Mitch Evans

MBA 2013 – Strategies & operations, Entrepreneurship

Co-Founder & CEO, Affirm Health

Could you provide a brief recap of your career since graduating from Vanderbilt? 

I worked at Jumpstart Foundry right out of college, which is now a healthcare investment fund. At the time, we were actually a consumer-facing broad technology accelerator, including consumer-facing tech. When I was there, we made the decision to shift it and focus more narrowly on healthcare which is what it is today. After that, I ended up actually going down to Franklin, and we built a game studio with a lot of the engineering team that we work with now. 

What is your company and where did the idea come from? 

Basically, if you were to look at healthcare, you hear a lot about value-based care, you hear a lot about fee-for-service, it’s kind of two different worlds, and the reality is we are not in either of them. If you are a typical practice, you are operating against a pretty messy kaleidoscope of different payment programs. In working with clinicians, we discovered that really for them, it is just a black box, and they aren’t informed on the different plans of each of their patients and what the different incentive behaviors are. Oftentimes, they end up doing the same thing for every patient regardless of the patient’s specific demographics or their triggering events, or the plan that they are on. It is not good for the patient, it is not good for the plan, and it is not good for the health system. So, there are a lot of missed opportunities. We saw an opportunity to come in and help clinicians and really give them tools to be able to do their jobs more effectively.

What are you most proud of about your business?

I think a couple of things. One is obviously the team that we built and getting to work with a lot of really great people. But I think the other part is shipping software and then seeing clinicians use it and seeing that make their lives better. It’s giving them the ability to deliver better patient care. I think there is a magical moment when you actually see that happen, and you see the delight on your customer’s face. Unless you are in entrepreneurship, you do not see the end user’s satisfaction, and it is pretty cool.

Organizational grit, right? If you are running a startup, nothing works like it is supposed to, like nothing is easy. So, the ability to deal with that, persist, and then just keep going even if it is not exactly what you imagined at any given point in time is probably the most important thing. 

What is the most challenging thing about being an entrepreneur and how have you worked to overcome those challenges?

Yeah, so, at any given time, just about anything in the business is broken. That is inherently the case regardless of how much money you have raised or how smart the people on your team are; everything is broken at a certain point. So, I think the ability to understand that and recognize it for what it is. Figure out what are the fires that are going to burn down buildings and you have to put out now, versus what are the ones you can deal with at a later time.

What advice do you have for students as they launch their business? Are there any tools you consistently use as an entrepreneur?

If I were to be blunt, the first thing, it is not right for everybody. It is actually probably not right for most people. If you are going through a program like Vanderbilt getting your MBA, you are going to be set up for a lot of great careers and your tolerance for risk is probably better suited for a consulting job or investment banking job. You are probably going to make more money. You are going to have a more balanced lifestyle. Maybe consulting and IB would be wrong examples of that, but there are options out there. So first off, I would say it is not right for everybody. Being clear and honest with yourself about how you are going to react to that environment is really important. I would say once you make the leap here are a couple of things. One we touched on a bit earlier, understanding what is important and what fires you can deal with later. I would say the other thing, just psychologically, I told people to keep their emotional scale kind of between a four and a six on a scale of zero to ten. When you are doing a startup, everything seems like it is magnifying the business in a rocket ship trajectory or completely tanking it. The reality is that it is not ever the case. So being able to just kind of understand that regardless of what the most recent data point is, we should not be at a ten or we should not be at a zero. Just kind of modulate that, and I think that is a lot healthier for most people.

What do you do to live a balanced life? Do you have any interesting or fun hobbies?

I have a 10-month-old and a three-year-old, so my hobbies are kids. I don’t have balance outside of that. Basically, if you were to break down your life into your professional life, your family life, and your social life, I have cut out the third one.