In US outpatient care, the limiting factor isn’t capital. It’s the operational drag. Physicians and clinic administrators spend up to a third of their work hours on non-patient-facing tasks, and a significant share of that burden falls on financial operations. Multiply that across 350,000+ independent group practices in a $5.9T market, and the problem becomes staggering. The tools available to most practices were never built for them. The entire stack — expense platforms, accounting software, procurement systems — was architected for a different kind of company, and practices have been patching around that mismatch ever since.
Nitra was founded to close that gap. The company provides an all-in-one finance and workflow platform for US practices: a healthcare-native credit card, expense management, bill pay, and a procurement marketplace aggregating 350,000+ medical SKUs.
Indeed, a $5.9T market is exciting, but markets don’t build companies. Underlying our thesis is Timothy Hwang — a founder who has already navigated the full journey from a shared Motel 6 room to the NYSE, and came back to do it again on one of the hardest problems in American healthcare.
From Capitol Hill to Silicon Valley
Before startups, Tim’s early ambitions were in politics. Growing up in Washington, D.C., he started a peer-to-peer tutoring nonprofit as a teenager, donating the proceeds to purchase school supplies for children in need. By eighteen, he had run for the county’s board of education and won—38,000 votes, a $500M budget, and responsibility for 60,000 employees. He later joined the Obama presidential campaign as a regional field organizer. Politics, for Tim, was never abstract. It was a system for mobilizing people toward a shared goal at scale.
That certainty about mobilizing people never left him—but the arena shifted. As a minority watching the Tea Party Movement reshape American politics, Tim began to question whether elected office was the highest-leverage path available to him. He followed his cohort to Silicon Valley, joining Square through an introduction to Jack Dorsey while still studying full-time at Princeton. What he found there reframed everything. Building a company, he realized, ran on the same fuel as a political campaign: a problem worth solving, a conviction strong enough to sustain you, and the ability to get people to move with you. The feedback loop was just much faster.
From Basement to NYSE
Tim and his co-founder Jonathan Chen received a small check from Plug & Play to kickstart FiscalNote, a policy and market intelligence SaaS platform, in 2013, registering the company in his parents’ basement and sharing a Motel 6 room to survive. Needing funding with no warm intros, they cold emailed Mark Cuban in the middle of the night. Cuban replied instantly, and what started as an email exchange turned into a six-hour live due diligence session, with the two founders making things up on the spot to keep up with his questions. It worked. Cuban invested. From there, that scrappy, fearless energy never left the company: FiscalNote scaled quickly, growing to a team of more than 200 in under five years and reaching eight figures in revenue.
After its Series D in 2018, FiscalNote was going head-to-head with The Economist Group’s CQ Roll Call. Tim tracked down a college friend with ties to the Rothschild family, a major shareholder of The Economist Group, and secured an introduction to its CEO. The CEO arrived expecting a mentorship chat; Tim arrived with a choice: sell the data division, or face a well-funded, tech-native competitor. The CEO left with a term sheet. The acquisition followed, cementing FiscalNote as the dominant player in its category. In August 2022, the company went public on the NYSE, and today serves over 6,000 organizations globally, including more than half of the Fortune 500 and over 1,000 US federal government agencies.
After FiscalNote’s listing, Tim ran a venture studio across fintech, defense, and climate. He found it stimulating, but something was missing: the grind. Healthcare kept surfacing as the largest unsolved problem in his orbit, and he and Jonathan regrouped to build Nitra. The move made more sense than it looked: Tim’s decade at FiscalNote had given him a transferable playbook for exactly this kind of market: earning trust from institutional buyers who aren’t technology natives, navigating compliance-adjacent workflows, and building software that embeds into daily operations. Government agencies and law firms are not so different from healthcare practices: professional services businesses inside a regulatory maze where billing errors carry both financial and compliance consequences. When Tim and Jonathan sat down to build Nitra, that playbook came with them.
Why Nitra? Why Now?
Three years since launch, the numbers are compounding. Nitra has onboarded 700+ practices, grown quarterly GTV 9.3x year-over-year, and is seeing a growing share of those practices adopt multiple products across its financial back office, with the card as the entry point, expense management, bill pay, and procurement building on top.
The forward-looking question is what this platform looks like with AI on top — and Nitra is already answering it. Today, Nitra AI agents already handle tasks across the platform, from issuing virtual cards, placing procurement orders, to surfacing expense anomalies in one conversation, while voice AI for patient scheduling and agentic modules for clinical workflow are on deck for 2026. Underneath all of it, the platform is capturing what no generalist fintech ever could: every dollar moving through a practice, tied to a vendor, a drug, a procedure. The long-term vision is a full CFO and operations layer woven into how a clinic runs. Practices have spent years stitching together tools that were never built for them. When the infrastructure is finally purpose-built, they stop patching, because they no longer need to.
The AI era is also accelerating how quickly underdigitized industries can adopt software — and healthcare is one of the largest of them. Tim has a direct track record of navigating exactly this dynamic: FiscalNote brought data intelligence to government agencies, congressional offices, and law firms. All of them were institutional buyers operating inside regulatory constraints, largely unfamiliar with software, and skeptical of change. He learned how to earn their trust, embed the product into daily operations, and scale from there. That experience maps directly onto what Nitra is building.
The market is large, the timing is right, and the product is already working. Underlying all of it is our founder bet. Tim and Jonathan chose to return to zero after a public exit, picked one of the most structurally complex markets in the US economy, and are building with the same scrappiness and significantly more accumulated wisdom. The fact that Tim has already taken a company from his parents’ basement to the NYSE, and came back for something harder, tells us more about what Nitra can become than any market sizing exercise. We are proud to support them on this second, more ambitious journey.
