Onos’ AI enables payers to identify optimal care pathways to maximize outcomes, reduce waste, and minimize reliance on care barriers, like prior authorizations.

SAN FRANCISCO: Onos Health, a healthcare AI company focused on transforming how health plans manage behavioral health, today announced $6.3 million in an oversubscribed venture round that will enable Onos to support growing interest from several of the nation's largest health plans. The round was co-led by Haystack and Pathlight Ventures, with strong participation from preseed investors Bertelsmann Healthcare Investments and Nebular. Onos is supported by an advisory board that includes executives from a range of health plans, from large incumbents like Optum Behavioral Health and Kaiser to AI-forward health plans like Oscar Health.

Since COVID-19, behavioral health needs have surged to record levels, with 1 in 4 Americans now seeking care. Rising costs have left payers overwhelmed and reliant on reactive, outdated, and manual processes to manage spending. These approaches create barriers for patients and providers alike, leading to significant waste in the system — with an estimated $60 billion lost each year in behavioral health due to care misalignment and unnecessary administrative work.

Onos is looking to change this and direct more of these dollars to high-quality care. Onos enables plans to eliminate outdated processes like prior authorization with proprietary AI models trained on a robust layer of behavioral health data. The platform analyzes payer data in real time, allowing health plans to make quick, accurate clinical decisions and identify ideal care pathways across their entire population to maximize outcomes. These pathways help ensure members are on the right care journey and enable rapid detection of low-value care.

Early deployments are already helping payers direct more dollars to effective treatments:

• 60%+ faster care decisions by reducing manual reviews, enabling easier access to care for members — especially important for high-risk populations such as those needing substance use treatment
• 30%+ increase in provider adherence to evidence-based standards, driving better outcomes and lowering costs for high-intensity services like ABA therapy for autism
• 55% increase in provider network satisfaction, driven by greater alignment and transparency between providers and payers on care pathways.

“Since the pandemic, behavioral health has become the fastest-growing driver of cost for health plans. Managing that growth while ensuring people get timely, appropriate care is one of the biggest challenges in the industry,” said Martin Rosenzweig, former Chief Medical Officer of Optum Behavioral Health. “What excites me about Onos Health is their clinically aligned, responsible use of AI to help payers and providers truly work together to guide members toward the right support at the right time.”

“In U.S. health system, patients are too often left behind. Costs keep rising, and health plans are forced to choose between higher premiums or outdated processes that create abrasion between providers and payers — leaving members caught in the middle,” said Akshay Agrawal, CEO and Founder of Onos Health. “We built Onos Health to redirect more dollars back to members, get them on the most effective care pathway, and align payers and providers on the right care for people.”

To guide its approach to clinically aligned, payer-ready AI, Onos Health is supported by an advisory board made up of leaders with decades of experience across health plans, provider networks, and national behavioral health policy. A few notable advisors include:

• Rebecca Schechter, former CEO of Optum Behavioral Health
• Dr. Sean Martin, former Chief Medical Officer of Oscar
• Dr. Martin Rosenzweig, former Chief Medical Officer of Optum Behavioral Health
• Ian Gordon, former COO of Kaiser Washington and BCBS NC

Onos Health will use the funding to keep up with the demand of new and existing clients and grow its clinical and data science teams.

About Onos Health:

Onos Health is a healthcare AI company dedicated to ensuring every dollar spent in healthcare goes towards high-quality care. Onos Health helps payers identify care misalignment and administrative inefficiencies. Onos’ proprietary models are purpose-built for behavioral health and designed to guide members to the right care at the right time. Onos Health is backed by leading investors. Learn more at www.onoshealth.com

Fonte: Business Wire