Maayan Cohen On Raising $70 Million To Improve Your Heart Health

Maayan Cohen is the cofounder and CEO of Hello Heart which is the leader in cardiovascular digital therapeutics. They help people understand and improve their heart health using technology. The company has raised $70 million from top tier investors such as Khosla Ventures, Social Capital, IVP, or Google to name a few. 

In this episode you will learn:

• The most important books for entrepreneurs
• Her top advice for founders
• How to build your network to raise capital
• Tips on team building and choosing your cofounder

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About Maayan Cohen:

Maayan Cohen is the founder of Hello Heart, a clinically based digital program that empowers people to understand and improve their heart health. Maayan is an experienced strategy and consumer behavior specialist. In her previous position, she ran the consumer goods and retail practice in a leading management consulting firm. She has managed several successful new-product launch projects for industry leaders, including Hyundai, Nestle and American Express. Maayan holds a BS in biotech and an MBA from Tel Aviv University.

Connect with Maayan Cohen:

• Crunchbase
• LinkedIn
• Twitter

Read the Full Transcription of the Interview:

Alejandro: Alrighty. Hello everyone, and welcome to the DealMakers show. I’m super excited about the guest that we have today. It is definitely a story where we’re going to be learning a lot about building, pivoting, financing, scaling, Coronavirus, crazy stories with big customers, and you name it. I don’t want to make anyone wait any longer, so without further ado, let’s welcome our guest today. Maayan Cohen, welcome to the show.

Maayan Cohen: Thank you so much, Alejandro. I’m super excited to be here.

Alejandro: So originally born in Israel, and there in Startup Nation, and I guess running around the fields there, so tell us about your life and your upbringing.

Maayan Cohen: Thanks for having me. I’m super excited to tell you more about myself and the company and share some of our experiences. I grew up in Israel, as you said, in a small town. I spent most of my childhood running around in potato fields, investigating insects and plants, and dreaming of one day becoming a scientist, which I kind of am today. It was really fun and a very free type of childhood. Israel is a weird country in which they let kids do a lot of crazy things. When I was 16, I decided that I wanted to take my professional life one step forward as a scientist, and I did an EMT class and started volunteering on ambulances. I think that connected me to touching people’s vibes and saving lives. So I’m proud to say that I had several successful resuscitations of people that went through heart attacks during that time, so it was really fun jumping on an ambulance in the middle of the night. “There’s somebody lying on the floor. We don’t know what’s going on.” And you come in and literally bring them back to life, so I think that’s also when my love for adrenalin set in.

Alejandro: Out of all things, Maayan, to volunteer for ambulances and resuscitating people at 16 years old. I remember at 16 years old, I was playing Play Station and not doing much. So, what triggered that for you?

Maayan Cohen: I don’t really know. I was always drawn to do things that are a little bit crazy, and a little bit impossible and are, “Are you sure you want to do this?” So I think that’s where it started, combined with a true passion for science, medicine, and healthcare. One of my friends started volunteering at the ambulances, and he told me about the crazy things that they do there. I’m like, “Really? They let you do that? You actually do the CPR and all that.” And he’s like, “Yeah. You have to wait for it. You have to sit and spend a few nights and do a few slow-type of calls, but in the end, once in a while, you get a chance to go out and save somebody from a car accident or from a heart attack.” I got super jazzed about that, and it became a passion. So I spent a lot of nights looking at the ambulance station and waiting for a call.

Alejandro: Wow. Just out of curiosity, when you’re resuscitating people and when you’re a first responder like that, you obviously get to see a lot of stuff. What kind of appreciation did that give you of life, and more importantly, I’m sure it has served you as an entrepreneur and how to deal with uncertainty?

