Dhrooti Vyas on Building Crosswalk Health and the Power of Healthcare Incubation 5-21-25

Summary

Becker Private Equity & Business Podcast: Dhrooti Vyas on Building Crosswalk Health and the Power of Healthcare Incubation

Release Date: May 21, 2025

In this enlightening episode of the Becker Private Equity & Business Podcast, host Scott Becker engages in a compelling dialogue with Dhrooti Vyas, a visionary leader in healthcare entrepreneurship and investment. The conversation delves into the intricacies of building venture-scale healthcare companies, the unique challenges of the American healthcare system, and the transformative potential of healthcare incubations. Below is a comprehensive summary of their discussion, highlighting key insights, notable quotes, and the overarching conclusions drawn during the episode.

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1. Introduction to Dhrooti Vyas and Her Current Focus

Timestamp: [00:00] – [02:03]

Scott Becker opens the episode by introducing Dhrooti Vyas, a multifaceted healthcare entrepreneur, builder, and investor. Dhrooti provides a brief overview of her background, mentioning her latest venture, Crosswalk Health, a value-based care enablement startup designed to support Emergency Medical Services (EMS) agencies in monetizing the critical yet often unrecognized care they provide within communities.

Key Points:

• Crosswalk Health: A startup focused on enabling value-based care for EMS agencies.
• Current Endeavor: Developing a new healthcare company creation platform aimed at fostering healthcare incubations.

Notable Quote:

"Healthcare incubations are a particularly fantastic way to commercialize innovation in this industry." — Dhrooti Vyas [01:11]

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2. Understanding Healthcare Incubations

Timestamp: [02:03] – [05:33]

Scott probes into the concept of healthcare incubations, seeking clarity on its definition and operational mechanics. Dhrooti articulates that incubation involves assembling the essential components necessary to launch a successful company. This includes the initial business concept, seed capital, a competent leadership team, and a strategic go-to-market plan.

Key Points:

• Venture-Scale Healthcare Companies: Targeting businesses with the potential for significant financial returns within a 7-10 year horizon and exits exceeding $100 million.
• Comparison with Traditional Startups: Healthcare startups, unlike their consumer and fintech counterparts, often struggle to achieve high MOIC (Multiple on Invested Capital) without incubational support.
• Success Rates: Only about 17.5% of health tech companies have successfully exited for over $100 million post-ACA, with a notable portion being incubations or corporate spinoffs.

Notable Quotes:

"If you look at healthcare startups that go through Y Combinator, their MOIC is somewhere between 1 and 2x, whereas in consumer and fintech, it’s closer to 7 to 8x." — Dhrooti Vyas [02:39]

"Healthcare incubations are a mechanism for scaling companies that already demonstrate great unit economics and viability." — Dhrooti Vyas [04:22]

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3. Defining the Incubation Process

Timestamp: [04:22] – [05:33]

Scott seeks a deeper understanding of what incubation entails beyond the general definition. Dhrooti emphasizes the importance of creating an environment where all critical elements—concept, capital, leadership, and strategy—are synergistically integrated to foster company growth.

Key Points:

• Essential Components: Business idea, initial funding, leadership team, and growth strategies.
• Facilitation Role: Incubators act as catalysts, bringing together necessary resources and expertise to ensure the startup's success.

Notable Quote:

"Incubating means bringing together the ingredients necessary to create a great company." — Dhrooti Vyas [04:51]

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4. Dhrooti's Academic Background and Influences

Timestamp: [05:33] – [10:56]

The conversation shifts to Dhrooti’s educational journey, highlighting her dual affiliation with the University of Chicago for both undergraduate and business studies. She praises the institution’s academic excellence and vibrant intellectual environment, which have significantly shaped her professional ethos.

Key Points:

• Educational Influence: The University of Chicago's rigorous academic environment and notable alumni have been instrumental in Dhrooti's development as a leader.
• Academic Excellence: Emphasis on the university's contribution to economics and business thought leadership.

