Building in Health
Why the Next Winners Won’t Pick a Side
Everyone’s asking the same question: should you build in wellness - or healthcare?
My answer: why not both?
The biggest winners in health won’t be those who pick a side - they’ll be the ones who connect the two.
Health is no longer confined to hospitals or clinics. It’s on our plates, our wrists, it’s with us while we sleep, and part of every daily decision we make. The entrepreneurs who recognize health as both a trillion-dollar consumer movement and a $4.5T healthcare system will define the next generation of market leaders.
The Healthcare Reality
Building in traditional healthcare is slow and complex.
Customers are large and deliberate - insurers, employers, health systems, and government. Just getting in the door often requires unpaid pilots. Even if those go well, it can take 18-24 months to convert to paid contracts. For many startups, reaching true product-market fit takes 3–5 years.
That timeline is brutal when about 40% of startups don’t survive past year three. Many never get the chance to show results, while other founders face steep dilution just to stay alive long enough to prove traction.
That said, success is possible. With the right founding team, early client partners, and committed investors, there will always be home run healthcare companies. And with healthcare spend accounting for 20% of U.S. GDP - our largest industry - the prize can be massive.
Healthcare isn’t going anywhere.
The Wellness Boom
Wellness is being celebrated like never before. Consumers are spending trillions on healthier food, diagnostics, functional health clinics, supplements, wearables, and more.
It’s easy to see why wellness feels so exciting. It dominates headlines, floods our social feeds, and fuels dinner table debates. From biomarkers to plant medicine, saunas to sleep optimization, whole-body MRIs to microplastic-free diets…proactive, personalized, and preventive care is going mainstream.
The global wellness industry is already worth $6T and is projected to hit $8T by 2030. Consumers are making health a top priority - across nutrition, dementia, infertility, depression, addiction, and more.
And for startups, building a company in wellness comes with real advantages:
Speed to market. You can launch quickly. Consumer demand is already there, without waiting on B2B approval cycles.
Paying customers from day one. Early adopters are willing to fund their own health journeys, giving you revenue while you prove outcomes.
Proof of outcomes in real time. Consumer feedback loops are fast, helping you validate efficacy and refine your product before expanding into healthcare.
Brand-first advantage. Direct consumer relationships build loyalty and trust that are hard for healthcare incumbents to replicate.
Optionality to expand. Once you demonstrate value in the wellness market, you can layer into the $4.5T healthcare ecosystem with channel partnerships via insurers, employers, health systems and the government.
Why We’re All-In on Health
At Pave, we don’t see healthcare or wellness. We see Health.
We back solutions that strengthen the healthcare system and support the 99% of life lived outside of it.
There will be a new category of companies emerging: consumer-first businesses that are ‘healthcare-ready.’ These are brands that start by winning consumer trust, then layer in reimbursement pathways: insurance coverage, HSA/FSA eligibility, or employer benefit integration. Examples range from diagnostics and women’s health platforms - to nutrition, mental health, and lifestyle therapeutics.
These dual-channel companies unlock the best of both worlds: fast adoption and revenue from consumers, plus scale and durability through healthcare players. That translates directly into bigger markets, stronger unit economics, and ultimately, higher valuations.
This shift is already underway. We’ve seen success stories like Noom and Omada - companies that began as consumer-pay businesses and later secured major contracts with insurers, employers, and government programs. More recently, innovators like TrueMed are expanding HSA/FSA access for consumer health brands, giving millions of people real flexibility to spend their dollars on what health means to them.
At Pave, we’re backing companies with this kind of dual reach. Consumers are already spending trillions on wellness, while payers, employers, and government programs control another $4.5T in healthcare spend. Both sides are moving in the same direction: away from reactive sick care and toward proactive, preventive solutions that address the chronic disease epidemic.
This is a once-in-a-generation opportunity to build at the collision point of two multi-trillion-dollar markets.
Very simply put, there is no better category to be in.
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