Maayan Cohen: That’s a great question. I think seeing how fragile life is, is something that I started valuing at a very young age. Then the you-only-live-once type of realization that a lot of people have at an older age is something that I realized very, very young, and it, fortunately, came to meet me again in several stations throughout my life. Like, do what you want to do; be passionate about the things you want to do because you only live once. Also, being a first responder, you have to function no matter what’s going on around you, and no matter what the situation is, you need to deal with it in a crisis. Sometimes, you just need to put your feelings aside for a moment, deal with the situation, and optimize the resources that you have in front of you. Later, you can process what just happened, but you don’t have time to panic. You don’t have time to overthink things. I think that’s one of the reasons and one of the key-shaping experiences that got me to be a very decisive person. Sometimes, you just need to look at the facts, and even if you don’t have all of the information, you make a decision, and you go, and you deal with it with everything else going on around you later.

Alejandro: Yeah, no kidding. I’m sure it served you well with doing startups because that’s what this is all about. In your case, another pivotal moment was joining the army. Obviously, there, in Israel, it’s mandatory. But in this case, for you, I’m sure there’s a lot that you learned around leadership. What were some of the things that you learned around leadership, and what were you doing in the army?

Maayan Cohen: When I got drafted to the army, they let you fill in a survey; again, going back to that age, I was an adrenaline junky. And I was very patriotic, and I wanted to serve my country the best way I can, so I signed up for the most frontline position that existed for women. Today, you have more, but I signed up to be a trainer for field platoons. That means I got a chance to train and technically command soldiers that were older than me that came from all shapes and sizes of the country, including people that had very rough backgrounds. I was an 18-year-old girl coming in, and they needed to do what I needed them to do. So that was a huge lesson about leadership. I remember coming in at the beginning and yelling at them or telling them, “That’s what we need to do, and that’s it.” And they were looking at me like, “Ha! She’s trying to tell us what to do. That’s so cute.” I think that taught me a lot about leadership. It took me a few months to figure out how I can actually harness people to do what I need them to do. If they’re stronger, if they’re angrier, if they’re lazy and they don’t want to do things, you deal with all kinds of personalities. In the end, you need to get along, and you need to make things work even with people that you don’t always like or necessarily connect to, so that served me very well later in my career as well. That’s what my army service taught me. I was driving tanks. I was shooting heavy mortars. The other lesson I would say from all of that is that it literally taught me how to break through walls, which, again, is something that I use a lot today working as an entrepreneur in the healthcare field that has tons of walls everywhere, and you need to be very persistent in pushing things sometimes and finding a way to get through.

Alejandro: In your case, after the army, you studied biotechnology, and then you also did your MBA. I’m curious. What pushed you to get the MBA because it’s different from the biotech approach that you were going after. So why an MBA?

Maayan Cohen: The MBA came after a very sad realization of my life. I was doing my final projects in my biotech degree, and I was passing liquids from one jar to another for six months in order to do one experiment. And although, as a kid, I dreamed to be a scientist, I realized that this is actually how biotech scientists’ lives look. It’s very slow, very repetitive, and actually very technical in a lot of situations, and you just sit by yourself in the lab, or maybe there’s one person behind you that’s also super quiet. I realized this was not the life that I could live. So though I’m super passionate about science, I need to find a way to bring my science skillsets into the world in a different setting, and I can’t sit in a lab for the rest of my life. So I decided to switch to business. I did my MBA, and after that, I started working in admin consulting.

Alejandro: In consulting, one of the things that I’ve encountered is very successful entrepreneurs that I’ve interviewed that have come on the show had their background in management consulting. One of the things that they teach is how you’re able to grab a really big problem, and you break it down into small problems, and then you start tackling each one of those problems. Did you see any of that training or approach, and also, what did you learn about consulting, or what makes people that go to management consulting end up being such great entrepreneurs later on?

