What You Should Know:
– Arbiter, a new AI-powered care orchestration platform, has launched from stealth with $52M in funding, led by TriEdge Investments and MFO Ventures, to unite payers, providers, and patients and rebuild the operating spine of U.S. healthcare.
– The company is built and funded by leaders overseeing over $25B in annual healthcare payments and millions of patient lives. Its team combines executive leadership from major health systems and payers (Cigna, UnitedHealth, Kaiser Permanente, VillageMD) with technologists from major tech firms (Meta, Apple, Google, and Amazon).
The $1 Trillion Problem: The Human Cost of Healthcare Fragmentation
Effective patient care is critically dependent on coordination, yet the current U.S. healthcare system sees providers, payers, and patients operating in costly, dangerous silos. The resulting fragmentation leads to a staggering nearly one trillion dollars in annual waste and causes patients to wait months or abandon care entirely.
For high-risk patients, this fragmentation is a matter of life and death, potentially turning a patient flagged for colon cancer from an early detection case into a late-stage diagnosis. Arbiter’s mission is “nothing less than to rebuild the operating spine of U.S. healthcare,” by aligning payers and providers around the needs of patients.
AI-Powered Orchestration: The Record-Action-Alignment Model
The company’s core solution is the Record-Action-Alignment model, a new operating foundation for healthcare. Arbiter ends fragmentation by using AI to intelligently direct next best actions and close care gaps. The model works in three steps:
- Record: Begins with a longitudinal patient record that integrates clinical, financial, and policy data.
- Action & Alignment: Uses AI to automate actions and keep all stakeholders in sync as care is delivered.
The company’s first application focuses on real-time site-of-care optimization, delivered in partnership with a leading national payer and major provider networks. The platform matches referrals to the best-fit provider based on cost, quality, and availability, while automating authorizations, outreach, and scheduling.
“Arbiter’s mission is nothing less than to rebuild the operating spine of U.S. healthcare,” said Michelle Carnahan, co-founder and CEO of Arbiter. “By aligning payers and providers around the needs of patients, we’re transforming healthcare from a fragmented set of parts into a connected system that works for everyone.”
