A tool company
Sells into somebody else's care model
The buyer is a budget line. The market is limited by the software line item. The product can improve a task without changing who is accountable for the patient, the outcome, or the economics.
Care Delivery Fund II
Develop care delivery companies that make better care easier
Fund II is in formation. It is being explored at a $25M starting point, perhaps as high as $50M, to create, acquire, and operate clinician-led care delivery companies rather than to fund tools that sit alongside care.
For fifteen years healthcare venture has been dominated by software-first founders selling tools into somebody else's care model. That produced real companies, and it also produced a generation of products that sit alongside care rather than inside it.
The constraint has moved. AI has collapsed the cost of building software far enough that engineering throughput is no longer the scarce input. The scarce input is judgment about how care actually works: what to measure, where the workflow truly breaks, what a payer will pay for, and what a frontline team will adopt. Clinicians have that judgment and have rarely had access to capital or company-building infrastructure. Fund II exists to close that gap.
Own the reimagined care, not just the software
A care delivery company
Owns the reimagined care itself
It uses AI, novel devices, remote and asynchronous care, and ambient measurement to redesign what care is, where it happens, and who does it. It owns the delivery model when that is the fastest way to prove it, and partners with existing operators when they already have the trust, contracts, and capacity to deliver the reimagined model at scale.
Those two companies differ in buyer, market size, margin structure, talent model, evidence burden, and exit path. Fund II is built for the second kind.
Why clinicians lead
The best care-delivery ideas come from people who spent their careers inside care. Physicians, nurses, advanced practice providers, pharmacists, therapists, care managers, and the people who run the front desk see problems that are hard to find from outside the building.
Fund II favors clinically experienced founders, chief executives, and operators, then puts business discipline around them: governance, capital, technology, relationships, and experienced management. Clinical leaders are not advisors on somebody else's company. They decide which problems get solved, how capital gets allocated, and which workflows change. Their job is to design the reimagined care model, not just to choose the tools that sit inside the old one.
Clinical credentials alone are not the qualification. Leaders have to show judgment, accountability, and an appetite for business and technology expertise. The model is clinically led and professionally supported; not every executive or employee is a clinician.
The thesis
Every company in the fund has to contribute to a better end-to-end patient and caregiver experience. That rule decides where money, operating attention, and leadership time go. Each company also reimagines at least one part of how care is delivered, using AI, devices, remote care, or new operating models rather than merely speeding up the existing workflow.
Better patient and caregiver experience
Care that is easier to understand, reach, navigate, receive, and continue over time, including for the family members who carry most of the work between visits.
Better outcomes
Clinical, functional, financial, safety, access, or quality-of-life outcomes. Every company names the outcomes it intends to move and how progress gets measured.
Less burden on clinicians
Fewer administrative steps, fewer fragmented handoffs, less repeated data entry, less cognitive load: the friction that pulls clinicians away from patients.
Making the right action the easy one
Clinicians usually know what should happen next. Complicated workflows, thin time, administrative requirements, disconnected systems, missing information, and misaligned incentives make the right action the hard one.
The fund backs businesses that redesign those conditions rather than asking clinicians to work harder, remember more, or complete another task. The best action for the patient should also be the clearest and easiest action for the care team.
Of every opportunity we ask which entirely new form of care work becomes possible, and what that function is worth to whoever carries the risk for the outcome. Time savings get handed back to the buyer at renewal, so they rarely settle the question.
More flexible than a traditional fund
Care-delivery opportunities do not all follow one path. Some companies should be built from nothing. Some need a new owner and an operating partner. Others need capital, software, clinical leadership, or experienced management to reach what they already are. Fund II is structured to do any of it.
Create
Turn a strong care-delivery thesis into a focused company. The fund defines the problem, sets the strategy, assembles the leadership team, builds the operating foundation, and capitalizes it.
New capacity against a real care-delivery problem.
Acquire and grow
Buy or partner with existing care companies that have a real foundation and unrealized growth. The fund supplies operating discipline, software, governance, clinical insight, and capital.
Better care delivery at greater scale.
Own for the long term
Hold good companies without a predetermined exit clock. Care companies need time to earn clinician trust, sit inside the workflow, and produce measurable outcomes. The holding period follows the business.
Durable improvements clinicians can rely on.
Sell or spin out when appropriate
Some companies end up better served by a strategic buyer, new investors, or an independent structure. That decision is made on sustainable value and impact, not on a schedule.
The ownership model that best serves patients and the business.
What Fund II is not:
- A traditional venture capital fund
- A private equity fund
- An accelerator
- An incubator
- A consulting firm
- A short-term financial buyer
Parts of those models get used when they fit. None of them sets the rules. No company is forced into a common holding period, financing structure, or exit schedule.
