A Breakout Moment: Joyful Health Raises $22M Ahead of Schedule

Every year, US healthcare providers collectively write off more than ~$125B in revenue they already earned. Not because the care wasn’t delivered or because the patients didn’t owe it. But because the financial infrastructure connecting clinical encounters to insurance reimbursements is broken. 

After care is provided, providers will send a claim from their electronic health record, and it passes through a billing platform, a clearinghouse, and a payer portal before - maybe - resulting in a deposit. At no point does a single system know the full story, and revenue often disappears into the gaps. As Eliana Berger, Joyful Health’s cofounder and CEO puts it: providers never knew when they were going to get paid, by who, or on what timeline. This means that practices routinely leave 10-30%+ of their revenue on the table. 

Most people think this is a solved problem, and revenue cycle management is a crowded market with no shortage of vendors in this space. But Joyful Health was founded on a different premise - building the map and infrastructure to help healthcare practices recover revenue. 

Joyful Health recently announced their $22M funding to date and Series A led by CRV. The Council was the only firm that participated in their pre-seed round. Being willing to underwrite teams at the earliest stage makes a magnitude of difference for us and results in meaningful markups as early as Series A for our LPs. We are able to take on that risk by investing in founders like Eliana and Warren who embody what we look for in a First Builder turned founder. We are proud to continue supporting this team, from sourcing their founding data engineer, to continuing to be a sounding board as they scale. This round comes a full year ahead of schedule as they saw a clear opportunity to pour fuel on the fire by expanding the team, drive product roadmap, and support demand upmarket from enterprise healthcare organizations. 

We chatted with Eliana on the First Builders podcast again (here’s their first episode with us) to get more details on the raise, what it’s like building at this speed, and what’s ahead for Joyful Health.

Why We Invested: First Builders Don’t See “Crowded” 

At The Council, we back founders we call “First Builders” - people who have lived inside the problem deeply and have been at high slope environments. The conventional wisdom on revenue cycle management is that it’s a saturated market with lots of players and lots of tools. 

This framing isn’t wrong, but it’s not the whole picture. While the supply side is crowded, the demand side remains largely unserved, as healthcare practices and systems are still looking for the tools that actually work for the people doing the billing every day. Joyful Health found that gap and went straight for it. 

What made us confident was the founders’ conviction and how they arrived at the solution. Before writing a single line of code, Eliana and Warren spent almost a year embedded in over a dozen healthcare practices as a fractional CFO. They sat with billing teams and saw the messy reality of piecing together information to manage revenue payouts. They earned the right to build a solution by spending months in the mess, and that’s exactly what separates the companies that find durable PMF from those that iterate their way into the wrong answer. 

Over the past couple of years since investing, we saw how Eliana and the team build upon the trust they earned from the initial practices. Distribution, which is notoriously challenging in the healthcare sector, was easier than expected for Joyful Health. They led with education, as there’s not a good way to learn medical billing today except through costly trial and error or outdated certification courses. Joyful Health hosted educational workshops, dinners, community events, and partnering with well known healthcare communities like Out of Pocket, and consistently delivering value to practices before asking for anything in return. 

Practices often already trust the Joyful Health team as an authority on RCM, and that trust translated into customers. This type of trust is hard to manufacture, and it’s also why distribution has felt, in Eliana’s words, “a lot more natural” than she expected! 

What’s Next for Joyful Health: 

The team has already doubled over the last quarter or two, and Eliana expects it to double again by the end of the year. They are taking on larger customers, expanding into new specialities, and automating more of the recovery workflow. We’re proud to have believed in Eliana, Warren, and the Joyful Health team from day zero. Watching how they have built with focus on the customers is exactly why we believe First Builders are the founders to back. 

If you’re a fast-growing healthcare practice looking to recover revenue you’re leaving on the table, or a talented person who wants to help solve one of the biggest problems in healthcare and fintech - reach out and we’d love to put you in touch!