Maayan Cohen: That’s a great question. I think consulting draws entrepreneurial types that tend to be successful because, as our HR person once told me, “You’re all a bunch of really smart, talented people that don’t like to focus on only one problem and keep it going, but actually need a lot of diversity in your day-to-day, and you like that, and you’re not sure what you want to do with your career. That’s why you’re here.” It’s an incredible training ground for business skillset and its incredible training grounds for learning a lot of different skills in the business world. You basically get a first seat to huge leadership decisions to building strategy. You can see what works; you can see what doesn’t work. You get a chance to visit a lot of different organizations and understand their cultures and how that actually contributes to or hurts their success. I got a chance to lead or contribute to huge moves from merger and acquisition, from the time you write the synergy deck to the fact that you actually need to combine the two companies and launch it. And sometimes, you have to do layoffs as part of that, and you deal with a lot of human and business situations at the same time. I’ve seen a lot of very successful priced strategies, and I’ve had to fix a lot of unsuccessful price strategies, so you can see how painful it can be if you have the wrong strategy in place or if you don’t have the right guard in place, and you can see the dilemmas that CEO have anywhere from growth engines of how to grow the company. That’s funny. Last week we did a workshop in our company about growth engines for the next two years, and I was like, “That’s awesome. I’ve done it for my own company.” We’re at a point where we’re now—we haven’t established enough business that we need to actually start thinking about new growth engines for the future. I think it’s an incredible learning ground for all kinds of business skill sets.

Alejandro: As they say, ideas are dormant. They take time to incubate, and I guess for you, that experience as a teenager when you were 16, driving ambulances and resuscitating people, that was like the seed that had to be planted, and definitely, one thing that pushed you over the edge and was a massive trigger that led you into building the business was the unfortunate diagnosis of your boyfriend at the time. So tell us about what happened there, and what was the sequence of events that ended up with you bringing this company to life?

Maayan Cohen: Sure. That’s a very personal story. I was 25, and my boyfriend at the time was starting to have headaches. I saw all the signs, and things just didn’t add up. Sometimes, you have a gut feeling, but gut feelings I now know are actually based on a lot of facts and experiences that you have. It was going on for a while. He was tested by doctors, and everything was fine. One day, he woke up with a headache, and I’m like, “Listen. Something is wrong. There’s no chance that you’re 26, and you’re having this level of headaches. We need to go to the hospital now, and you need to get checked by a hospital, not by a doctor.” He looked at me, and I was like, “No, we’re doing it now.” Within a few hours, they diagnosed a brain tumor. He was already out for very urgent surgery. He was very close to losing his eyesight at the time. And the sky fell on me. I was 25, living with my boyfriend, and I became a caregiver. For two years, I collected medical records, finder, and I was tracking vital signs at home on paper and Excel. I spent two or three hours every night trying to understand what was going on. Is he doing better? Is he doing worse? Although I had a scientific background, and I can read a lab result, it was really hard to understand what was going on and what can we do about this patient. You have a five-to-ten minutes window with the doctor to ask questions, and that passes by. There’s actually so much you can do as a patient or as a caregiver to help the situation. There’s research that shows, by the way, of any condition, not just cancer, but also the heart and muscular skeleton that your social support, your nutrition, the sun exposure that you have, your exercise levels, there are so many factors that can completely affect the course of your disease and healing from death to full recovery that doctors don’t really train you on, and sometimes, they don’t even have the knowledge themselves. The toolkit that they have is mostly drugs and surgeries, and then they give very vague lifestyle tips around, “You need to eat better and exercise more and don’t be so stressed.” Great. That’s not very helpful. That’s when I realized that patients just don’t have any tools to understand and improve their own health, and that’s what I want to do. Things got better. He went into remission, and after he got better, I decided that’s what I wanted to do. So I quit my job, found an incredible co-founder whose expertise is designing UX, and we were off to the races with Hello Heart.

Alejandro: And that was the time you said hello to Hello Heart. All right. Good stuff. How did you come across this co-founder, and you had this idea now, and you needed someone to help you, so why did you think that this co-founder was the one, and how did you go about enrolling this person into becoming the person you would share the journey with?

