Roja Garimella: Developing a Founder's Judgment

Roja Garimella’s path to becoming a founder was anything but straight. Setting her sights on a career in medicine since childhood, she committed to medical school with her acceptance to college. And yet, throughout her studies, she continually explored alternative options, from management consulting to venture capital. Gradual exposure to the entrepreneurial process led her to Harvard Business School in the Fall of 2020. Come Commencement 2022, Garimella felt that becoming a medical founder was the way to maximize the impact of her career. Lacking an idea and harboring some reservations about the risk, she took a role as an Entrepreneur in Residence (EIR) at a venture studio, foregoing residency programs in the process. The studio seemed like the perfect way to “de-risk” her dream: she would receive a salary with benefits, in-house resources to explore and validate ideas, plus a pathway to becoming a founder/CEO of a company that she would build with as much as $10 million in funding—in exchange for 75% equity. Within a year, however, market conditions significantly deteriorated; the terms were changed, the promises broken. After parting ways with the studio, she fought through self-doubt to found Kubera Health with the goal of developing a “next generation payment system” to cut the cost of processing healthcare payments in half. The market conditions, however, remained poor, and she struggled to raise capital. Then, in the Fall of 2023, she received an “incu-vestment” offer from a reputable firm with a dedicated healthcare vertical: in exchange for 30% equity and a board seat, the firm would invest $1.5 million and help get her off the ground. Garimella felt conflicted. Would she again be giving up too much control? At the same time, could she really turn down the offer and risk not raising at all? After the venture studio, could she even trust her own judgment?