How the fund deploys
The same opportunity can call for a different mode depending on founder readiness, data conviction, time to market, and how much capital and control the redesign requires. In each case we are looking for the most direct path to proving that a reimagined care model actually works.
Invest
A clinician founder is already in motion with a clear wedge and either early commercial signal or a design partner worth funding. The fund writes the check and brings a commercialization path, not a contact list.
Take selective control
A cash-flowing care operator—a service line, regional group, or specialty asset—can be re-platformed around AI-native workflow and moved toward at-risk reimbursement, either by taking control of delivery or by embedding the reimagined model inside a partner operator that already delivers care. Control or deep partnership is warranted when capital, software, and clinical leadership all have to move together.
Build
The data conviction is loud, the operating thesis is clear, and no suitable company exists or the right delivery partner is already in place. The fund designs, staffs, and capitalizes the reimagined care company, then pairs in the clinician CEO, or partners with an established operator to deliver it.
How an opportunity gets sized before a dollar moves
The intelligence engine is the Medigy Opportunity Atlas, built and running inside Fund I on CMS and claims data. Fund II starts with that analysis in hand instead of commissioning it.
The Atlas reads public payer data, quality signals, geography, labor data, research, and clinician experience as one system. It looks for the point where a care failure, a reimbursement path, and a new operating capability meet.
What it ingests
- CMS claims and reimbursement data
- Medicare Advantage encounter data
- MDS and OASIS assessments
- HEDIS measures and quality programs
- Star ratings
- Public utilization and geographic data
- Labor and licensure data
- Peer-reviewed care delivery research
- Clinician and operator signal
What it looks for
- Utilization mispricing
- Quality collapse
- Transition failure
- Capacity loss
- Referral friction
- Chronic-care leakage
- Reimbursement asymmetry
- Patient engagement failure
- Quality and cost asymmetry
- 01
Cohort
A population defined out of claims: diagnoses, utilization, and risk flags, not a market-research estimate.
- 02
Geography
County and metro-level targeting, so a deployment lands where the gap is largest rather than where the first meeting happened.
- 03
Signal
The specific CMS metric that shows the gap: readmissions, unmet quality measures, eligible services that are never billed.
- 04
Reimbursement path
Every code and bundle that makes the model pay, named before anyone builds anything.
- 05
Revenue at stake
Per-patient rate times addressable cohort times a capture rate the firm is willing to defend in writing.
Each pass ends in a decision. The Atlas identifies the pain point, locates the operational bottleneck, matches the clinician founder or operator, and says whether to invest, support, acquire, or build.
What an Atlas brief looks like
A useful brief names the cohort, the place, the public signal, the code stack, the company shape, and the founder or operator who should exist. Market size on its own is not actionable.
Diagnostics and home testing
Obstructive sleep apnea diagnosis gap
A large population shows sleep-related utilization and comorbidity patterns without a formal obstructive sleep apnea diagnosis or a completed home sleep test.
Illustrative value
$420M to $940M
Illustrative annual addressable revenue
Cohort
Medicare and commercial beneficiaries with claims for excessive daytime sleepiness, obesity hypoventilation, or habitual snoring, but no obstructive sleep apnea diagnosis in the lookback period.
Geography
Counties where sleep-related emergency utilization runs well above benchmark while home sleep test claim density sits near the bottom of the national distribution.
CMS signal
Hypertension, atrial fibrillation, and type 2 diabetes cluster in the same cohort. Undiagnosed patients consume materially more inpatient and cardiology spending than diagnosed and treated patients.
Reimbursement path
Home sleep testing codes, CPAP device reimbursement, chronic care management, and remote monitoring create a pathway that can pay for diagnosis and downstream management.
Market logic
The illustrative sizing comes from a small capture rate across the undiagnosed cohort, before device revenue or downstream management revenue.
Company shape
A convenient testing and treatment pathway that removes the device burden, works under the right laboratory and clinical governance, and targets geographies with weak incumbent coverage.
Founders and companies to find
- Home sleep testing platforms
- Direct-to-consumer diagnostics
- Remote CPAP management
- Primary care workflow operators
Provider operations
COPD spirometry gap in rural primary care
Patients with repeated respiratory utilization reach rural primary care without spirometry, a confirmed COPD diagnosis, or the recurring management reimbursement that follows diagnosis.
Illustrative value
$2,400+
Illustrative revenue per managed patient each year
Cohort
Patients with repeated emergency visits coded as acute bronchitis or unspecified respiratory failure, no pulmonary function test in the prior window, and no COPD diagnosis on record.
Geography
Rural counties where COPD-adjacent admissions rank high and the nearest pulmonologist is far enough away that primary care needs a practical screening path before referral.