Maayan Cohen: Ziv and I have known each other from way back, and we used to run all kinds of ideas together. Every time I came to him with a startup idea, he would laugh or tell me it was the worst idea he had ever heard. I would challenge him on a lot of things. He was head of design at eBay’s innovation center at the time. When I came up with Hello Heart, I didn’t run it by him initially, and I decided that’s what I wanted to do. I took a few months to think about it for real, and I knew that it would be very challenging because it’s a very big mission to empower people to understand and improve their health, but I decided that’s what I wanted to do, and this time I’m taking it seriously with Ziv, too. So I took him to dinner. I ordered a bottle of wine. Ziv never drinks, so I got him a little bit drunk. After half a glass of wine, he was done, and then I pitched. When he listened to the story, and when he listened to the mission, he just looked at me, and he was like, “Okay. I’m in. I need two months to leave eBay. Let’s go. Let’s do this. Let’s help people.” So it was very easy to convince him relatively. But why Ziv, why design? Our approach is very different. We’re coming to this mission from the patient’s side, or the member’s side, or the people’s side, not from the clinician side, which means that make or break of a company like this is the user experience, so building a very slick, simple, easy-to-use user experience that’s personalized to each one of our members is the key success factor of Hello Heart. I knew that design was going to be the make or break of the company, so that was the first person I needed to come in.

Alejandro: And for the people that are listening to get it, what is the business model of Hello Heart?

Maayan Cohen: Today, Hello Heart is basically a software solution that helps people understand and improve their heart health. It’s coupled with a wireless blood pressure cuff for the members. Our business model is B2B2C, so we sell through self-insured employers and health plans. We have over 50 large, mostly Fortune 500 clients today. And the next thing is that it’s a win, win, win. So the employers are saving money. We just had a study that was issued that showed that we saved over $1,800 per member per year on cardiac care because we were able to prevent catastrophic events in time mostly, and avoid inpatient surgeries, ER visits, and expensive imaging, and keep patients more with a PCP and have them manage their own condition. It’s a win for the patient because you get a tool that helps you understand what happens inside your body. You can catch risk in time and hopefully prevent heart attacks and strokes, and it’s free for you, and it’s obviously a win for Hello Heart because we can get both compensated for our services, but also, we have an incredible distribution channel to get to people. The reality is that a lot of people today with chronic conditions, although there’s more and more consumerization of healthcare, for chronic conditions, people still expect to get solutions from either their provider or their employer’s health plan. So we have to play with one of the sides, and we found payers and employers are a much strong partner for us because our interests are very aligned. We want to prevent serious and catastrophic events from happening together.

Alejandro: Why executing in Silicon Valley versus executing back in Israel?

Maayan Cohen: The sad truth is that I tried, and nobody understood what I wanted. Digital Health started eight years ago. It wasn’t even a market. It was an idea of like the world is going to go into digital health. There were some health-back, mostly in Mars, but it wasn’t really digital health. So people just didn’t understand what I wanted. The health scene in Israel is incredible, but there was no digital health scene in Israel, and we actually pounded on many, many doors for a very small community of investors that said that they liked digital health, and nobody understood what I wanted. So I packed my bags, took a suitcase, and came to Silicon Valley with a suitcase and a bike. I started biking myself into building a network and talking to angel investors until we got our seed round.

Alejandro: That’s incredible. Obviously, as an immigrant, and I relate myself to that too, coming here to the U.S., not knowing anyone, and figuring out your way, and especially building up those relationships with investors, it’s not easy. For some of the people that are listening and that are wondering, “Maybe I should go to the U.S. and build my network, too.” What are the biggest lessons that you learned from going about building your network from nothing, coming to a country where you especially didn’t know much?

