The strategy brief for The Gate. Updated after the May 15 call with Kerry Kellogg. The strategic spine — the Derby, the prospect inventory, the curation discipline — holds. What's new is product validation, a name committed, and a design principle worth solving for.
EC doesn't sell the horses. EC provides the track, the conditions, and the field of buyers who only show up because they trust the venue. The fund pays for the right to run its horses on EC's track, in front of EC's buyers, under EC's credibility.
The vetting is the product. If we let any startup into the room, the buyers stop coming. The quality of the field is what makes the venue worth attending.
Rob's May 15 call with Kerry Kellogg went deep. Kerry was forthcoming, generous, and credible. He validated the pricing, the buyer-access value prop, and the curation discipline. He also pushed back on one thing that matters: scale. The full synthesis lives in Kerry-Kellogg-Call-Synthesis-2026-05-15.md. The short version below.
Kareem — a founder from the fall Project Healthcare cohort, $25K impact grant winner — is returning to Nashville next week and asked Sam and Dakota for buyer meetings with zero lead time. Dakota is assembling them now. Rob shared this on the call as a live example of the distilled version of The Gate. Kerry's reply: "I love it." If those meetings land, we have proof-of-concept for the matchmaking model before we sell a single cohort. Track this. It is the most important thing happening in The Gate workstream this week.
Is The Gate a 3-day cohort or a year-round matchmaking subscription? Both are defensible. The cohort is easier to package, sell, and price. The matchmaking subscription is more efficient and more honest about what we actually do. Kerry's instinct — and Kareem's accidental proof — point toward the matchmaking model. The two aren't mutually exclusive: matchmaking could be the year-round product with a twice-yearly cohort as the marquee gathering inside it. This is the question for Sam in the next strategy session.
Ayo's partner. Co-founder of A Very Stable Conference Season 2 with Ayo and Aaron Frank. Sent Rob a follow-up email asking to chat.
Read: Ayo isn't offering a casual intro. He's sending the operator who runs his playbook. The conference offer is real and staffed.
Twine, Manresa, Recall, Floating Point, Meridian Street. Ayo's words: "they all hustle for their founders" — pre-seed first-check writers who will push portfolio to Nashville on request.
Read: The first prospect list for the cohort sales motion. Outreach order in §04.
Charta, Sage Care, SuperDial, CloudCruise, Nen, Youshift, Substrate. All enterprise HC GTM. Three of the seven trace to one Carbon Health team.
Read: Founder-side pipeline. Pilot-cohort candidates. Carbon Health cluster in §04.
Ayo offered to co-build a healthcare version of A Very Stable Conference — including his VC sponsor pipeline as the revenue mechanic. Single-day, ~300 attendees, invite-only.
Read: Real offer, real playbook. Our call on this is in §03.
Ayo offered a conference. We're saying no — for now. The cohort is the product. The conference is a consequence of cohort success, not the entry move.
National networks pretending to be local — Marcus Evans, HLTH, Plug and Play, Rock Health — can't replicate Nashville without buying a building here. HCA, Vanderbilt, Humana, Ardent, CHS, BCBS-TN inside a 30-mile radius is structural geography, not curation methodology. That's the Derby moat. A bigger stadium doesn't strengthen it. A tighter field does.
"If you told me I had three meetings with the right healthcare buyers in Nashville tomorrow, I'd fly out tonight, change my flight, and come back."
Ayo Omojola · CEO, Substrate · May 7 meeting
Status as of May 15: validator, not yet a buyer. Ayo's partner. Co-runs AVSC. NY-based healthcare investor; portfolio split ~40% healthcare, ~40% fintech, stages seed/A/B. Validated price, profit math, and sponsorship layer on the May 15 call. Endorsed the cohort-over-conference call and the Bumble-style matchmaking model. Did not name portfolio companies for a Fall 2026 cohort — that's the 2-week follow-up ask. Requested the one-pager; sending today. Conversion path: named portfolio fit + a specific decision criterion ("I'd commit if X is true"). He's a partner regardless of outcome.
Meridian Street first — Woody Baum founded Local Infusion in Nashville and has publicly called Nashville "the Silicon Valley of healthcare." Warmest geography fit of the five.
| Fund | HQ / Fund | Healthcare DNA | Why this order | |
|---|---|---|---|---|
| 01 | Meridian Street Capital Woody Baum, Scott Law, George Ribaroff MD |
NYC (orig. Indianapolis) 34+ investments, 3 exits |
100% healthcare × tech | Founder/CEO started Local Infusion in Nashville. He already gets the buyer-concentration story. Easiest first call. |
| 02 | Twine Ventures Leshika Samarasinghe, Ethan Yeh PhD |
Bay Area / NYC Fund I ~$25M, $500K–$750K checks |
~50% portfolio is health | Purest thesis match. Waltz Health, Waymark, Rupa Health (exited), Teiko Bio, Alaffia. Maps cleanly to the EC's buyer access. |
| 03 | Floating Point Eddie Segel, John Loser — both ex-Bridgewater, both founding team Oscar Health |
Boston + NYC Fund II $70M, >$150M AUM |
Core thesis vertical | Oscar Health lineage = deep payer DNA. Commons Clinic, Dandelion, Wheeler Bio, Mevo. Strong pitch hook for Humana. |
| 04 | Manresa Ventures Jackson Gates (solo GP) |
SF $40M Fund I, $500K–$3M checks |
Opportunistic | One confirmed health portfolio company (Camber, RCM/billing). Pitch as "your one healthcare deal this year." |
| 05 | Recall Capital Sarah Tierney Niyogi, Somrat Niyogi |
Bay Area Fund + AngelList syndicate, size not disclosed |
Not confirmed | B2B SaaS focus. No named healthcare portfolio. Qualify before pitching. |
Three of the seven startups Ayo named trace back to one ex-team. Ayo Omojola was CPO at Carbon Health. Caesar Djavaherian, MD co-founded Carbon Health — he's now co-founder of Sage Care and CMO of Charta Health. Ayo is CEO of Substrate. Land one Nashville visit, close all three. That's the easiest first cohort.
