Arbital Health

What Arbital Health does

Arbital Health, founded in 2023 by Travis May and Brian Overstreet, operates an AI-powered actuarial platform that automates adjudication and performance monitoring for value-based care risk contracts. The company addresses a structural data asymmetry between healthcare payers and risk-bearing providers by centralizing claims, benchmark, utilization, eligibility, and contract data, then running actuarial-grade analytics and contract reconciliation at scale. Its customers are enterprise healthcare payers, provider systems (including ACOs and risk-bearing primary care groups), and value-based care enablers managing risk-based arrangements. Notable named customers and partners include HarmonyCares, Arkos Health, Complete Health, UNC Health, Aligned Marketplace, Podimetrics, SonarMD, ChamberCardio, MDX Hawaii, Communicare Health Centers, and WellBe Senior Medical.

The product portfolio is built around the Arbital Platform, a cloud-based SaaS adjudication engine with Data Ingestion and Enrichment, Contract Financials, Adjudication, Performance Monitor, and Insights modules. On top of this sits Merlin AI, a generative AI assistant launched at HLTH in October 2025 and described as the first Actuarial AI assistant for risk contracting, which provides conversational interpretation of contract performance, forecasts financial impacts, and surfaces next-best actions grounded in Arbital's proprietary actuarial logic. ATLAS, introduced in June 2026, extends the same actuarial modeling into CMS program evaluation, specifically the LEAD Model for ACOs. Actuarial Services provide human-in-the-loop advisory for opportunity analysis and contract design.

The business operates a hybrid SaaS-plus-services model: enterprise subscriptions on multi-year contracts sold via direct field sales to payers, providers, and VBC enablers, layered with higher-margin actuarial consulting. Pricing is quote-based and not publicly disclosed. The company is headquartered in San Francisco at 98 Battery Street, is venture-backed (approximately $41M raised across a $10M Series A in January 2024 led by Transformation Capital and a $31M Series B in July 2025 led by Valtruis), and is led by Brian Overstreet as President and CEO with Travis May as Co-Founder and Chairman.

Name

Arbital Health

Legal name

Arbital Health, Inc.

Website

https://arbitalhealth.com

Company type

Private

Founded year

2023

Operating status

Operating

Headcount range

1–10 employees

Short description

Arbital Health operates an AI-powered actuarial platform that automates adjudication and performance monitoring for value-based care risk contracts, serving enterprise healthcare payers, providers, and VBC enablers via SaaS subscriptions and actuarial consulting services.

Ownership category

akta.pro rank

Product category

Healthcare Risk Management Software

NAICS

Other Insurance Related Activities (52429)

SIC

Hospital & Medical Service Plans (6324)

akta.pro primary industry

Accounts Receivable (A/R) & Collections Management (HLACACAJ)

akta.pro secondary industry

Enterprise Risk Management (ERM) Advisory (BPAHAFAA)

Keywords

• Value-based care software
• Actuarial AI platform
• Healthcare risk contracting
• Contract adjudication services
• Medical loss ratio analytics

Headquarters

HQ city

Santa Rosa

HQ country

United States

HQ region

North America

Offices1 record

Markets served

GTM type

B2B

Offering type

Software

Cost components

Personnel, Technology or R&D, Marketing or Sales, Operations, Infrastructure

Revenue model

1. SaaS Platform Subscription: Arbital Health operates as a SaaS platform providing the Arbital Platform for value-based care contract management. The platform is sold as a subscription to payers and providers managing risk-based contracts.
2. Actuarial Consulting Services: Expert actuarial consulting services for contract design, opportunity analysis, and optimization of risk contracts. Provided by industry-leading value-based care actuaries.

Pricing tiers

Go-to-market motion3 records

Distribution channels2 records

Marketing channels8 records

Core offering

Arbital Health provides an AI-powered SaaS adjudication platform that automates value-based care risk contract management for payers, providers, and value-based care enablers. The Arbital Platform centralizes claims, benchmark, utilization, and contract data to deliver contract performance monitoring, reconciliation, and financial forecasting. Complementary offerings include Merlin AI (a generative Actuarial AI assistant), ATLAS (an actuarial modeling tool for CMS's LEAD Model), and expert actuarial consulting services.

Product overview

Arbital Health offers a unified Actuarial AI platform for value-based care risk contracting, comprising the Arbital Platform (a cloud-based SaaS adjudication solution), Merlin AI (a generative AI assistant), ATLAS (an actuarial modeling tool for CMS programs), and Actuarial Services (advisory consulting). The core Arbital Platform centralizes fragmented data and automates contract reconciliation, while Merlin AI serves as the intelligent conversational layer powered by proprietary actuarial logic to forecast financial impacts and surface actionable insights. ATLAS addresses specific CMS regulatory requirements, and Actuarial Services provides human expert support for contract design and negotiation.