CMS signal
COPD is part of the Hospital Readmissions Reduction Program. Hospitals in the flagged counties carry above-average readmission rates and a direct payment incentive to reduce them.
Reimbursement path
Spirometry opens the diagnosis. Chronic care management and remote physiological monitoring can then create recurring reimbursement for the right operating model.
Market logic
The illustrative model multiplies flagged rural practices, eligible patients per practice, and annual management reimbursement. Device revenue is separate.
Company shape
A rural primary care operator or platform that combines point-of-care spirometry, diagnosis capture, and billing infrastructure without adding another disconnected screen.
Founders and companies to find
- Point-of-care spirometry operators
- COPD management companies
- Rural primary care platforms
- CCM and RPM infrastructure teams
Cardiology and chronic care
Heart-failure remote monitoring
Cardiology practices and chronic-care companies already have the patients, penalty exposure, and billing codes. Many still do not use remote monitoring for their highest-risk heart-failure population.
Illustrative value
$1,440 to $2,400
Illustrative revenue per patient each year
Cohort
Medicare beneficiaries with a primary heart-failure diagnosis, repeated hospitalization in the prior year, and no remote monitoring claim from the treating cardiologist or care-management company.
Geography
Metropolitan areas where heart-failure readmission rates are elevated while remote monitoring claim density among attributed patients remains low.
CMS signal
Readmission penalties, cardiology utilization, and the existing RPM and CCM code stack point to an operating gap rather than an absence of reimbursement.
Reimbursement path
The RPM setup and monitoring series can stack with chronic care management, creating recurring annual reimbursement for practices that operate the workflow correctly.
Market logic
The illustrative value is revenue per managed patient, not a claim that every eligible patient can or should be enrolled.
Company shape
A clinician-led monitoring service that owns enrollment, escalation, documentation, billing, and cardiology review rather than selling another dashboard.
Founders and companies to find
- Cardiology service companies
- Heart-failure monitoring operators
- CCM and RPM companies
- Clinician-led chronic care teams
Value-based care operations
Chronic Care Management capture
Eligible patients sit in primary care panels while practices leave Chronic Care Management reimbursement unclaimed because consent, documentation, time tracking, and review are still operationally hard.
Illustrative value
$744 to $1,584
Illustrative annual reimbursement per enrolled patient
Cohort
Medicare beneficiaries with two or more chronic conditions who are eligible for Chronic Care Management but have no CPT 99490 or related management claim in the measurement window.
Geography
Practices and counties where eligible chronic disease panels are large, CCM billing penetration is low, and staffing constraints make manual enrollment unrealistic.
CMS signal
Eligible patients generate avoidable utilization while practices fail to claim the management revenue CMS already makes available.
Reimbursement path
CPT 99490 and related codes create recurring monthly reimbursement when consent, care planning, time tracking, and clinician review are handled correctly.
Market logic
The illustrative range reflects annual reimbursement per enrolled patient. The operating question is how much of the eligible panel can be enrolled and served credibly.
Company shape
An AI-assisted care-management operation that handles the routine work, keeps clinicians accountable for review, and gives practices a service rather than another task list.
Founders and companies to find
- CCM operating companies
- Primary care enablement teams
- AI care-management platforms
- Value-based care operators
These are illustrative briefs drawn from public CMS data patterns. Figures show how the Atlas frames an opportunity; they are not current claims, return projections, or offers to invest.
What the fund would back
AI-native chronic care
Continuous, agent-augmented management of the conditions that drive most of the spend, in place of episodic and reactive care.
Legacy disease-management vendors still sit inside episodic workflows and pre-AI staffing models.
Post-hospital redesign
Accountable post-acute models built against bundled and at-risk economics, where quality and cost most often collapse.
Home health and skilled-nursing rollups often optimize census rather than outcomes inside an episode.
Care-transition ownership
Companies that own the seam between sites of care: staff, software, and accountability under one roof.
Care-management software often records the seam without owning the outcome.
Reimbursement-aligned specialty care
Specialty models priced for the next reimbursement curve rather than financial rollups wearing a clinical label.
A financial structure can aggregate clinics without redesigning the specialty model for the next contract.
Digitally enabled care teams
Companies that hire and equip the clinicians instead of selling another tool that adds clicks.
A point solution cannot rewire workflow when it does not own the team.
Clinician-led service platforms
Services with proprietary software inside, priced correctly on both sides and compounding on each.
Pure software underprices the clinical work. Pure services underprice the technology leverage.
Engagement that moves outcomes
Engagement measured in adherence, biomarkers, and admissions, the things a buyer actually pays for.
Portals and reminders can report activity without moving adherence, biomarkers, or admissions.
