At 7wire Ventures, we back companies that take on the healthcare system’s most entrenched problems, ones where the scale of the need is obvious, but the structural incentives have made meaningful change elusive. Few areas fit that description better than cardiovascular care. Heart disease is the single largest cost driver in U.S. healthcare, consuming roughly one in every six healthcare dollars and projected to grow from $450 billion today to over $1 trillion by 2035. Heart failure represents nearly one in three hospital readmissions, medication adherence to guideline-directed therapy is inconsistent, and a significant share of cardiac utilization is either low-value or preventable with better proactive coordination. Yet despite the scale and urgency of this problem, cardiac care remains anchored in a fee-for-service model that rewards volume over outcomes and leaves the highest drivers of avoidable cost largely unaddressed.

That’s why we are excited to announce our investment in Karoo Health, a value-based cardiology company partnering with payers and providers to re-architect how cardiac care is organized and delivered. Karoo holds risk-based contracts with health plans, partners with a national network of cardiology practices, and deploys a specialized care team and proprietary technology platform to reduce total cost of care and improve outcomes for patients.

Partnering With Cardiologists, Not Working Around Them

Karoo’s care model is built around a simple but important insight: cardiologists hold the most trusted clinical relationship for patients with heart disease, and any model that works around them rather than with them will struggle to drive meaningful behavior change. Karoo begins by signing cardiology practices into its network, then uses those relationships as the foundation for payer attribution, enrollment, and care delivery. Payer attribution flows from members who already see Karoo network cardiologists, meaning patients enter the program through a trusted referral rather than a cold outreach.

Inside partner practices, Karoo embeds Patient Engagement Specialists who facilitate warm handoffs at the point of care, the time and place where patient trust in their care is highest. Once enrolled, members are stratified by clinical complexity. High-acuity patients receive RN-led, multidisciplinary management with close monitoring, medication titration support, and frequent virtual touchpoints. Lower-acuity members are supported through automated adherence programs and coach-led engagement, with the platform surfacing early signals of deterioration that can trigger timely intervention. The cardiologist remains the clinical decision-maker throughout. Karoo extends their reach without disrupting their workflow, while giving practices access to value-based revenue streams.

To providers, payers, and its own caregivers, Karoo also brings its own technology to bear through Karoo Flow, a proprietary AI-native platform that integrates payer claims, EMR data, remote patient monitoring, pharmacy records, and social determinants of health into a unified view of every patient and practice. The platform identifies intervention opportunities in real time and coordinates responses across care teams and providers, enabling Karoo to focus on the levers with the greatest impact on total cost of care: optimal medical management for patients, reduction of low-value cardiac testing, transitions of care, and shifting appropriate procedures to higher-value sites of care.

Karoo’s results validate the model. With a network of more than 600 cardiology providers across eleven states and live value-based contracts with leading national and regional health plans – representing first-of-kind cardiac value-based care arrangements – the company has built meaningful commercial momentum with exceptional capital efficiency. Through its program, Karoo has reduced both emergency department visits and inpatient admissions among attributed members by more than 40% and driven a greater than 10% total cost of care reduction among entire attributed populations.

A Team Built for This Moment

At the center of Karoo’s success is CEO and co-founder Ian Koons, who brings extensive experience building tech-enabled services businesses in healthcare and whose engagement with health plans were instrumental in securing the company’s earliest payer agreements. Ian is joined by CFO and co-founder Ben Selzer, COO Pia Shivdasani, and CTO Daniel Litvak, a team with deep operational experience across value-based care, clinical services, and healthcare technology.

“Cardiovascular disease has been the largest cost driver in American healthcare for decades, and the system still has no good answer for it. We built Karoo because we believe the solution must start with the cardiologist, not work around them. When you align the provider, the payer, and the patient around the same goals, you can move the needle on outcomes and cost at the same time.” – Ian Koons, Karoo Health CEO

Looking Ahead

We are proud to partner with Ian and the Karoo team alongside a distinguished group of co-investors – including Allumia Ventures, First Trust Capital Partners, SpringRock Ventures, Hyde Park Angels, Dria Ventures, Johns Hopkins, and others – in an oversubscribed Series A. With multiple live payer contracts and a growing pipeline of additional partnerships, Karoo is building the infrastructure to become the definitive cardiac value-based care platform in the United States.

At 7wire, we see Karoo as an embodiment of our thesis: empowering individuals to better manage their health while helping payers and providers align around what works. We are excited to support the team as they scale this model and work toward a future where cardiovascular care delivers better outcomes at a lower cost.