Healthcare is at a turning point. People are living longer, and an American who reaches 65 can now expect to live close to 20 more years, with much of that time managing conditions that used to be a death sentence. More people need more care across more of their lives, but care itself is changing on both sides of the exam room, and patients and providers face very real, albeit different, challenges.

The Patient Experience

On the patient side, how people pay for, understand, and monitor their own health is changing. With premiums at record highs, people are paying more out of pocket or going without insurance altogether. The CBO projects roughly 16 million more will be uninsured by 2034, and RAND estimates $664 billion in lost state Medicaid funding over the same period, with New York the second hardest-hit state after California.

Simultaneously, personalised, consumer-driven healthcare is finally within reach. AI is putting medical knowledge that used to sit behind a clinic door directly in patients' hands. With 1 in 3 Americans using AI for health and medical information, patients are behaving more like consumers, researching their disease and treatment options and arriving at medical appointments more prepared than ever.

Add to this an always-on stream of personal health data now available, with 57% of US adults owning a wearable, up from 13% in 2015. The Apple Watch can detect atrial fibrillation four times more often than standard care, Samsung's Galaxy Watch can flag sleep apnea with FDA-cleared accuracy, Dexcom's Stelo gives the 125 million Americans with prediabetes real-time visibility into their glucose, and the Oura Ring can spot early signs of illness up to three days before symptoms appear.

The Provider Experience

Providers face a different set of pressures. The independent practice is disappearing: as of January 2024, 77.6% of US physicians were employed by hospitals, health systems, or corporate entities - up from roughly two-thirds at the start of the decade. Those who remain are stretched thin, buried in administrative work, and short-handed against a projected shortfall of up to 86,000 US physicians by 2036.

Here, the opportunity is to help clinicians do more of what they do best. A provider drowning in administrative work can finally have some of it stripped away. Decision support tools at the point of care can help a generalist practice more like a specialist, which matters most where specialists are scarcest (for example, in obesity medicine where there are under 10,000 board-certified obesity medicine physicians relative to over 100 million Americans with obesity). The same tools are also what make precision medicine finally possible: a treatment plan built around a patient's own biology instead of a one-size-fits-all default.

We're looking for founders building healthcare companies that last. Ones defined by the trust, relationships, and depth of care that take years to earn and can't be shortcut.

Giant is a firm of former founders and operators, and we try to back people the way we would have wanted to be backed: with real conviction rather than a spread of small bets. And at the risk of sounding like every other VC right now, we’re also looking for healthcare founders using AI in novel ways.

Here’s what gets us most excited:

• ◦Becoming an ongoing part of a patient's care. Nearly a third of US patients don't have a primary care provider, and the ones who do often find the system disjointed and hard to navigate. Companies that give patients real continuity and a relationship that deepens as their needs change are solving something people have wanted for a long time.
• ◦Serving a truly unmet need. There are some specific areas with needs that we believe remain unmet. These include addiction, sleep, environmental health, fertility, and neurodivergent care.
• ◦Addressing the shortage of people. The shortage of professionals such as embryologists, BCBAs, specialists, and nurses is problematic, and thoughtful automation can meaningfully expand who gets access to care.
• ◦Closing enterprise-side gaps. There are ample opportunities to go deep enough to become a true enterprise partner, not just a feature that could be wiped out by Epic or OpenAI. We're especially interested in AI governance and deployment, payment integrity, provider data and credentialing, pharmacy infrastructure, and AI-driven drug development.

The most important thing is that a company makes the system genuinely better for the people in it. We look for founders who've spent real time becoming an expert in the problem they're trying to solve. We’re not afraid of reimbursement or regulation, and appreciate founders who take the “go slow to go fast” approach to building.

Seven of the twenty largest companies in the US by revenue are in healthcare, and the biggest of them out-earns both Apple and Alphabet. We believe there is an opportunity to disrupt these incumbents by building a generational healthcare company built around the right incentives. That company is being built right now, powered by AI, data, and compute that didn’t exist a few years ago, and I’m excited to find and support them. At the growth stage, we typically invest at Series B and beyond, writing checks in the $10–20M range, and we're glad to lead, co-lead, or join a strong syndicate.

If your company sits inside this thesis—or challenges a piece of it we haven't gotten right yet—we'd love to hear from you.