medicare-advantage
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Hometown Health’s big bet on staying local
A Nevada health plan built its business around nearby care. Its next chapter asks whether a national partner can make that local promise affordable.
Lynx wants your health benefits to survive the checkout
A healthcare allowance is only useful if you can actually spend it. Lynx connects accounts, payment cards and shopping behind the scenes, giving health plans and benefits administrators a way to make that promise work.
Connie Health wants Medicare to feel local again
Connie Health pairs Medicare comparison technology with agents who know the neighborhood. Its growing acquisition business puts an old-fashioned promise to the test: someone will still be there after you enroll.
ConcertoCare brings the house call back - with an entire team
A missed appointment can begin with a missing ride. ConcertoCare connects medical care, medication support and everyday help at home, betting that fewer loose ends can mean fewer hospital visits.
The Helper Bees turns insurance promises into help at home
A meal, a ride, a grab bar: small things can decide whether someone stays at home. The Austin company builds the machinery that gets insurance benefits through the front door.
Inovaare wants the audit to be a non-event
A health plan can resolve a complaint and still struggle to prove it did the right thing. Inovaare connects the case, the rule and the evidence - then offers to run the operation, too.
Reveleer’s billion-page bet: read once, use again
A medical chart can travel through three departments without telling them the same story. Reveleer is betting that shared evidence, careful AI and a few well-chosen acquisitions can end the relay.
AdhereHealth asks why the prescription never became a habit
A missed refill can conceal a missing ride, a confusing regimen or a perfectly reasonable fear. AdhereHealth puts analytics and care navigators to work on the life around the pill.
Vatica Health makes the paperwork worth a doctor's time
Health plans pay. Clinicians prepare. Doctors decide. Vatica Health's wager is that better risk adjustment starts with making the primary care practice's day a little less maddening.
Quest Analytics and the Doctor Who Wasn't There
A health plan can list thousands of doctors and still leave patients stranded. Quest Analytics makes a business of checking whether the network on paper survives contact with the world.
MHK and the Hidden Cost of a Handoff
A health plan can have capable people and still leave thousands of disputes waiting. MHK’s wager is that better care begins with fixing the work between the people.
The Insurance Plan That Learned the Hard Part Was the Paperwork
Pooja Ika built a Medicare Advantage insurer around a simple complaint: coverage can be generous and still be miserable to use. A 2021 application fight and a renewed 2026 enrollment freeze show just how much of this business turns on the machinery behind the benefits.
The Health Plan That Asked the Neighbors to Help
Wider Circle sells health plans an old-fashioned intervention: people who live near one another, meet regularly, and help each other get care. The machinery behind that simple scene is far more deliberate than a potluck.
Karen Walker Johnson Learned to Listen at the Bedside. Now She Does It at Scale.
A pediatric nurse became a lawyer, an operator and, eventually, a chief executive. Across every reinvention, Karen Walker Johnson kept the same instrument close: the discipline of listening before designing the answer.
Health IQ Bet the Company on Knowing You Better Than Your Broker
A health quiz became a life-insurance discount, then a Medicare prediction engine. The idea was unusually legible. The bill for scaling it was not.
American Logistics and the hard part of getting to the doctor
A medical ride starts long before a driver arrives. American Logistics has built a business around the insurance rules, local operators and human judgment that make the trip possible.
The $0 Commission Error Is the Product: How e123 Is Rewiring Health Insurance's Messy Front Office
Health plans spent decades polishing claims and billing while agent onboarding and commissions lived in spreadsheets. e123's bet is that fixing that neglected front office can turn accurate payouts, cleaner data and faster onboarding into growth.
The 24-Hour Shortcut Hidden Inside America’s Health Plans
Simplify Healthcare built a business around the least glamorous problem in insurance: the same benefit being typed, checked and explained again and again. Its pitch is simple - configure it once, then let the data travel.
The Company Quietly Replacing 45 Systems Behind Your Dental Claim
Dental insurance looks simple until a payer tries to run it across 50 states. SKYGEN built the plumbing - software, claims operations and provider tools - that turns a thicket of legacy systems into one working benefits business.
Meridian Built a $2.5 Billion Medicaid Machine - Here’s the Local Playbook Health-Tech Founders Can Steal
A Detroit physician and his family turned a small Medicaid plan into a $2.5 billion acquisition. Inside Meridian’s enduring formula: win the public contract, build the provider plumbing, and treat food, housing and transportation as part of the product.
Semler Scientific
One company, two ledgers: a five-minute artery test that scans for hidden vascular disease, and a corporate treasury that traded idle cash for Bitcoin.
Silver Health Plus
Silver Health Plus is building an at-home care operation around a single wager: that the sickest 5% of Medicare patients decline on a schedule you can watch - and interrupt.
Evolent
The company betting that the most expensive corner of American medicine - cancer, cardiology, and back surgery - can be run better when the people paying for care and the doctors delivering it are finally pulling in the same direction.
Humana
How a 1961 nursing-home bet in Louisville became a Medicare Advantage powerhouse - and why Humana is now buying the clinic, the pharmacy and the house call instead of just the insurance card.
UnitedHealth Group
UnitedHealth Group has built a vast loop around American health care - paying claims, delivering care, managing prescriptions and supplying the data beneath it all. The same integration that gives it unusual reach also puts every friction point under a brighter light.
Messagepoint
The future of AI-powered CCM. Transform how customer communications work gets done with the Messagepoint Communications cloud.
careCycle
careCycle (YC W25) builds voice AI teams for Medicare agencies and Field Marketing Organizations. Its AI agents handle the non-licensed parts of the member journey - pre-screening, appointment booking, 24/7 questions, and post-enrollment follow-up - then warm-transfer to licensed human agents. The pitch is that a Medicare agency loses roughly half its members each year to poor post-sale engagement, and careCycle keeps those members answered, called back, and retained without the agency hiring a call center.
Insurf
Insurf is an AI-native decision and data layer for U.S. health insurance. Its first product, Inveto, turns denied healthcare claims into source-cited, physician-attested appeals so medical practices recover revenue they would otherwise write off. Each resolved claim feeds a proprietary coverage-decision graph of real payer behavior, which powers a second product, Surely, that prices the true cost of a health plan for employers and brokers. Founded in 2026 by Chang Lu and Bryan Chung, the company is part of Y Combinator's Summer 2026 batch and is based in San Francisco.
Ash
Ash (poweredbyash.com) is a New York-based health technology company that gives healthcare organizations a customizable, white-label platform for at-home diagnostic testing. Founded in 2019 as a direct-to-consumer sexual health testing service for the LGBTQ+ community, Ash pivoted to a B2B model that lets health plans, digital health companies and public health agencies launch branded testing programs across 100+ biomarkers in all 50 states. The company handles kit design, a vetted lab network, multilingual patient engagement, logistics and real-time reporting through one API, and has shipped more than 500,000 kits while helping organizations close care gaps and improve HEDIS and Star Ratings measures.
Headway
Headway is a New York-based healthtech company building a software-enabled network that makes it easier to find a therapist and to pay for one with insurance. Its three-sided marketplace connects patients, mental health clinicians, and insurance plans: patients search for in-network providers with transparent copays, clinicians offload credentialing, billing, scheduling, and claims to Headway, and insurers gain a larger accessible network. Founded in 2019 by Andrew Adams and co-founders, Headway operates in all 50 states with roughly 34,000 clinicians and, after a $100M Series D in 2024, is valued at about $2.3 billion.