Why Healthcare
01 · THE MULTIPLIER
Healthcare Is Upstream Economic Infrastructure
$2 to $41
Every $1 invested in healthcare infrastructure generates $2–$4 in direct economic activity¹
In underserved communities healthcare is not a downstream service; it's upstream economic infrastructure.
Two Outputs of Every Investment
Access and Good Jobs
When we invest in healthcare companies, we advance two goals: expand access to quality care, and we help create the kind of jobs that anchor people to a community.
Care People Can Reach
When we invest in a healthcare company, the first goal is simple: bring care closer to the patients who were going without it. In-home dialysis on tribal lands. Mobile surgery in rural towns. Telepsychiatry across all 50 states.
1,600+
care locations across our portfolio in the United States.
Healthcare Jobs Are Good Jobs
In rural and underserved geographies, a job at a clinic, hospital, or behavioral health practice is rarely just a paycheck. These roles typically come with health benefits, which immediately lowers the uninsured rate and reduces the number of households dependent on Medicaid. Every clinician and staff member we help recruit can become an anchor to a local economy.
2x
Total employment more than doubled across our Fund III portfolio companies.
The Flywheel
The Virtuous Flywheel
As residents gain access to quality healthcare, they are likely to take fewer sick days from work.
That sets a virtuous cycle in motion for residents and their children: higher household incomes, more local spending, a stronger tax base, better school attendance, stronger test scores, and ultimately higher lifetime earnings and economics for the next generation.
The Reverse Flywheel
The same dynamics that compound positively when care is accessible compound negatively when it isn't. When the nearest appointment is weeks away or more than a 90-minute drive, people are more likely to defer care until they have no choice. By the time they're seen, conditions have advanced — outcomes are worse, treatment is harder, costs are higher, and each patient consumes more clinician time.
That, in turn, shrinks the number of patients a practice can see, which pushes wellness and preventative visits — the least urgent and therefore the first to be cut — even further out of reach. Over time, chronic diseases that should have been caught early go unmanaged, becoming the costliest part of the system and the largest driver of missed work and school days. Lower productivity and lower test scores follow, then lower graduation rates, lower average incomes, a thinner tax base, and less local spending.
I
Care gets deferred
II
Conditions advance, costs climb
III
Clinics stretch thinner
IV
Prevention is cut first
V
Chronic disease goes unmanaged
VI
The local tax base thins
“Many of our portfolio companies were built for exactly this problem. One brings the operating room to rural towns by truck. Another delivers dialysis in patients' homes, sparing trips that once took half a day.”
Portfolio Stories →In these communities, healthcare access is economic strategy.
POVERTY AND BEHAVIORAL HEALTH
Breaking the poverty cycle requires healthcare — especially behavioral health
Unemployment is rarely just an economic event.
It is a health event.
Job loss triggers stress, loss of identity, and social isolation — the very risk factors strongly associated with the onset of substance use. Unstructured time and reduced accountability accelerate the slide. In communities without health benefits or accessible treatment infrastructure, there is nowhere to turn.
Once substance use takes hold, cognitive function and workplace reliability decline; drug testing and a new criminal record make returning to work harder still; physical health deteriorates with prolonged use. The loop tightens: unemployment leads to substance use, which makes work harder to find or keep, which deepens unemployment, which erodes the local tax base, which underfunds the schools and social programs that might have intervened earlier — until what began as a job loss becomes learned hopelessness passed from one generation to the next.
Behavioral health infrastructure is the single most effective place to interrupt that cycle, which is why we treat it as core economic infrastructure, not a niche specialty.
70%+
more than 70% of crimes involve addressable behavioral health or substance abuse issues
When behavioral healthcare is accessible, crime falls, communities feel safer, families and employers return, and property values rise — the same flywheel, now spinning forward again.
Why
Why We Keep Investing Here
Over time, state Medicaid expenses fall significantly as employer-sponsored coverage expands, preventative care displaces emergency care, and chronic disease is managed earlier. Healthier residents, healthier balance sheets, healthier communities — that is the return on healthcare investment we are building toward.
Our singular mission: reduce healthcare disparities nationally.
[1] Bureau of Economic Analysis; Deloitte, “Economic Impact of the Healthcare Industry,” 2023. Multiplier range reflects direct, indirect, and induced effects.
[1] Bureau of Justice Statistics; SAMHSA, “Behavioral Health and Criminal Justice,” 2022