| Company | What they do | Funding | Buyer ICP | Fit | |
|---|---|---|---|---|---|
| 01 | Charta Health | AI pre-bill medical chart review. Claims 11% revenue uplift. | $22M Series A (Jul 2025), Bain Capital Ventures led. ~$30M total. | VP Revenue Cycle, CFO, Chief Compliance Officer | Strong |
| 02 | Sage Care | AI patient access — triage, scheduling, provider matching. Claims 15–20% revenue lift. | $20M (Oct 2025), Yosemite + General Catalyst + Metrodora. | Chief Patient Access Officer, COO, VP Contact Center | Strong |
| 03 | Substrate | AI agents for medical billing — claim status, appeals, payment posting. | YC S24. Series A not publicly disclosed. | VP Revenue Cycle, CFO, Practice Administrator | Strong |
| 04 | SuperDial | Voice AI outbound calls — eligibility, prior auth, claims follow-up. | $15M Series A (Jun 2025), SignalFire led. ~$20M total. | VP Revenue Cycle, RCM outsourcers, DSOs, MSOs | Strong / Medium |
| 05 | YouShift | AI shift scheduling for physicians and hospital staff. | $500K seed (Feb 2025), YC W25. | CMO, CNO, VP Medical Ops, department chairs | Medium |
| 06 | CloudCruise | Dev infrastructure for browser-agent automation against EHRs. | $5M seed via YC W24. Floating Point, Meridian Street, Twine all backed. | Engineering at other healthcare-AI companies | Weak (for buyers) |
| 07 | Nen | Cloud Windows desktops for AI agents — 2-sec spin-up against legacy EHRs. | Reported $5M seed (not fully confirmed). | Engineering at other healthcare-AI companies | Weak (for buyers) |
CloudCruise is portfolio-backed by Floating Point, Meridian Street, AND Twine — three of our five target funds. That's not random. These funds already know each other and already invest in the same infrastructure layer beneath Charta and Substrate. The cohort thesis is real, and the prospect map has internal coherence.
Buyers in 2026 are not a monolith. The CIO and the CFO buy on different criteria. Every founder in the cohort must answer both — distinctly — before they enter the room. We use this as a curation gate and a buyer-matching axis.
| The CIO | The CFO | |
|---|---|---|
| Primary concern | Integration capacity. Technical debt. Cybersecurity attack surface. | P&L impact. Reimbursement shifts. Service-line margin. |
| Risk filter | Rejects "one-off" integrations that destabilize the stack. | Demands direct ROI. Rejects long-term liabilities. |
| What earns the meeting | EHR-native posture. Built to live inside Epic, Cerner, or the regional instance. | Quantified P&L story. Reduced ED boarding, denial-rate lift, service-line contribution. |
| Pair with | HCA enterprise architecture. Ardent IT. Vanderbilt's clinical informatics. | Vanderbilt finance. Humana plan economics. HCA margin teams. |
Every founder produces a one-page Workflow Integration Map before the cohort. Not an EHR sandbox — a single artifact the founder brings into the buyer meeting.
"We protect your buyers' cognitive load by curating only founders who've mapped their workflow to the buyer's actual operations. The fund pays. The founders get the meeting. The buyer never wastes an hour."
At the end of the May 15 call with Kerry, Rob articulated what The Gate actually is at its core. Kerry confirmed the efficiency and named the tension. The exchange below is the design north star for whatever The Gate evolves into next.
"Your velvet rope is removed. This place is actually quiet and you can hear yourself think — versus a club bouncing with people."
Rob, on the distilled version of the product · May 15
"Yes. But that's not sellable, so to speak... that's definitely the most efficient."
Kerry's reply
The cohort wrapper, the conference wrapper, the 3-day format — these exist because they're easier to package and price. The work now is figuring out how to package and price the quiet room without rebuilding the velvet rope. Kerry's "Bumble" matchmaking analogy is one answer. Kareem's accidental proof-of-concept next week is another data point. Sam's call on cohort-vs-matchmaking-subscription is the next decision.
The name landed on The Gate. It joins EC's existing program family — InFlight, TakeOff, PreFlight, Project Healthcare — but pushes the naming toward access, authorization, and earned position. The folder is renamed. The one-pager is built around it. Kerry called it "The Gate" on the May 15 call without anyone correcting him. It works.