Frist Cressey Ventures was founded on a single conviction: that healthcare—an industry projected to represent nearly 20% of U.S. GDP by 2032—is both urgently in need of innovation and uniquely resistant to outsiders. The Nashville-based healthcare VC firm, founded by Senator Bill Frist and Brian Cressey, has built its model around that tension: a mission-driven investment strategy backed by a strategic LP network that includes some of the largest payers and providers in the country.
In our latest Fundraiser Feature, we spoke with Zach Johnson, VP of Accounting and Administration, about how Frist Cressey Ventures approached Fund 4, why a strategic LP network is a genuine competitive advantage, and how the firm is using technology to operate with efficiency without sacrificing quality.
Congratulations on being named a Top Fundraiser. Tell us about 2025. What gave you and your team the confidence to raise capital?
Johnson: 2025 started with real macro uncertainty, but what gave us conviction was threefold:
First, our mission. Everything we do starts with the goal to transform healthcare to improve lives. When we evaluate a potential investment, the first question is always: how does this improve the patient's life? That clarity creates conviction, and it communicates clearly to our LPs.
Second, our LP base. We've built strong financial and strategic partnerships over multiple funds, and many of those relationships have deepened with each successive raise. Our strategic LP network now includes some of the largest payers and providers in the country.
Third, the opportunity itself. By 2032, healthcare spending is projected to reach north of $7.5 trillion. That's one industry commanding one-fifth of the American economy, and it remains ripe for the kind of innovation we back.
Your firm is genuinely mission-focused. How much does that alignment between mission and investment strategy factor into securing commitments from LPs?
Johnson: It matters enormously. When we evaluate an entrepreneur, the mission comes first: does this transform healthcare and improve lives? That discipline means the companies we back have a story that's legible and compelling beyond just the return profile.
For LPs, that clarity matters over the long haul. If you're writing a check into a fund with a ten-year-plus timeline, you need something beyond returns to stay grounded. We think our mission gives everyone something to rally around when things are hard. And in venture, things are almost always hard.
You explicitly refer to portfolio companies as "partners." What does Frist Cressey do to add value that goes beyond a financial commitment?
Johnson: Our partnership development team coordinates a range of programs for portfolio companies. Beyond that, our portfolio companies get access to our strategic LP network, the same payers and providers who are the end users of the products these companies are building. The goal is to work with payers and providers rather than around them. You can't change healthcare without partnering with the incumbents.
Policy is another dimension most VC firms can't match. Healthcare is heavily shaped by Washington, and having Senator Frist on the team—and our COO Mark Tipps, his former chief of staff—means we can help portfolio companies understand where things are heading, not just where they are today.
Healthcare is experiencing a moment of convergence: policy shifts, AI, and evolving reimbursement models. How are those forces shaping Frist Cressey's thesis?
Johnson: I'd describe myself as an AI optimist, and I think healthcare is actually the clearest case for that optimism. In other industries, there's caution around AI—what does it replace, who does it displace? In healthcare, the framing tends to flip: look at everything it could do.
One company we've backed, Ambience Healthcare, is an ambient listening scribe—a doctor walks in, records the visit, and the documentation is handled automatically. That might sound incremental, but it gives back hours every day to clinicians who otherwise spend their nights charting instead of doing what they entered medicine to do. Those are real wins, and they compound.
The bigger vision—AI accelerating pharmaceutical research, AI as a primary care tool—is where we want to get, but the path runs through these incremental improvements.
Fundraising is built on trust over time. What does your investor communication approach look like between funds—and is ongoing LP relationship management itself a competitive advantage?
Johnson: Absolutely. The LP relationships we've built over multiple funds are among our most valuable assets.
Our approach is consistent: quarterly communications, regular touchpoints with strategic LPs either in Nashville or at their offices, and a genuine investment in staying familiar, not just formal. We try to practice a kind of Southern hospitality in how we operate: be available, be open, treat every conversation as important.
Technology has made this more scalable without making it less personal. The Juniper Square AI CRM has been particularly useful—it tracks prior conversations, lets you add notes and context from a meeting, and means that when you reconnect with an LP you can pick up in the middle of the conversation rather than starting over. The high-net-worth investor with a smaller commitment receives the same level of communication and transparency as our anchor LPs. That consistency has paid dividends in retained and renewed relationships across funds.
Behind every successful fund is an operating model that can scale. How is Frist Cressey using technology to stay lean while continuing to raise the bar?
Johnson: We think about this deliberately. Our ethos is: if we're going to invest in AI-driven innovation, we need to be forward in using it ourselves. You can't credibly back companies building AI tools for healthcare if you're running the firm on spreadsheets.
On the operations side, we're using enterprise-grade AI tools from frontier models—with appropriate compliance and security guardrails—to support deal sourcing, network connectivity, and value creation work with our portfolio. We've encouraged the whole team to find ways to use tools like Claude Cowork and Claude Code to work smarter.
Within Juniper Square specifically, we've found real value in JunieAI and the ability to query data across everything in the platform and pull it into analyses quickly. And the AI CRM has become central to our LP relationship management. It's all part of building an infrastructure that can scale as we grow, without growing headcount at the same rate.
We're proud to be your operations partner. How has Juniper Square helped with the fundraising process?
Johnson: We're a lean team. The goal is always to protect the investment team's time so they can focus on deals, not on administrative work. Juniper Square made that possible. I went from CRM contact management to opening the data room, to tracking where every prospective LP was in the process, to sending subscription documents, to integrating our legal team so they could work directly within the platform, to a fully executed subdoc, to getting that investor into the entity—all from one place.
I actually joked to another CFO at a conference that I didn't use a single Excel spreadsheet throughout the entire raise. I think that surprised them. But that's the reality. And even then, I feel like I only scratched the surface of what the platform can do.
The other piece is what it does for our LPs. They're not receiving a PDF financial statement, and that's it. They can log in to the portal, see their investment value, pull transactions, access reporting, and give their wealth manager or tax advisor exactly what they need—all from one place. As a fund manager competing for institutional capital, that kind of transparency matters. LPs expect it now.
Looking ahead, what excites you most about Frist Cressey's next chapter—and what does success look like five years from now?
Johnson: What excites me is that the opportunity is genuinely bigger than what we can address in five years. Every time we look at the landscape, there's more to do, not less. Healthcare is the one industry that touches every single person, and it has the power to give people back the most valuable thing there is: time. Time with their families. Time to build community. Time to live better.