Tim Hwang

CEO/Co-Founder, @NitraFinance. Exec Chair / Founder @FiscalNote. Chairman and Co-Founder, @GetAmberEV, Jericho Security. Princeton and Harvard.

[Tim Hwang @timthwang]

Welcoming America’s newest public company @FiscalNote (NYSE: $NOTE) to the @NYSE by ringing the Opening Bell!

[Tim Hwang @timthwang]

Silicon Valley this month is all abuzz with companies like Instinct (and Muse), where the stated business model is to provide a free AI service and monetize it through take rate and transaction volume.

Instinct, an end-to-end consumer agent, has grown to $1 billion of annualized transaction volume this summer, with roughly 50% of that coming from travel, and the stated goal of monetizing through interchange and OTA merchant fees. VCs have now bid it up to a $10 billion valuation.

I guess VCs are finally waking up to the fact that the real prize isn’t in twisting people’s arms to pay for software. Unless you’re a model developer, the real playing field for AI monetization may ultimately be taking a percentage of the enormous volume of real goods and services that AI helps people discover, purchase, finance, and manage.

This is what we’ve been building at Nitra for the last two years.

We provide an increasingly comprehensive set of AI services to some of the hardest-to-reach AI adopters in America’s largest industry: healthcare providers and operators. Instead of trying to charge them enormous software fees, we transparently monetize primarily through interchange and merchant fees from the biopharma, medical device, and healthcare supply industries, markets which collectively are larger than the entire U.S. hotel and flight industry.

The result is an extremely fast-growing, free or heavily discounted suite of AI agents for accounting, inventory management, payables, front office, claims, and other administrative workflows serving tens of thousands of providers and healthcare administrators nationwide. In specialties like eye care, Nitra is now more than a quarter of the market in the United States.

On the other side of the network, merchants, including pharmaceutical distributors, device manufacturers, suppliers, and other healthcare companies, pay Nitra to efficiently access and transact with this aggregated provider market, which now collectively purchases several billion dollars through our platform.

It’s a great model because everyone in the ecosystem gets something they actually want. Providers get amazing software that dramatically reduces administrative work and improves their economics without another massive SaaS bill. Distributors, pharma companies, and device manufacturers get a more efficient channel to reach, acquire, and serve an incredibly fragmented provider market. And Nitra participates economically in the transaction volume that our software helps facilitate rather than having to extract increasingly large subscription fees from the doctors that are sick and tired of being sold to.

The best AI business models may ultimately look less like selling AI and more like using AI to reorganize enormous existing markets. GLP-1 drugs and ChatGPT were released in the same quarter of the same year. Guess which one is doing more “ARR”.

That’s the bet we’ve been making in the $6 trillion healthcare market.

[VCs Congratulating Themselves 👏👏👏 @VCBrags]

Lord give me the confidence of a person that has never built anything writing advice posts on how to build a startup

[Merriam-Webster @MerriamWebster]

Why is it ‘cancelled’ in the U.K. but ‘canceled’ in the U.S.?

Because we gave them that L in 1776.

[Tim Hwang @timthwang]

Nitra is an N of 1 company on track to become the next decacorn in healthcare. There was never a company like it, and probably will never be a company like it.

VCs struggle to define what we are because we’re not focused on investor pattern matching, but on solving real problems for customers. Here’s how we cracked the code:

We started with a simple mission - save doctors time and money - building an all-in-one financial management platform for doctors:

(1) We built a regulated vertical fintech company from scratch (credit cards, accounts payable, point of sale, etc.) bundled with the best AI accounting, expense management, and vendor controls specific to healthcare finance. All of it free to doctors.

This business has grown 13x in 18 months and will cross $100M in annualized revenue this year. The US commercial banking market did $800 Billion in revenue last year, with $200 Billion+ (25% of US GDP) in healthcare.

(2) We used that expense data to build a fully fledged B2B online pharmacy and medical/surgical equipment marketplace with agentic workflows for purchasing, procurement, and inventory management.

This business has grown from nothing into an 8-figure business since launching last fall. The top 5 specialty pharma distributors did $1 trillion in revenue last year.

(3) We identified the most challenging workflows in healthcare and began automating them one by one with AI agents. We started in voice scheduling and eligibility, the most commoditized segment, and partnered with customers to deliver the lowest cost, highest quality solution by bundling our full offering.

Now we’re moving aggressively into prior auth, specialty RCM, and more, with emergent services previously unheard of. If a patient is scheduled for an infusion next Thursday, our system verifies insurance eligibility, predicts drug demand, purchases inventory, arranges financing, and ensures the drug is available before the appointment without staff intervention.

Because we operate the financial and procurement systems of a practice, our AI agents have access to context unavailable to point solutions and we’re bundling it with other areas making us the lowest cost provider.

(4) We’re partnering with life sciences companies to bring new drugs to market faster, eliminating buy and bill financing obstacles and accelerating market access through our procurement engine. As AI-driven biologics and therapies hit the market, we’re making it easier than ever for life sciences companies to get life-saving drugs to providers and patients.

Nitra is onboarding 3-5 practices per day across the full platform and is on a run of a lifetime. The numbers show it. Every day I talk to doctors who are amazed at how fast we’re moving.

So what does it all mean?

Our mission: save doctors time and money.

Our vision: maximize the time doctors spend with patients and make everything else work effortlessly.

The outcome: we’re going to build the biggest VC-backed healthtech company of our generation.

