The Access Trade
Six Companies Quietly Rewriting the Future of Healthcare Reach
In today’s market, access is everything.
A new cohort of public companies is engineering healthcare access where incumbents failed: bringing care closer, cheaper, and more human. While the market chases molecules, these firms are fixing the system’s bottlenecks, the infrastructure of delivery, the usability of care, and the invisible barriers of stigma, complexity, and distance.
We call this theme The Access Trade. A 3% model allocation split evenly across six companies, each solving a different dimension of health accessibility:
Local oncology (TOI)
Insurer-scale mental health (TALK)
Tech-native insurance (OSCR)
Direct-to-consumer care (HIMS)
AI-enabled diagnostics (TEM)
Rare disease testing (WGS)
What unites them isn’t sector, but strategy: healthcare as a solved coordination problem.
1. TOI – Local Cancer Care for the Underserved
The Oncology Institute isn’t curing cancer. It’s democratizing access to the cure. In a system where academic centers dominate oncology delivery, TOI scales a community-first model: small-footprint clinics in underserved geographies, run under value-based care contracts. It operates on capitation economics, low cost, predictable revenue, aligned incentives.
Its edge? Don’t make patients travel. Bring world-class care to where they live. Clinics in CA, FL, and NV are expanding covered lives under managed care contracts. Its pharmacy integration further boosts ARPU and margin control.
Cancer outcomes hinge on timeliness and proximity. TOI grows not by innovation, but by translation: adapting best-in-class protocols to local access points. With profitability on the horizon and $40M in cash, TOI is executing a quiet but critical inflection, from SPAC stigma to sustainable, unit-level care infrastructure.
2. TALK – Text-First Therapy That Actually Scales
Talkspace rebuilt itself around payors and employers, pivoting from flashy direct-to-consumer therapy into a network reimbursed by insurance. That shift turned a meme stock into the only profitable scaled player in its space. Today, over 200 million Americans have access to Talkspace services through commercial and government payors.
Behavioral health is a public crisis. But care isn't just about supply, it’s about format. TALK's asynchronous model (chat, video, short form) meets users where they are, and its insurance contracts unlock scale most competitors can’t replicate. The result: expanding margins, rising engagement, and real volume in a category long defined by cash-pay fragmentation. Mental health is no longer niche or optional. TALK's moat is functional scale.
3. OSCR – Insurance with a User Interface
Oscar Health didn’t reinvent the insurance chassis. It rebuilt the experience. Through elegant UX, real-time claims processing, and smarter routing, Oscar delivers a more usable ACA plan. It’s profitable, growing, and operating at a structural margin advantage to legacy peers. Its stack, claims automation, digital-first onboarding, and transparent care navigation, creates a simpler customer journey, especially for first-time insured populations.
Health insurance isn’t broken because of coverage, it’s broken because of comprehension. Oscar doesn’t just offer a plan; it offers a product. With margins now sustainable, MLR <80%, and SG&A <20%, Oscar may be the first insurtech to graduate from startup to utility. In a commoditized space, product experience becomes the moat.
4. HIMS – DTC Care for the Underserved and Overlooked
Hims & Hers built a telehealth engine targeting the most neglected health verticals: hair loss, ED, acne, anxiety. Now it’s layering on GLP-1s, chronic care, and mental health. With over 2.4 million subscribers and 111% YoY growth in Q1 2025, it’s evolved into a full-stack health super-app.
Its vertically integrated model, from prescription to fulfillment, enables high margin control and customer retention. Gross margin exceeds 70%, and its adjusted EBITDA is scaling quickly.
Most healthcare startups chase complexity. HIMS chases demand. By normalizing stigmatized conditions and offering low-friction care, it expands the addressable market and monetizes it efficiently. Its margins rival e-commerce, but its product is care. That distinction, and its LTV/CAC profile, is still mispriced. HIMS isn’t a brand story anymore; it’s a unit economics story.
5. TEM – AI Infrastructure for Clinical Insight
Tempus isn’t a diagnostics company. It’s a data refinery. With one of the largest multimodal datasets in medicine, it layers machine learning atop genomic, radiologic, and clinical data to inform decision-making across oncology, cardiology, and neurology.
Recent revenue acceleration (+80% YoY), breakeven adjusted EBITDA guidance, and pharma licensing deals mark a transition from data gathering to monetization.
Tempus is building the Palantir of personalized medicine. Diagnostic revenue funds the platform, but the long-term upside is in insights and infrastructure. Profitability is near, but more importantly, optionality is now in focus, pharma partnerships, AI expansion, and eventual software margins. Clinical data becomes a flywheel.
6. WGS – A Comeback Story in Rare Disease Genomics
GeneDx was nearly left for dead. Now, post-restructuring, it leads in pediatric genome/exome diagnostics. It’s adjusted-profitable, gross margin is near 70%, and it serves hospital networks with precision sequencing for rare pediatric disorders. Fabric Genomics integration enhances its AI capabilities, while FDA engagement and partnership interest signal optionality beyond testing.
Rare disease is a wedge. GeneDx is both a turnaround and a platform play, a genomics utility that serves hospitals, researchers, and potentially AI training pipelines. Execution is now disciplined, the balance sheet clean, and the dataset scarce. It’s no longer a SPAC recovery story, it’s a compounding genomics platform.
Conclusion: Access is the Unlock
Healthcare isn’t a drug problem. It’s a delivery problem. These six companies operate at the frontier of that insight, solving for:
Proximity (TOI)
Format (TALK)
Comprehension (OSCR)
Stigma (HIMS)
Precision (TEM)
Equity (WGS)
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