Differentiator

Problem solved

Functional benefit

Products and services

• Arbital Platform An AI-powered SaaS adjudication platform built on actuarial science that centralizes claims, benchmark, utilization, and contract data; provides real-time contract performance monitoring; and streamlines monthly and final contract reconciliation for providers, payers, ACOs, and value-based care enablers managing risk-based contracts.
• Merlin AI The first Actuarial AI assistant for value-based care risk contracting. A generative AI-powered conversational interface that interprets contract data, explains performance drivers, forecasts financial impacts, and recommends next steps in plain language for finance, clinical, and actuarial teams. Built on an LLM trained on Arbital's proprietary actuarial logic.
• ATLAS (ACO TIN Level Analysis & Simulation) An actuarial modeling tool that helps Accountable Care Organizations evaluate participation and financial performance under CMS's LEAD Model. Replaces manual spreadsheet-driven processes with a self-serve platform based on proprietary actuarial logic and national Virtual Research Data Center data.
• Actuarial Services Advisory and consulting services provided by Arbital's team of healthcare actuaries, supporting opportunity analysis (quantifying opportunities in risk deals and establishing baseline prices) and contract design (restructuring VBC contracts and negotiating favorable terms).

Quantifiable outcome

• 6:1 ROI - Payers and providers save thousands on each Arbital AI query
• +7 more outcomes

Named customers11 records

Segments3 records

Ideal customer profiles3 records

Technology focussed Yes

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

AI capability7 records

Feature4 records

Partnerships

Five partnerships are on record, tiered strategic.

• HarmonyCaresstrategicStrategic or Co-development Partner · 29 July 2025HarmonyCares is a strategic partner with expanded partnership over the last year. Value-based care organization using Arbital's platform for risk contract management. CFO Zack Mulligan quoted as a customer reference.
• Aligned MarketplacestrategicStrategic or Co-development Partner · 29 July 2025Aligned Marketplace is a strategic partner with expanded partnership over the last year.
• Arkos HealthstrategicStrategic or Co-development Partner · 29 July 2025Arkos Health is a strategic partner and early adopter of Merlin AI. CEO Eric Tanner quoted as customer reference praising the platform's ability to interpret risk and utilization patterns.
• Complete HealthstrategicStrategic or Co-development Partner · 29 July 2025Complete Health is a strategic partner with expanded partnership over the last year. Also an early adopter of Merlin AI.
• Santa Barbara ActuariesstrategicStrategic or Co-development Partner · 4 January 2024Acquired by Arbital Health as part of growth strategy. Specializes in value-based care and data analytics, supporting Arbital's role in healthcare adjudication. Co-founded by Ian Duncan (current Arbital Senior Advisor and SOA President-Elect) and Andrew Mackenzie (Arbibe Chief Science Officer).

Scale indicators7 records

Recent moves6 records

Expansion highlights6 records

Direct peers

• Arcadia: Arcadia provides a healthcare data analytics platform with strong value-based care and population health capabilities, competing directly with Arbital's contract performance monitoring and risk analytics for payers, providers, and ACOs.
• Innovaccer: Innovaccer offers a healthcare data platform with value-based care analytics, risk stratification, and contract performance tools that overlap with Arbital's adjudication and insights offerings for payers and providers.
• Health Catalyst: Health Catalyst provides enterprise healthcare analytics and insights, including value-based care performance and risk management capabilities that directly compete with Arbital's contract monitoring platform.
• Lumeris: Lumeris is a value-based care enablement platform serving payers and providers with analytics, care delivery, and risk-bearing infrastructure, overlapping with Arbital's adjudication and contract performance modules.
• Aledade: Aledade enables ACOs and independent primary care practices to succeed in risk-bearing arrangements with proprietary analytics and network support, competing with Arbital's ACO-facing ATLAS tool and risk contract analytics.
• Evolent Health: Evolent Health partners with payers and providers to manage value-based specialty care arrangements, with performance and risk analytics that overlap with Arbital's contract adjudication and performance monitoring scope.
• Cohere Health: Cohere Health applies AI-driven utilization management and clinical decisioning to value-based care arrangements, intersecting with Arbital's risk contract management and AI-assisted adjudication workflows.
• Lightbeam Health Solutions: Lightbeam provides population health management and value-based care analytics for ACOs and payers, with contract performance and risk adjustment capabilities that overlap Arbital's core adjudication and performance modules.
• Privia Health: Privia Health enables physician practices and ACOs to operate under value-based care arrangements with embedded analytics and contract performance tools that overlap with Arbital's provider- and ACO-facing platform.

Broad incumbents

• Optum (UnitedHealth Group): Optum is the largest vertically integrated healthcare analytics, RCM, and risk-bearing services platform in the US; its analytics and value-based care offerings compete broadly with Arbital's payer and provider-facing capabilities as part of a much larger portfolio.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat5 records

Key risks6 records

Key highlights7 records

Customer concentration

• YouTubeyoutube.com/channel/UCj4aKXaKg4J-u8Pylj_qUNQ
• LinkedInlinkedin.com/company/arbital-health

Compliance2 records

Revenue estimate

Valuation estimate

Number of profiles

Profiles11 records

Subsidiaries1 record

Funding overview

Funding rounds2 records

Investors7 records

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A1 record

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about Arbital Health