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Nebraska’s medtech scene is outperforming its coastal counterparts.

While healthtech ecosystems across the country recalibrated after venture capital funding collapsed in 2022, startups in the Cornhusker state proved more resilient than expected.

Unlike larger markets where inflated valuations and investor pullback stalled innovation, Nebraska’s smaller, more measured ecosystem has weathered the storm. The state’s university spinout pipeline, tight-knit support networks and customer-first founder culture helped it sidestep the worst of the crash. 

“When I first started 20 years ago, I’ll say 90% of our deals were with existing companies,” said Michael Dixon, president at the University of Nebraska tech transfer office (UNeMed). That’s changed, and UNeMed now works with a lot of smaller firms.

“What big companies are telling us is, ‘Hey, go create a startup, build it and then we’ll just buy the startup. We’ll probably pay more, but we want to de-risk,’” Dixon explained.

Bigger medtech hubs like Philadelphia still attract more VC funding overall, but many are facing a noticeable slowdown in capital and exits. The difference? Nebraska’s slow and steady approach — one investors have clearly noticed.

Research strength behind the rise

In 2024, the University of Nebraska system ranked 49th in the US and 82nd in the world for utility patents — far behind the University of Pennsylvania’s 14th national and 22nd global rankings, but it signals growing research strength in the Midwest.

The University of Nebraska Medical Center (UNMC) Global Center for Health Security, launched in 2017, has become a national resource for biopreparedness and infectious disease management. It includes the country’s only federal quarantine unit and a biocontainment training facility.

That growing reputation, plus access to trained workers and manufacturers, has put Nebraska on the map, attracting talent and startups alike. 

Entrepreneurs tap Omaha-based plastics companies to prototype devices domestically amid looming tariffs and test innovations with national franchise partners headquartered in the area.

“We really see a big opportunity to unlock, inspire and accelerate the talent that’s coming out of UNMC, and even Creighton,” said Erica Wassinger, cofounder and general partner of the Nebraska-based VC group Proven Ventures.  

Remote work gives Plains states a boost

Multiple factors contributed to a rise in VC funding across verticals in 2021, many related to new realities sparked by the pandemic. 

Remote work loosened the idea that founders had to be in New York or San Francisco to succeed, according to Ben Williamson, principal and general counsel at the statewide organization Invest Nebraska. 

Investors were afraid of missing out on the next big thing, fueling a rise in early-stage funding and more support for commercialization that helped Nebraska startups spin out of university labs at a faster rate.

Between 2020 and 2024, UNeMed helped launch 19 affiliated companies — a sizable increase from the 11 founded between 2015 and 2019. 2020 and 2021 also saw record-breaking invention disclosures.

Other regions may have experienced a “bubble pop” after 2021, when startup valuations cooled. 

But Nebraska’s smaller, more conservative ecosystem helped shield it from dramatic fallout, Williamson said. Since 2017, he said, valuations and revenue multiples in the state have remained consistent.

A blueprint for beating the bubble

Among Nebraska’s 2021 funding recipients was Virtual Incision, a surgical robotics company that raised $46 million in a Series C round. 

The startup, a collaboration between UNMC and the University of Nebraska–Lincoln, used the funds to continue developing its Miniaturized Robotic-assisted Surgery system (MIRA).

The funding Virtual Incision landed in 2021 was more related to timing than anything else, company leaders said. Nebraska’s more relaxed lockdown rules compared to other areas of the country allowed the startup to continue research and development during the pandemic.

Since then, Virtual Incision has raised additional funds, achieved FDA authorization, tested a modified MIRA aboard the International Space Station and was hailed as one of the top 10 most innovative medical device makers in the world. 

Based in Lincoln, the company credits Nebraska’s university talent and patient, problem-focused culture for its growth. Its decision to stay signals to founders that they can build successful healthtech companies outside major coastal hubs.

“I think we’ve just got smart people who know how to solve a problem and are doing it at a big level,” Wassinger from Proven Ventures said. 

Putting customers first, instead of VCs

Four years after the spike, the 2025 economic downturn has changed how startups develop. VCs want to get their money back, meaning they may not be able to take the risks that come with healthtech experimentation. 

While in Nebraska, that looks like continuing on a slow and steady trajectory, in places like Philly, it looks like betting on established companies over taking a risk on new, unproven endeavors. For example, one of the region’s recent major raises — a $38 million Series D extension for Fore Biotherapeutics — went to a 15-year-old company.

With strong academic roots, disciplined capital, and a focus on solving real-world problems, Nebraska is forging a healthtech identity all its own. While it draws lessons from more mature ecosystems like Philly, its approach offers a compelling model for resilient growth.

“By and large, entrepreneurs in Nebraska care about growing via their customer, not their investor,” Wassinger said. “They want the money to come from actual customer money — from sales.”

Stefanie Monge contributed to this story.