Notable Quote:

"Undergrad was just so fun exploring a bunch of different ideas and it just was really a place to flourish." — Dhrooti Vyas [10:06]

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5. Deep Dive into Crosswalk Health

Timestamp: [06:22] – [10:06]

Dhrooti elaborates on the mission and operations of Crosswalk Health. The company aims to bridge the gap between EMS agencies and payers, ensuring that EMS providers are compensated not just for transportation but also for the preventative and community-based care they deliver. She shares compelling on-the-ground experiences that highlight the critical role of EMS in addressing non-emergency health needs and the systemic challenges they face.

Key Points:

• EMS as a Social Safety Net: EMS often serves as the primary response for non-emergency situations due to gaps in the healthcare system.
• Uncompensated Care: EMS agencies provide valuable interventions in the community without adequate financial recognition.
• Preventative Measures: Crosswalk Health facilitates connections with payers to incentivize EMS agencies to engage in preventative care, thereby reducing unnecessary 911 calls.

Notable Quotes:

"We estimated that something like 90% of 911 calls didn't actually need medical emergencies." — Dhrooti Vyas [08:25]

"Crosswalk is solving is getting EMS agencies connected to health insurance companies to payers to risk-bearing provider groups so they can get compensated for providing interventions in the community that stop the 911 call before it happens." — Dhrooti Vyas [08:53]

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6. The Overwhelming Burden on EMS Providers

Timestamp: [08:53] – [10:06]

Scott raises concerns about the inundation of EMS services with non-emergency calls, exacerbating the strain on emergency departments. Dhrooti confirms this, noting that the high volume of non-critical calls delays responses to genuine emergencies, highlighting the necessity for solutions like Crosswalk Health to optimize EMS workload and resource allocation.

Key Points:

• Resource Strain: Non-emergency calls overwhelm EMS services, leading to slower response times for true emergencies.
• Systemic Issues: Lack of access to primary care drives reliance on EMS for non-critical health issues.
• Solution Impact: By compensating EMS for preventative care, Crosswalk Health aims to alleviate the burden on emergency services and improve community health outcomes.

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7. Closing Remarks and Final Thoughts

Timestamp: [10:56] – [11:22]

As the conversation wraps up, Scott commends Dhrooti on her impressive career and the impactful work she’s spearheading at Crosswalk Health. Dhrooti expresses gratitude for the opportunity to discuss her endeavors and reiterates her commitment to fostering innovation in the healthcare sector through effective incubation strategies.

Key Points:

• Recognition of Efforts: Emphasis on the significance of Dhrooti’s work in transforming EMS roles and enhancing community health.
• Commitment to Innovation: Continued focus on building platforms that support the creation and scaling of high-impact healthcare companies.

Notable Quote:

"What you're doing is fascinating—incubating healthcare companies, what you're doing with Crosswalk." — Scott Becker [11:03]

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Concluding Insights and Takeaways

Dhrooti Vyas's insights shed light on the transformative potential of healthcare incubations in addressing systemic challenges within the American healthcare system. By strategically supporting EMS agencies through platforms like Crosswalk Health, there is a pathway to not only alleviate the strain on emergency services but also to foster a more proactive and preventative approach to community health. Her emphasis on the critical components of successful incubations underscores the importance of holistic support in nurturing venture-scale healthcare enterprises capable of delivering substantial financial returns and societal impact.

Final Thoughts:

• Healthcare Incubations as Catalysts: Effective incubations can bridge gaps in the healthcare system by supporting startups that address unmet needs.
• Strategic Investments: Focusing on venture-scale companies with strong unit economics can yield significant returns and advancements in healthcare delivery.
• Community-Centric Solutions: Empowering EMS agencies to act as care navigators enhances community health and reduces unnecessary emergency responses.

This episode offers valuable perspectives for entrepreneurs, investors, and stakeholders in the healthcare sector, highlighting the importance of innovative incubation models in driving meaningful change and achieving sustainable business success.