[Yann LeCun @ylecun]

@eladgil BS.
Attention was born in Montréal
PyTorch in NYC.
AlphaGo in London
AlphaFold in London
ESMFold in NYC
Llama 1 in Paris.
Llama 2 in Paris+NYC+SV
DeepSeek in Hangzhou

Plus:
DINO in Paris
JEPA in Montréal+Paris+NYC

SV is 3 mos ahead on topics SV is singularly obsessed with.

[Bruno Faviero @Bfaviero]

@whollera Soma? Views?

[FORTUNE @FortuneMagazine]

On Tuesday, Nitra, an AI-powered healthcare financial and operational platform, announced a $50 million Series B round, bringing its total capital raised to $205 million. https://t.co/kgSuA9dbxC

[Tim Hwang @timthwang]

If you’re a physician who wants to modernize your practice or want to help us build the future of healthcare we’d love to hear from you.

Appreciate @FortuneMagazine & @CatGioino for the story: https://t.co/Nsr7gSTNqq

Learn more about the Nitra story: https://t.co/aBEGwnPW0t

[Tim Hwang @timthwang]

Today we’re announcing that @NitraFinance has raised a combined $187 million in financing as we build the AI-native operating system for healthcare practices.

We're also announcing that Dr. Richard Park, founder of CityMD and healthcare legend, will be joining Nitra’s Board.

[Tim Hwang @timthwang]

Doctors are not just service providers. They are the backbone of every community, yet many are forced to act as part-time CFOs, insurance specialists, and procurement officers just to run their practices. They deserve software that works as hard as they do.

[Cathie Wood @CathieDWood]

According to @ARKInvest’s research, the most profound application of #AI will be in health care. Deregulation is accelerating this transformation in healthcare. Check out Tempus’s results, reported today.

[Tim Hwang @timthwang]

Thank you to the amazing team at NVIDIA for the fruitful conversations and inspirational look at the future of generative AI. Particularly struck by the willingness to lift up the entire ecosystem and make sure that this amazing technology reaches every corner of the planet.

[Tim Hwang @timthwang]

I like you Raj, but if you're short you should disclose it before you post stuff. Don't be a douchebag. I've explained multiple times that 10B51s which were set up last year are used to do sell to covers for income taxes on RSUs that vest every month and that my net share position in the company is up. Biz divisions sell at large premiums to trading EV/sales multiples because the underlying business is valuable (recurring revenues, enterprise software, high gross margins, etc.).

You were wrong about your PartsID position and you'll be wrong about FN. Just because you barely run a 2 person hedge fund with barely any fees to cover your office rent and Bloomberg terminal doesn't mean anyone should listen to you.

[Tim Hwang @timthwang]

Will look into it (would really like to). Lawyers make doing everything so hard to do in a public company. Probably a good thing in general just a lot of red tape. We're not a giant company with like Tesla or Palantir with armies of lawyers so everything needs to be above board, especially when doing stuff outside of normal earnings calls.

[Tim Hwang @timthwang]

The first sentence of this morning’s New York Times coverage of crypto reads: “Few people own cryptocurrencies,” followed by a detailed critique of deregulation under the new administration (https://t.co/CKpWhplV2q). This characterization is both misleading and dismissive of the growing participation in digital asset ownership and innovation. Estimates suggest that somewhere between 25% and 33% of Americans actively own cryptocurrencies—far from a “few.”

Just another example of biased narratives that often overlook the transformative potential of fintech innovation, particularly in areas like blockchain technology and digital assets. The crypto ecosystem continues to be a hub for technological advancements that can redefine global financial infrastructure. Instead of minimizing its impact, we should engage in balanced discussions that recognize both the opportunities and challenges in this rapidly evolving space.

It’s clear that blockchain has far-reaching applications beyond just digital currencies—applications that could fundamentally improve financial systems while promoting transparency and efficiency. For those of us exploring responsible and sustainable ways to apply these technologies, such reporting does little to advance meaningful discourse.

[Tim Hwang @timthwang]

Whether DeepSeek/Chinese companies violated export controls or they produced novel innovations (both can be simultaneously true), it was always inevitable that the costs of LLMs were going to be driven down exponentially through relentless competition and innovation. Not really worth debating how it happened but what it means. This was always going to be the case whether it was just American companies competing amongst themselves or globally.

The simple reality is that competition drives down cost. The real game starts now as the costs of implementing AI continue to get driven down and the ability to implement and extend novel use cases continue to multiply. While OpenAI, DeepSeek, etc get all the mainstream press there are thousands of companies who are working to implement these models into their own use cases and workflows from medicine to law to customer support.

If you are one of those companies (particularly startups), your costs will continue to go down and implementing novel AI use cases will continue to become more accessible. The real value of AI was never in the LLMs but in the applications they were going to serve.

[Tim Hwang @timthwang]

@VestaviaCapital @pennycheck @davepotter17211 @kingtutcap Better to consider fundamental enterprise value (what is this company fundamentally worth) not short term share price fluctuations for long dated convertibles. Plenty of strategic options for a company to realize value.

[Tim Hwang @timthwang]

Most of that data wrong: $9M AEBITDA 2024 (five straight quarters of profitability now). Don’t even know what that 1,400% references (probably some accounting from converting from a private company into a SPAC in 2022). Government contracts solid (https://t.co/tvyQ7dqZdD) and a portion of SBC expenses from previous year granted stock that continues to vest at higher prices (when stock was granted at $6,$10+ in some cases but is vested over multiple years) and amortized out over vesting years.