Founder Profile / Health
Ian Koons
He turned a phone call no one wants to get into a company that exists so fewer people get one. Co-founder and CEO of Karoo Health.
He turned a phone call no one wants to get into a company that exists so fewer people get one. Co-founder and CEO of Karoo Health.
Ian Koons spends his days convincing cardiologists to change how they get paid. That is the quiet, unglamorous, deeply difficult work at the center of Karoo Health, the Albuquerque company he co-founded in 2021 and runs as CEO. The pitch sounds simple and is anything but: stop paying for volume - more visits, more procedures, more billing codes - and start paying for value, meaning patients who actually stay healthier and out of the hospital.
Karoo's model is a hybrid. On one side, dedicated care teams, some on-site and some virtual, wrap around the patient between appointments. On the other, software stitches the whole thing into what the company calls a 360-degree view of a patient's heart health - communication, data exchange, and the kind of actionable nudges that traditional cardiology, built around the 15-minute office visit, rarely delivers. The point is to catch trouble early, when it is cheap and survivable, rather than late, in an ambulance.
By 2024 the company had grown from a New Mexico curiosity into a national play. Koons reported partnerships with more than 700 cardiologists across nearly a dozen states. In May of that year, Karoo joined forces with Heartbeat Health to assemble what the two companies billed as the first national, scalable, end-to-end cardiac value-based care solution. The team backing it - roughly three dozen employees and investors including FirstMile Ventures and BIP Ventures - is betting that the heart is the right place to prove value-based care can work at scale.
What is striking is the address. Koons builds his heart-care company from Albuquerque, a city that does not show up on many health-tech maps. He launched the platform there in 2023, lined up nearly a hundred providers, and kept going. The choice reads as a thesis: good ideas in medicine do not require a coastal zip code, and the patients who need better cardiology are everywhere, not just in the cities investors like to fly to.
Ask why he picked the heart, and the answer is not a market-size slide. It is grief. In 2014, Koons lost his best friend to a heart attack. Years later, that loss became the engine of a company designed so that other people might not get the same call. It is the rare startup origin story where the founder's pain and the customer's pain are the same wound.
Before he was a healthcare founder, Koons was a competitor in a literal sense. He played college tennis, the kind of solitary, scoreboard-clear sport that rewards people who can lose a point and immediately want the next one. That competitive streak never quite left. He describes himself as driven, and admits with some self-awareness that he tends to get overly excited in conversation and jump in with ideas before the other person has finished talking. He is, by his own account, working on it.
His first job out of the gate was about as far from a hospital as you can get: post-game broadcasting for ESPN Radio, covering the NFL team now known as the Washington Commanders. It is a fun, slightly improbable line on the resume - the cardiac-care CEO who once filled airtime after football games - and it hints at something useful. Koons can talk. He can read a room, hold an audience, and translate a complicated thing into a plain one. Those are not bad skills for someone whose actual job is persuading skeptical physicians to bet their practices on a new payment model.
The pivot into healthcare came through the operator's door, not the clinical one. In 2012 he founded Patient Ready Clinicians, a Virginia-based staffing and recruiting firm, and ran it as president and CEO. He then moved into provider growth at Advantia Health, a private-equity-backed women's health company, where he owned talent strategy and execution. From there he became VP of physician partnerships at Ovation Fertility. The through-line across all of it is the same muscle: building the relationships and the networks that get doctors and care models to actually work together at scale. By the time he turned to cardiology, he had spent a decade learning how the supply side of medicine really behaves.
He holds a B.S. from Eastern Mennonite University and also studied at the University of Pennsylvania - an unflashy academic path for a founder, which fits a man who seems more interested in execution than pedigree. That preference is not incidental. It is something he learned the hard way.
Early on, Koons hired for the names on the resume, assuming that a stint at an impressive company automatically translated into execution. It did not, reliably. The correction shaped how he builds Karoo's team now: a bias toward people who do the work over people who look good on a slide. For a founder selling a product premised on outcomes over appearances, it is a fitting lesson - the company's whole thesis, applied to its own org chart.
Traditional cardiology revolves around the office visit. Between appointments, patients are largely on their own - exactly when small problems quietly become big ones.
Karoo pairs dedicated on-site and virtual care teams with a platform that gives a 360-degree view of patient health, so the heart is watched between visits, not just during them.
The harder shift is economic: moving cardiologists off fee-for-service and onto value-based contracts that reward keeping people healthy and out of the hospital.
In 2024 Karoo and Heartbeat Health combined forces to build what they called the first national, scalable, end-to-end cardiac value-based care solution.
A homegrown New Mexico company proving that serious health-tech does not require a coastal headquarters - and reaching patients far beyond the Southwest.
The catalyst was the 2014 death of Koons's best friend from a heart attack. The company is the answer he built to that loss.
Figures per Karoo Health, FirstMile Ventures, and Albuquerque Journal reporting, 2023-2024. Bars scaled for readability.
For all the talk of value-based contracts, Koons is refreshingly low on founder mythology. He drinks his coffee black. He has three active children, and his off-hours go to them. His most-quoted productivity trick is almost aggressively ordinary: when he hates a task and is dodging it, he sets a timer for ten minutes and starts. The bet is that starting is the whole battle, and ten minutes is short enough to disarm the part of the brain that wants to flee.
His reading runs to the unexpected. The last book he mentioned was The Last Kings of Shanghai, historical fiction about Jewish families in 1800s Shanghai - not the usual founder diet of productivity manifestos. For the day job, he keeps up with Blake Madden's Hospitalogy newsletter, a sign of someone who reads the healthcare business closely rather than skimming the headlines.
Put the pieces together and a coherent person emerges: competitive enough to have played college tennis and chased the next point, social enough to have worked sports radio, disciplined enough to use a kitchen timer on himself, and honest enough to name his own bad habits in a public interview. The self-awareness is not a marketing pose. It is the same instinct that makes him a credible salesman to cardiologists - he is willing to say the uncomfortable thing, including about himself.
The aspiration underneath all of it is consistent and unsentimental: prove that cardiovascular care can be paid for by results instead of volume, keep heart patients healthier at lower cost, and scale Karoo into a genuinely national, end-to-end solution. It is a hard, slow, deeply human problem - the kind you only take on if, somewhere in the story, it got personal.