risk-adjustment
(6)
Beacon Health
Beacon Health is a Y Combinator (W26) startup building AI agents that operate real electronic health record systems the way a human employee would - clicking through Epic, athenahealth, and eClinicalWorks to close care gaps, capture risk adjustment codes, handle prior authorizations, and run preventative screening outreach. Aimed at primary care practices in value-based care arrangements, the product turns recorded EHR workflows into deployable agents so small practices can chase quality measures and shared-savings revenue without hiring more back-office staff. Founded in 2025 by Mark Pothen and Obinna Akahara, the company has gone live with an independent physician association covering roughly 40,000 patients.
RapidClaims
RapidClaims is a New York-based healthcare technology company building autonomous AI agents for medical coding and revenue cycle management. Its platform helps hospitals, physician groups, ACOs and community health centers automate coding, prevent claim denials, recover underpayments and improve documentation - reducing operating costs by up to 70% while capturing earned revenue. Founded in 2023 by three IIT Kharagpur alumni, the company raised $11M led by Accel and Together Fund to expand across 25+ medical specialties.
Vim
Vim is a healthcare technology company that builds a middleware and developer platform connecting data to clinical workflow at healthcare's 'last mile' - the point of care. Its EHR-agnostic Vim Connect layer sits on top of popular electronic health records, pulling in insights and applications from payers, health plans, and digital-health innovators and surfacing them directly inside a provider's existing workflow. By automating tasks such as care gap closure, diagnosis capture, prior authorization, referral management, and chart retrieval, Vim helps payers and providers align on value-based care while reducing administrative burden for clinicians.
Cozeva
Cozeva is a cloud-based, real-time data platform built by Applied Research Works that helps health plans, physician organizations, and their partners move from fee-for-service to value-based care. It unifies quality measurement (HEDIS, Medicare Stars, P4P), risk adjustment (HCC coding and recapture), and population health analytics in a single, EHR-interoperable system that lets clinicians act on care gaps at the point of care. Founded in 2012 and based in San Ramon, California, Cozeva serves 25M+ lives and 97,000+ providers, holds NCQA and HITRUST certifications, and earned Best in KLAS recognition in 2025 and 2026. In October 2025 it merged with Vatica Health to combine top-ranked quality and risk-adjustment platforms.
Charta Health
Charta Health is a San Francisco AI startup building a pre-bill chart review platform that reads every patient encounter, catches coding mistakes and missed revenue, and flags compliance risks before claims go out the door. Founded in 2023 by two ex-Rockset engineers who got themselves certified as medical coders, the company raised a $22M Series A in 2025 led by Bain Capital Ventures.
Penguin Ai
Penguin Ai is a healthcare-native agentic AI platform built to chip away at the roughly $1 trillion in administrative waste choking U.S. healthcare. Founded by former chief data officers from UnitedHealthcare, Kaiser Permanente and Optum, the company ships Gwen, a build-your-own AI environment that turns plain-language prompts into containerized digital workers for prior auth, claims, coding and payment integrity.