_01]: my cards and make this text message, and it's like, why can't we have more of this in healthcare?

[00:16:41] [SPEAKER_01]: It is really this digital transformation that needs to continue to occur. I think about

[00:16:46] [SPEAKER_01]: healthcare, we avoid having conversations around price transparency. We avoid conversations

[00:16:52] [SPEAKER_01]: altogether. Most of the communication is done either over the phone or using paper billing

[00:16:57] [SPEAKER_01]: statements, which that's antiquated now. So really taking this digital first perspective and being

[00:17:04] [SPEAKER_01]: laser focused on the patient experience is where I think we need to go. And then once you have that

[00:17:10] [SPEAKER_01]: bad rock figured out, then you can start to layer on AI on top of it to then improve it.

[00:17:15] [SPEAKER_01]: We'll say so. That's what I'm excited to continue to monitor and watch in healthcare.

[00:17:20] [SPEAKER_01]: If anybody wants to learn more about our company or me, you can contact me on LinkedIn.

[00:17:25] [SPEAKER_01]: If you search for Chris Cox, there's probably 500 of us out there. So search for Chris.

[00:17:30] [SPEAKER_00]: We'll put the right one in the show notes. We'll put the right one in the show notes.

[00:17:34] [SPEAKER_00]: Yeah. Perfect. And then the website probably, right?

[00:17:37] [SPEAKER_01]: Yep. You want to go to our website, ID to financial, ID, financial.com. And you can follow us there too.

[00:17:45] [SPEAKER_00]: Amazing. Well, Chris, thank you. This has been informative, insightful. Love the work

[00:17:52] [SPEAKER_00]: you guys are doing. Love your entrepreneur story. And for all the listeners out there,

[00:17:57] [SPEAKER_00]: man, there's pearls of wisdom in our chat with Chris today, not only from a ref cycle

[00:18:01] [SPEAKER_00]: management, but also from a business development standpoint. So definitely one I would

[00:18:06] [SPEAKER_00]: re-listen to and take some notes on. Thank you all for tuning in. Stay tuned until our next

[00:18:11] [SPEAKER_00]: time. But until then, Chris, we want to thank you for being with us.

[00:18:14] [SPEAKER_01]: Thank you so much. Thanks for having me.