Maayan Cohen: I think Silicon Valley has an incredible culture of pay-it-forward, and people are always excited to talk to entrepreneurs if you respect their time. If you reach out to a person and tell them, “Can I have a quick coffee or a quick conversation? I want to get your advice.” And explain why them, and invest the time in getting to them coupled with the true excitement and enthusiasm that you have as an entrepreneur, you can open a lot of doors, and people are always happy to help. Until today, by the way, I had so many coffee meetings, and so many people helped me when I was just entering the U.S. I made sure that I spent at least two or three meetings every week helping other entrepreneurs that reached out to me and asked for help today. I still do it, and I think I’m still in debt for humanity around the amount of help that I got when I started off. It’s possible if you’re nice to people and if you respect their time and if you respect their advice, and if you are telling a really compelling story with true passion of what you’re doing, Silicon Valley is the place for dreamers as they say. There are a lot of people that would love to help you and share their experiences.

Alejandro: Good stuff. In your case, you were talking about meetings with investors and so forth. How much capital have you guys raised so far as of today for Hello Heart?

Maayan Cohen: So far, we’ve raised $70 million. We’re a capital-efficient company, so we’re growing very fast, and we actually hit cash flow positive back in 2020. We’re investing a lot more in growth now, so our last round was larger, it was $45, but we actually made it pretty far at the beginning with not a lot of cash. That taught us all to be very efficient, innovative, automated a lot of things, and built to scale instead of just throwing a bunch of people at every problem that you have.

Alejandro: The last round that you guys did was in May, so that was your Series C, and you were alluding to it now on investing in growth. What is that moment where, and perhaps this was more like the shift from Series A to Series B, but what does it look like when you go from being in an early stage to all of a sudden, you’re in growth-stage mode? What are the main differences?

Maayan Cohen: There are a few differences. First, I don’t know the names of everybody who are in the company today. That happened a few weeks ago, and that was a shock to me. I think in the early days, the CEO can be the only engine in the company. As you scale, you need to work with a team. You’re the main engine. You’re driving the initiatives. Everything happened super-fast. When people get down, you encourage them. You grow a lot of people. A lot of people grew in Hello Heart and grew their careers. Some of them are founders and entrepreneurs themselves today, some are tech executives, but you teach, you grow, but you’re the main engine. As the company grows, you have to create more engines, and you have to hire people that can build their own teams and senior teams that can delegate work and drive a lot of initiatives themselves. I think that’s the main thing for me knowing I can trust other strong executives that work alongside me to build their own teams, build their own way of operating, drive their own passion and energy into their teams, and also be very calm with me not knowing what happens across the company and be able to trust a lot of people that work with you. A lot of CEOs tend to be control freaks, and so am I. So being able to trust the people you work with is very important. It took me some time to get to that point. Now I have an incredible team that I can trust without even looking back. When I go on vacations, I just close my phone, and that’s it. But getting to that point, I think, is the biggest difference—hiring people that are better than you, that you can trust, and letting them work.

Alejandro: How big is Hello Heart today for our listeners to get an idea. Is there anything you can share in terms of the number of employees or anything else?

Maayan Cohen: We’re 130 employees today. We’re still a very lean and effective company. I think one of the magical things that we do in our product is that we’re able to have very strong clinical outcomes at scale using software only. That’s what makes it so scalable. For members, it’s also a huge advantage because we’ve basically destroyed this model of a nurse needs to call you or a coach needs to call you and offer for you to change your behavior. We’re able to do it with software only, so nobody calls you. It’s super private. You can do it anytime, anywhere, and it’s tailored to your specific behavior, so it’s an incredible value proposition for the member. And also, financially, I don’t need 500 or 2,000 or 20,000 people to make an impact on hundreds of thousands and millions of lives.

Alejandro: Got it. Imagine, Maayan, that you go to sleep tonight, and you wake up in a world where the vision of Hello Heart is fully realized. What does that world look like?

