Laguna Health

Every year in the United States, roughly six million people are admitted to a hospital or wheeled into surgery. Most are discharged and sent home - and then, too often, left largely on their own. The follow-up that should keep them out of the emergency room falls to care managers, usually nurses, working for health plans and calling members one at a time.

Those calls are where recovery is won or lost. They are also where care managers spend a punishing share of their day not talking, but typing - filling in assessments, logging notes, and satisfying compliance requirements. Laguna Health was built to move that burden off the human and onto the software.

Founded in 2020 and split between Tel Aviv and New York, Laguna makes conversational AI purpose-built for care teams. Its system listens to a member call, drafts the clinical documentation, and surfaces the social, emotional, and cultural context a nurse needs - then hands the conversation back to the person best equipped to have it.

The premise is deliberately narrow. Laguna does not sell a chatbot to replace the care manager, and it does not chase the crowded market of hospital documentation tools. It combines what it calls conversational intelligence with clinical protocols, and it sells to the payer side of healthcare - the health plans and virtual care organizations that actually own the follow-up relationship.

That focus has drawn notice. In 2024, TIME magazine named Laguna Insight, the company's analytics layer, one of its 200 Best Inventions of the year, citing its work supporting healthcare workers. The recognition landed not for a consumer gadget but for a tool most patients will never see - the kind that quietly helps the person on the other end of the phone.

Laguna reports it has validated its approach the hard way, through published randomized clinical trials showing 50% cost savings and roughly 10x productivity gains for care managers. In a field where "trust me" rarely scales, evidence does.

Yoni Shtein and Yael Adam met as software engineers at Microsoft. Shtein, born in Kishinev, Moldova, went on to Harvard Business School and MIT, helped build the insurance business at patent-litigation firm RPX, and led hundreds of millions in investments at Fortress. Adam is a former Olympic athlete who came through three knee surgeries.

Both had reason to distrust how healthcare handles people after the acute moment passes. Shtein's mother-in-law died unexpectedly in Israel following a hospital stay. Adam had lived the long, under-supported grind of recovery herself. During the pandemic, the pattern crystallized: millions discharged home each year, with thin, fragmented follow-up.

They built Laguna around the people meant to fill that gap - the care managers stretched too thin to be as present as the work demands. Rather than automate them away, Laguna's design keeps a human in the loop and aims AI at the repetitive tasks that crowd out real conversation.

It is a pointed answer to the reflexive fear that AI will hollow out healthcare jobs. Laguna's bet runs the other way: automate the busywork, expand the team's reach to lower-risk members, and let the humans do the human part.

The market for AI in clinical documentation is busy, with ambient-scribe tools like Abridge and Nuance DAX aimed largely at doctors inside hospitals and clinics. Laguna deliberately points elsewhere. Its customers are health plans, payers, third-party administrators, virtual care organizations, and the care-management BPOs that run member outreach at scale.

That positioning matters. The payer owns the longitudinal relationship - the follow-up calls, the assessments, the risk stratification - and that is exactly the ground Laguna's conversational intelligence and clinical protocols are tuned for.

The business runs on the familiar B2B SaaS model: subscription access to the platform, with value tied to documentation time saved, care-team productivity, and increased member enrollment and reach. Names attached to its programs include large plans in the Blue Cross Blue Shield orbit and specialized care partners.

With roughly 52 employees and about $21.6M raised, Laguna is still early. But its niche - conversational AI for care management on the payer side - is a specific enough door that most of the field walked right past it.