Transcript

[A]

This is Scott Becker with a special combined episode of the Becker's Healthcare Podcast and the Becker Private Equity Podcast. We're thrilled today to be joined by a brilliant leader and thinker and investor, Truthi Vaz. And Truth is going to talk to us about what she's doing, how she looks at healthcare and a lot more. Truthi, can you take a moment to introduce yourself and tell us a bit about what you do?

[B]

Thank you so much Scott and thank you for having me on. So, as Scott said, I'm Dhruti. I'm a healthcare entrepreneur, builder and investor. I most recently founded a value based care enablement startup called Crosswalk Health which helps EMS agencies get compensated for the high impact, often invisible care they deliver in the community. I'm now working on something new, but today I'll tell you about Crosswalk and then I'll tell you a bit about what I've learned about building venture scale businesses in health care more broadly.

[A]

Yeah, tell us a little bit about Crosswalk, but take a moment first and tell us where you're most focused today. What are you most focused on currently?

[B]

Yeah, so I am working on a new healthcare company creation platform. Healthcare incubations are a particularly fantastic way to commercialize innovation in this industry and I can share some of the reasons why. I am very bullish about this thesis and how we're thinking about it and.

[A]

Tell us about that and tell us where that would fit in. Is that at the seed stage? Is that closer to more the venture stage? How does that look and what are the different stages when people invest in health care companies? Because a lot of our audience is all over the board in this, whether they're familiar with seed stage versus not versus venture stage versus PE stage, where do you fit in and what type of companies would you look at wanting to help seed and incubate?

[B]

Yeah, so I am thinking about venture scale healthcare companies, those that have the potential to generate financial return on a seven to ten year time frame and have the potential to exit for call it over $100 million outcome. And it's very interesting when we think about healthcare startups. If you look at the traditional pathway of starting startups, for example, if you look at healthcare startups that go through Y Combinator, Y Combinator's overall realized MOIC on healthcare is somewhere between 1 and 2x, whereas in the consumer and fintech investments that hovers closer to 7 to 8x. And if you look at the flip side, if you look at healthcare health tech companies that have successfully exited for over $100 million since the passage of the ACA and returned investor capital. It's some 17.5% of those are incubations or corporate spinoffs. Think companies like Trials Rx or Landmark Health. Some are slightly more complex stories. Two entities that merged and then brought in some corporate backing progeny. Story looks something like this. But when I think about these data points, my takeaways are twofold. One is that there's a lot of complexity to the American healthcare system. So it's hard for an entrepreneur in the wild to start a health tech startup and be successful. There's a lot of alpha to being able to be slow and considered and in the early days of launching something new. And then the other takeaway is that there are a lot of places in the healthcare ecosystem where things are working quite well, but they're subscale. So this is the story of Trellis. This is hopefully our story with Crosswalk Health, the last company I incubated. And that makes me feel very bullish about incubations as a mechanism for scaling these. These companies that already are demonstrating great unit economics and viability.

[A]

Talk to us about what does it mean to incubate? You know, obviously we're familiar with the term from birthing words and we're familiar with it some in venture capital or early stage companies with Y Combinator and others. How do you define incubating? Just because a lot of people like myself aren't really sure exactly what that means. Does that mean you're the first founder or hire the CEO, find some seed capital? What does that mean?

[B]

Yeah, so incubating, I would say means bringing together the ingredients necessary to create a great company. So that includes the concept behind the company, some initial capital, a great CEO and founding team to lead it and scale it, and a general go to market playbook that the company can follow to grow. It's really hard for all of these elements to come together themselves, creating a contained environment that brings them together.

[A]

Thank you. Now, in addition to being a founder and incubator, you're also a double University of Chicago person, University of Chicago undergrad, University of Chicago Business School. And what is the best business school in the country?

[B]

Wow, that's a toughie, I gotta say. My alma mater. I don't know what else to say. Scott, you didn't go to business school, did you?

