Becker Private Equity & Business Podcast
Dhrooti Vyas on Building Crosswalk Health and the Power of Healthcare Incubation 5-21-25
Wed, 21 May 2025
In this episode, Dhrooti Vyas, Co-founder at a value-based care startup and expert in healthcare incubations, joins Scott Becker to share her perspective on what makes a healthcare startup truly impactful.
Chapter 1: What is Crosswalk Health and its mission?
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 healthcare more broadly.
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?
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.
Chapter 2: What role do healthcare incubations play in startup success?
And tell us about that and tell us where that would fit in. Is that at the seed stage? Is that closer to more at the venture stage? How does that look? And what are the different stages when people invest in healthcare 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?
Chapter 3: How do investment stages differ in healthcare startups?
Yeah. So I am thinking about venture scale health care companies and those that have the potential to generate financial return on a seven to 10 year time frame and have the potential to exit for call it over 100 million dollar outcome. And it's very interesting when we think about healthcare startups.
If you look at the traditional pathway of starting a startup, so for example, if you look at healthcare startups that go through Y Combinator, Y Combinator's overall realized moik on healthcare is that 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 health care, 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 TrellisRx or Landmark Health.
Some are slightly more complex stories, two entities that merged and then brought in some corporate backing. Progeny's story looks something like this. But, you know, when I think about these data points, my takeaways are twofold. One is that there's a lot of complexity to the American health care 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 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 companies that already are demonstrating great unit economics and viability.
and talk to us about what does it mean to incubate? You know, obviously we're familiar with the term from birthing wards and we're familiar with it. Some in venture capital or early stage companies with Y Combinator and others. What is, how do you define incubating? Just because a lot of people like myself are 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?
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 kind of go-to-market playbook that the company can follow to grow. It's really hard for all of these elements to come together themselves.
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Chapter 4: What does it mean to incubate a healthcare startup?
Chapter 5: What are the challenges of starting a healthcare startup?
Does that mean you're the first founder or hire the CEO, find some seed capital? What does that mean?
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 kind of go-to-market playbook that the company can follow to grow. It's really hard for all of these elements to come together themselves.
So creating kind of a contained environment that brings them together.
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?
Wow, that's a toughie. I got to say my alma mater. I don't know what else to say, Scott. You didn't go to business school, did you?
No, I did not. But nothing better than the University of Chicago for business school and just a general academic institution. So brilliant, brilliant, brilliant people. So fantastic. Sort of the home of Milton Friedman and some of the other brilliant, brilliant people from the economics and business perspective. So fantastic. Tell us about Crosswalk and what you all do at Crosswalk.
Yeah, so Crosswalk helps EMS agencies get compensated for the value that they're delivering in their communities. So the story behind Crosswalk is 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'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 writing 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.
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Chapter 6: What are the key ingredients for building a successful healthcare company?
Chapter 7: What insights can be drawn from successful healthcare exits?
So creating kind of a contained environment that brings them together.
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?
Wow, that's a toughie. I got to say my alma mater. I don't know what else to say, Scott. You didn't go to business school, did you?
No, I did not. But nothing better than the University of Chicago for business school and just a general academic institution. So brilliant, brilliant, brilliant people. So fantastic. Sort of the home of Milton Friedman and some of the other brilliant, brilliant people from the economics and business perspective. So fantastic. Tell us about Crosswalk and what you all do at Crosswalk.
Yeah, so Crosswalk helps EMS agencies get compensated for the value that they're delivering in their communities. So the story behind Crosswalk is 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'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 writing 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.
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