While SpaceX's Nasdaq-100 inclusion and Bending Spoons' volatile debut dominate 2026 IPO headlines, a quieter and arguably more important signal is running underneath: overall US IPO count is tracking roughly 8% ahead of the same point in 2025, driven partly by smaller, less flashy filers testing public-market appetite outside the AI-mega-cap spotlight.
OneMedNet is a representative example. The healthcare data-management company, whose iRWD platform curates clinical data including medical imaging for pharmaceutical, medical-device and AI-diagnostics customers, filed an S-1 for an offering of 11.68 million shares. The company has scaled to more than 90 million patient journeys and 270 million studies across over 2,300 healthcare partner sites -- a real, substantial healthcare-data business, just one operating several orders of magnitude smaller than SpaceX or even Bending Spoons.
This kind of filing matters disproportionately to the broader startup ecosystem precisely because most VC-backed companies will never approach SpaceX or Bending Spoons' scale at exit. A functioning small-cap IPO window -- where a company like OneMedNet can credibly test public markets without needing a trillion-dollar valuation or a dramatic roll-up growth story -- is a better proxy for whether the IPO exit path is genuinely open to the broader venture portfolio, not just its most extreme outliers.
The historical comparison is useful: in tighter IPO markets (2022-2023, for instance), small and mid-cap tech and healthcare-data companies were often the first to pull filings or postpone indefinitely, while only the largest, most well-capitalized companies could still access public markets. A 2026 environment where smaller filers like OneMedNet are moving forward, even as mega-cap AI IPO timing gets more cautious (see OpenAI's reported 2027 hesitation), suggests the IPO window's health varies more by company-specific factors than by pure market-wide risk appetite.
For healthcare and healthtech investors specifically, OneMedNet's filing is a data point that real-world-data and clinical-data infrastructure businesses -- a category that has had a mixed public-market track record -- can still find IPO-stage investor interest when the underlying business (scale of data, breadth of partner network, AI-customer demand) is credible.
For VCs and founders more broadly, an 8%-ahead-of-2025 IPO count is a meaningfully encouraging signal for exit planning, even if none of the smaller filers generate SpaceX-level headlines -- it suggests the public-market door hasn't closed for solid, mid-scale businesses even in a year dominated by AI mega-cap narratives.
The bear case: a slightly higher IPO count year-over-year doesn't guarantee strong aftermarket performance for smaller filers, and healthcare-data companies specifically have had uneven public-market receptions historically, with valuation multiples that can compress quickly if growth decelerates post-IPO.
What to watch: how OneMedNet and similar smaller 2026 filers price and trade once they complete their offerings, whether the 8% year-over-year IPO count growth holds through the back half of 2026, and whether investor appetite for smaller healthcare-data and industrial-tech IPOs remains stable if mega-cap AI IPO timing gets pushed further into 2027.