[A]

No, I did not. But nothing better than University Chicago for business school and just a general academic institutions. So brilliant, brilliant, brilliant people. So fantastic. Sort of the home of Milton Friedman and so many other brilliant, brilliant People from the economics and business perspective. So fantastic. Tell us about Crosswalk and what you all do at Crosswalk.

[B]

Yeah. So Crosswalk helps EMS agencies get compensated for the value that they're delivering in their communities. So the story behind Crosswalk like, the 911 system has effectively become the default social safety net for our communities, but it isn't paid for that. So in the process of incubating Crosswalk, I visited maybe 10 or so EMS agencies around the country, and it's so fascinating to be in an ambulance with a paramedic or an emt. I highly recommend it to anyone that's building solutions for vulnerable communities. But, you know, you're in the ambulance, most of your time is spent waiting for the next call. And when the next call comes in, it's often not a medical emergency. So some of the calls that I had the privilege of being of riding along for included, you know, a woman that had stomach pain for seven days. She couldn't get a primary care appointment. Her local urgent care wouldn't take her insurance, so she called 911. Someone that had fallen and couldn't get back up. And then we dug into it a bit more. It turned out they'd fallen because they couldn't pay their utility bill and they couldn't see. You also have stories of people that encounter an unhoused individual on the street and they call 911. And, you know, all that EMS today gets compensated for doing is transporting those individuals to the emergency department. But EMS agencies around the country are trying to solve this problem on their own. So they've become some mix of care navigators, getting people enrolled in Medicaid, trying to fix the utility bill problem, et cetera, et cetera, but they're not getting paid for it. Yeah, yeah.

[A]

And let me ask you a question there, because I see this now more clearly. So EMS providers, if I look at emergency departments, they're just overwhelmed. Recently, I had one of the elderly people in our family in the emergency department. Incredibly challenging, even with knowing everybody. And so in terms of EMS today, are they just overwhelmed with calls? Because people don't have access to primary care, they don't have access to healthcare. So EMS just gets overwhelmed today. Is there some of that going on, or how does that look?

[B]

Yeah, that's exactly right. That's exactly right. You know, we estimated that something like 90% of 911 calls didn't actually need medical emergencies, did not need transportation to the emergency department. And, yeah, like, EMS agencies are getting overwhelmed. And what that ends up doing is, you know, it takes longer to get to the people that do have two medical emergencies. So that, that's the, that's the problem that Crosswalk is solving is getting EMS agencies connected to health insurance companies to payers, to risk bearing provider groups so that they can get compensated for providing interventions in the community that stop the 911 call before it happens. Right. Like that. Make sure a utility bill is paid, make sure a person in the community has access to Meals on Wheels or whatever social services it is that they need. And you know, yeah. Just getting compensated for creating more healthful communities.

[A]

Fantastic what you're doing, Dorothy. Just fantastic. Amazing. One more question. When somebody gets in the University of Chicago to high school, they go there to business school, what does that academic household look like? When somebody's that brilliant and that intelligent, what does that look like? Give me a sense that you're flattering me.

[B]

Oh, my God. I don't know if I can take all these compliments. I had a great time. I mean, yeah, like, undergrad was just so fun exploring a bunch of different ideas and it just, it was really, it was really a place to flourish. And business school was fun in a very different way. So I had a great time. Much love to the city of Chicago and its great universities.

[A]

And for those that don't know, I think the Maroons. Is it still called the Maroons? University of Chicago.

[B]

That's right. That's right.

[A]

So best of luck to University of Chicago Maroons as well. Truthy, what a magnificent pleasure to visit with you. Fascinating what you do in terms of incubating healthcare companies, what you're doing with Crosswalk. You've worked with a bunch of different startups. Just fascinating career. Thank you for joining us in this combined episode, the Back of Healthcare and the Back of Private Equity podcast. Thank you very, very much.

[B]

Thank you, Scott. Thanks so much for having.