Maayan Cohen: In a world where Hello Heart is fully realized. Every person that has a heart-risk condition has Hello Heart on their phone. They wake up in the morning. They can check their blood pressure. They can look at their cholesterol results. They can understand their own health. Incrementally, they’re continuing to improve their health. If they fall off the wagon, I call it, and something happens, they move, they have a new baby, something happened in their life, and they’re going back in terms of lifestyle, the app will continue to bring them back to life. And we’re saving millions of lives every year because we’re able to catch heart attacks and strokes in time and get these patients to get diagnosed and treated instead of getting there when it’s already sometimes too late. They either pass away, or they’re having very serious damage that shortens their lifespan and quality of life. If I can fall asleep and wake up, that’s the world I’d like to live in.

Alejandro: That looks like a beautiful world to me. It is incredible, the journey that you’ve had with Hello Heart all the way dating back to 2013 when you got started. That’s a lot of years in, I would say dog years, in startups because it’s tremendous, the experience, the ups, and downs. If you were able to go back in time, and you had the opportunity of having a chat with your younger self, maybe it’s that younger Maayan that now is stuck with all these medical records and figuring things out and really realizing that there’s something there that could be done from a business perspective. What would be that one piece of business advice that you would give to that younger Maayan before launching Hello Heart and why, given what you know now?

Maayan Cohen: I would say that the vision and the mission will always be key. I come from a business background and a science background, so I’m very data-driven, I’m very KPI-driven, and that’s always what keeps me going. But it’s amazing to see eight years later that still hiring employees, bringing new investors on board, bringing clients on board, and signing them up. In the end, what differentiates us as a company is that we actually care and that our mission is what drives us, including me. In the end, that was what wins over everything else, every competition that we have with an employee, with a client, with an investor. The business metrics have to be there, but in the end, the business metrics are there because of the mission and the passion that the rest of the team and I bring to life. So don’t forget to continue to be led by the mission and the vision and get distracted with KPIs because sometimes in your day-to-day you get there, and then you when I take a step back, I’m like, “Why us or why Hello Heart?” And I sit in front of people that tell me, “I hear a pitch every day, and it’s all about KPIs and savings, and growth, and blah, blah, blah. But this is different. You guys actually do that because you care. Because you care, I’m going to get good service. I know you’re going to get very far, and you’re going to fight through obstacles when they come up”. So continue to keep the passion alive no matter what happens, and do it because you actually want to do it.

Alejandro: Yeah, during the early days, that’s critical because that passion is what, especially, during the tough days, which there are 99% of them at the beginning, that passion when you’re having a tough day, it’s all a matter of reminding yourself why you got started in the first place, so I couldn’t agree more with letting that passion keep you in that driven type of mood. So, in your case, Maayan, what is a book that you wish you would have read sooner?

Maayan Cohen: Wow. My favorite book that is an entrepreneur of all time is The Hard Thing About the Hard Things by Ben Horowitz. I’ve probably read it about 20 times to date. By the way, Ben Horowitz is not one of our investors, but I still have a ton of respect for him because of that. And one of the chapters I keep reading, as you said, the entrepreneurial journey is hard. There are a lot of bad days in the beginning. You still have bad days later on, but they’re a little bit less, but they still come, and when they come, there’s more at stake. He has a chapter about the fight you have with yourself about why am I continuing to do this? And that’s one of the hardest things that I think entrepreneurs need to do is to figure out and find the strength within themselves how to deal with very tough challenges that they deal with and continue to fight forward enough even in tough days.

Alejandro: Amazing. Maayan, for our listeners, what is the best way for them to reach out and say hi?

Maayan Cohen: You can go to my LinkedIn account. It’s Maayan Gonnen-Cohen, or you can go to our website, or you can email me. [email protected]. I’m always happy to help. I’m always happy to meet new people in times where I have time for new meetings. And thank you so much for listening.

Alejandro: Amazing. Well, Maayan, thank you so, so much for being on the DealMakers show. It has been an honor to have you on the show today.

Maayan Cohen: Thank you, Alejandro, for the opportunity.

 

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