The Healthcare Sherpa: How Navigation Tech Is Becoming the Glue in a Fragmented System

Healthcare in the U.S. remains an expensive maze: fragmented networks, unclear billing, redundant care, and stressed-out patients. But as value-based care gains traction, a new class of startups is emerging to solve an old problem — helping people actually use the healthcare system effectively.

These companies don’t deliver care directly. Instead, they function more like Sherpas — guiding patients, caregivers, and even employers through a healthcare experience that’s increasingly complex and hard to navigate. With venture capital warming again to digital health, navigation and advocacy startups are quietly becoming infrastructure — and drawing serious investor attention in the process.

The Why: From Reactive Care to Real-Time Guidance

For decades, healthcare delivery in the U.S. has been reactive: show up when you’re sick, figure it out as you go. But with the shift toward value-based care, stakeholders are incentivized to manage populations, reduce costs, and improve outcomes. That means patients need support — before, during, and after clinical care.

Navigation tech sits squarely in that whitespace.

HealthJoy Navigation App

Who’s Building the Sherpa Stack

Rightway: Focused on employer-sponsored plans, Rightway offers a personalized care navigation platform that connects employees with advocates, benefits education, pharmacy support, and provider matching. It’s essentially a digital front door for self-insured employers.

CareBridge: Serving Medicaid and dual-eligible populations, CareBridge partners with states and payers to manage home- and community-based services (HCBS). It uses tech to coordinate non-clinical services like food delivery, personal care, and remote monitoring.

Each of these startups sits between the patient and the system — streamlining access, reducing administrative burden, and improving clinical outcomes through non-clinical interventions.

The Market Moment: Reimbursement + ROI + Retention

There are three tailwinds driving investor interest in this space:

Reimbursement is catching up
CMS has expanded support for care management, care coordination, and digital engagement, especially for underserved populations. Value-based contracts now reward navigation services that reduce unnecessary ED visits and admissions.

Employers want ROI and retention
As healthcare costs skyrocket, employers are prioritizing vendors who can show a direct impact on employee health, satisfaction, and productivity. Navigation tools are especially sticky — they touch multiple points of the healthcare journey and create daily utility.

The data layer is compounding
Navigation companies have access to unique, longitudinal patient data across clinical and non-clinical contexts — making them ideal candidates for integrating predictive analytics and care planning.

Investor Activity: Fewer Buzzwords, More Infrastructure

This category isn’t as flashy as generative AI or wearables, but investors are starting to treat navigation and advocacy startups as long-term infrastructure plays. These businesses often:

• Have sticky enterprise contracts

• Serve underserved, high-cost populations

• Integrate with payers, employers, and care providers

• Capture high-fidelity data that other platforms miss

Notably, venture firms with a focus on healthcare systems (e.g., General Catalyst, Transformation Capital, Define Ventures) have been early to back these models.

Healthcare navigation started out as a concierge service for white-glove employer plans — think Grand Rounds or Accolade. But today, the movement is far more expansive. We’re now seeing scalable models that:

Work across Medicaid, Medicare, and commercial populations

Integrate behavioral, physical, and social care navigation

Incorporate AI and automation without removing human empathy

In a world where a patient’s ability to access the right care at the right time directly impacts costs, navigation is no longer a nice-to-have — it’s a core pillar of system performance.

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If you are a builder, investor or researcher in the space and would like to have a chat – please reach out to me at amit.k@thelotuscapital.com