Editor’s Note: Max Sanders is our HBCU.vc Summer 2025 Fellow. 

On June 19, 2025, Goodie Nation convened a focused roundtable for healthtech investors, founders, and operators exploring the shifting dynamics of AI adoption, care delivery, procurement bottlenecks, and underserved patient engagement. Held on Juneteenth, the conversation was intimate but rich, bringing together leaders from startups, healthcare VCs, former hospital execs, and value-based care organizations.

This was not your typical roundtable. It was a working session where honest reflections about failed pilots, platform fatigue, and cultural blind spots took precedence over pitch decks. For founders and VCs who could not attend, this recap captures the key ideas, cautionary tales, and strategy pivots discussed.

AI as Infrastructure – But with Caution

The roundtable opened with a sharp metaphor: AI is a knife, not a magic wand. When used by experienced hands in the right setting, it can be transformative. But used indiscriminately or placed in high-friction environments (like prior authorization), it risks alienating key stakeholders.

One founder put it bluntly: “AI replacing prior auth is DOA.” The provider and payer ecosystem remains deeply risk-averse, especially when AI encroaches on reimbursement decisions or care gating. Instead, participants highlighted pragmatic entry points for generative and predictive AI—revenue cycle management (RCM), pre-visit planning, and ambient documentation.

VCs were urged to probe how founders plan to integrate within incumbent workflows and whether their pilots include both IT and operations champions. The group emphasized a key idea: AI that augments clinicians and staff is welcomed. AI that tries to replace or bypass will hit a wall.

Epic’s Shadow Still Looms Large

The most sobering founder anecdote came from a pricing transparency startup. Despite delivering 3x greater accuracy than existing tools, the CIO of the hospital declined to move forward because Epic already had a native module, and pushing a competing tool would risk friction with IT and compliance.

The lesson: Performance is not the sole determinant of adoption. Integration risk, internal politics, and Epic’s footprint all shape decision-making. If you are building in this space, you must know the governance map inside hospitals as well as you know your product’s feature set.

As the group discussed, integration points and political palatability often matter more than functionality. Unless you are explicitly replacing Epic (and ready to go to war), founders were advised to find adjacent or complementary lanes.

D2C Health Innovation – The BGB Case Study

Jasmine Marie, founder of Black Girls Breathing, shared a blueprint for the next generation of healthtech entrepreneurship. Her platform delivers community-driven mental health programming tailored to Black women, scaled to 66,000+ subscribers, all while remaining bootstrapped and profitable.

But what stood out was her data monetization model, not just community building. Jasmine partners with pharma and CPG brands to deliver insights from her user base, effectively blending a digital health platform with an agency offering.

“We do not waste time with some health systems. We go where Medicaid expansion, public health investment, and culturally-aligned needs intersect,” she noted.

Founders were encouraged to rethink binary business models. Especially in capital-tight markets, consulting, community campaigns, and data licensing offer monetization paths long before traditional SaaS traction.

The Rise of the Agency-Platform Hybrid

Building on Jasmine’s approach, the roundtable identified a new archetype in healthtech: the agency-platform hybrid. These companies combine software delivery with human-led insight, cultural fluency, and services. They do not win by product alone, but by offering trust, access, and understanding to brands, plans, and public agencies.

Joey Womack noted that some of today’s most sustainable startups are not pure tech, they are community-based infrastructure layers that monetize through multiple channels: surveys, partnerships, SDOH pilots, wellness programs.

For VCs in the room, it was a moment to reconsider what defensibility means. In Medicaid and CSR-aligned markets, empathy, representation, and executional trust often outperform proprietary code.

Private Equity Struggles & the Talent Bottleneck

Despite healthy EBITDA and clinical margins, the platform struggled to attract new dental talent. Why? “No young doctor wants to work in a system that still runs Windows 2007.” In an era of Slack, Notion, and AI charting tools, outdated IT stacks are a dealbreaker.

The implication for investors: tech debt is talent debt. And org design, onboarding, and digitization are no longer operational afterthoughts, they are core to enterprise value. Especially in fragmented services sectors, private equity firms must now price in the cost of workforce modernization.

The conversation also referenced General Catalyst’s recent announcement of its acquisition of Summa Health, a major integrated health system in Northeast Ohio. This move was viewed as emblematic of how larger, tech-forward investors are stepping into traditional healthcare, especially in secondary or underserved geographies. Attendees discussed how acquisitions could accelerate infrastructure upgrades, close IT gaps, and modernize care delivery models, potentially easing longstanding issues like clinician attrition and system fragmentation outside tier-one metro markets. As more sophisticated capital enters community-based healthcare, investors must pair financial engineering with long-term transformation strategies.

Policy Shifts & Underserved Markets

The roundtable closed with a discussion on converging needs in underserved urban and rural healthcare. From food deserts in Atlanta to home health deserts in Kentucky, attendees noted a growing opportunity for founders to serve where incumbents cannot or will not.

CMS and state-level programs were flagged as underrated channels for growth. Community paramedicine pilots, SDOH reimbursements, and value-based contracting for non-licensed providers (like EMTs or doulas) are expanding across states.

Jasmine Marie’s company is now evaluated based on population-level health metrics, like improvements in mammogram rates among Black women. These are the metrics public-sector buyers care about. Culturally specific, outcomes-based models are getting funded.

Investors were reminded: federal innovation budgets may be flat, but local demand is growing fast.

Call to Action

If there was one unifying message from the discussion, it was this: 2025 is not about “move fast and break things.” It is about moving tactfully and building trust. Whether through integration with existing systems and software providers like Epic, co-creation with clinicians, or contracts with Medicaid MCOs, the future of healthtech will reward alignment, not disruption for disruption’s sake.

As one attendee put it, “You do not sell into healthcare. You earn your way in.”

For founders, build products that align with workflows, not challenge them, embed empathy and community in your growth model, and create monetization optionality beyond just recurring SaaS.

For VCs, fund hybrid business models, not just pure tech, expand your definition of defensibility to include trust and talent retention, and pay attention to state and local funding pathways

 

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