The wider aperture, where the same rules apply:
- Healthcare services and care delivery
- Digital health and healthcare technology
- AI-enabled healthcare businesses
- Patient engagement and navigation
- Caregiver support
- Care coordination and continuity
- Healthcare data and workflow infrastructure
- Clinician workflow and burden reduction
- Revenue, administrative, and operational services
- Specialized business services for healthcare organizations
- Overlooked healthcare opportunities with strong fundamentals
This list is not a boundary. Each opportunity is judged on its own case.
What gets asked of every opportunity
- 01
Does it address a real problem for patients, caregivers, clinicians, or care teams?
- 02
Does it improve the end-to-end care experience rather than optimizing one isolated transaction?
- 03
Can it move clinical, functional, financial, safety, access, or quality-of-life outcomes?
- 04
Does it remove unnecessary work or cognitive burden from clinicians?
- 05
Does it make appropriate care easier to deliver and easier to receive?
- 06
Can the impact be measured with credible, practical indicators?
- 07
Is the business model aligned with better care rather than dependent on avoidable friction?
- 08
Would the fund's capital, operating support, technology, and relationships materially change its odds?
Nothing has to answer all eight. Every company needs a credible connection to better care delivery and real impact on patients, caregivers, or clinicians.
When the fund builds instead of funding
A build starts when three things line up in the evidence: a sized gap in the data, a reimbursement opening, and a workflow redesign that AI has only just made possible. Then the clock is 90 to 180 days: design partners approached in the first 60, the first clinical workflow live by 120, first revenue in sight by 180, and a clinician CEO paired in rather than recruited afterward.
The operating model, the target buyer, the contract chassis, and the unit economics are settled before incorporation. If they cannot be settled, the build does not start.
What a company gets
Capital and company formation
Capital formation, investor relationships, entity and cap-table structure, and the work of standing a company up.
Diligence and operating plans
Clinical, market, technology, financial, and regulatory diligence, then an operating plan with measurable goals and a governance rhythm.
Technology, data, and AI strategy
Architecture, data and cybersecurity posture, and the AI strategy that decides which new form of care work the company can actually perform.
Growth and market access
Business development, payer and provider access, and a commercialization path rather than an introduction list.
Executives and shared services
Executive recruitment, leadership development, and shared finance, administrative, and technical services across the portfolio.
Outcome definition
Defining what the company will move, how it gets measured, and what evidence is published when it does not work.
The path from conviction to company
- 01
Clinical conviction
The clinician or operator names the workflow that has to change and the evidence that the status quo is failing.
- 02
Data validation
The Atlas sizes the cohort, geography, CMS signal, reimbursement path, and revenue at stake before capital moves.
- 03
Venture design
The operating model, target buyer, contract chassis, leadership need, and first unit economics are settled.
- 04
Pilot strategy
The first design partners are chosen for evidence value and procurement realism, not for a friendly logo.
- 05
Market entry
The company goes through workflow validation, security review, contracting, launch, and the first revenue motion.
- 06
Scale
Follow-on capital, shared services, payer and provider access, and selective control support the company as the evidence compounds.
How companies get to market
Clinical credibility opens the first conversation. It does not finish the sale. Fund II treats commercialization as an operating discipline that starts before the company is formed and continues after the first contract is signed.
- 01
Identify reimbursed demand
Start with a cohort, a place, a payer signal, and a reimbursement path rather than a product looking for a budget.
- 02
Pressure-test the workflow
Put the proposed work in front of the clinicians, operators, patients, and buyers who would have to live with it.
- 03
Shape the contract path
Map the buyer, code, bundle, value-based arrangement, security review, and procurement route before the pilot starts.
- 04
Line up the first proof
Sequence design partners and pilots that can answer the commercial question, not just produce a case study.
- 05
Stay through the sale
Remain involved through procurement, implementation, contracting, renewal, and the operating work that makes early revenue repeatable.
How impact is measured
Each company defines a small set of practical measures that connect business performance to a change in care. The measures vary by company, and every company has to name its own up front.
- Clinical or functional outcomes
- Patient and caregiver experience
- Access to care
- Time to diagnosis, treatment, or follow-up
- Care coordination and continuity
- Preventable complications and avoidable utilization
- Clinician time returned to patient care
- Administrative steps eliminated
- Staff workload and burnout indicators
- Patient understanding and adherence
- Affordability and financial burden
- Access across different populations
These are the principles used to select, support, and operate companies. They are not results we claim to have produced.
Status
Fund II is in formation. Nothing here is an offer, and we make no claim about returns. Fund I is the live vehicle, and the ventures it holds are the evidence Fund II will be judged on.
The right people to write are clinicians with a thesis, owners exploring a sale or recapitalization of a care business, executives and operators who want to run one, strategic partners with a market need worth a company, and co-investors who read claims files.