COPE Health Solutions

What COPE Health Solutions does

COPE Health Solutions is a Los Angeles-based, privately held healthcare technology and services firm founded in 2002 that partners with health plans, risk-bearing provider organizations, FQHCs, and state/federal programs to enable performance under value-based care arrangements. The company sells a bundled platform-plus-services offering anchored by its Analytics for Risk Contracting (ARC) platform, which aggregates fragmented payer and provider data into workflows spanning risk adjustment, utilization management, care coordination, and contract performance. In May 2026 it launched ARCi, an agentic AI suite that extends the platform by automating administrative workflows such as Medicaid redetermination, with planned expansion into care gap closure, clinical documentation, and autonomous enrollment and authorization.

The company monetizes through two streams: subscription-based platform/SaaS access to ARC (with annual billing under custom enterprise contracts) and professional services covering health plan build, restructuring, optimization, and ongoing VBC enablement. Go-to-market is primarily direct enterprise field sales targeting health plans, IPAs, and health systems, supplemented by named channel partnerships with Aon (re-insurance bundling for advanced risk arrangements) and HealthAxis (BPaaS bundling for mid-market health plans). Customer logos include Kaiser Permanente, Temple Health, Aspirus Health Plan, Sun River Health, CAIPA, and Key Medical Group, with public testimonials emphasizing MLR savings, contract performance improvement, and TPA operations support. The firm holds NCQA Prevalidation for Population Health Management, NCQA Certified Data Partner status, HITRUST r2 Certification, and CalAIM TA Vendor designation, which collectively lower procurement friction in regulated buyer environments.

Headcount is 51-100 employees across Los Angeles and New York, and the company raised a $7.5 million Series A in April 2022 led by Mindtree with participation from MSO Solutions. The operating model combines technology IP (ARC and ARCi), domain advisory services, and a workforce development program (COPE Health Scholars), positioning the firm as an integrated enablement partner rather than a pure software vendor or traditional consultancy.

Name

COPE Health Solutions

Legal name

COPE Health Solutions

Website

https://copehealthsolutions.com

Company type

Private

Founded year

2005

Operating status

Operating

Headcount range

51–100 employees

Short description

COPE Health Solutions is a Los Angeles-based healthcare technology and services firm that partners with health plans, risk-bearing providers, FQHCs, and state/federal programs to enable value-based care. Its ARC analytics platform and new ARCi agentic AI suite support risk contracting, population health, and administrative automation.

Ownership category

akta.pro rank

Product category

Healthcare Value-Based Care Enablement and Analytics

NAICS

Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension Funds (524292), Health and Welfare Funds (525120), Human Resources Consulting Services (541612)

SIC

Services-Computer Programming, Data Processing, Etc. (7370), Services-Prepackaged Software (7372), Services-Health Services (8000), Services-Misc Health & Allied Services, Nec (8090)

akta.pro industry

PRIMARYHLACAHAA

Value-Based Contracting Analytics (ACO/MSSP/MA, shared savings/risk)

Healthcare & Life Sciences/Digital Health & Health IT/Population Health Management & Value-Based Care Analytics

SECONDARYFSAIAGAJ

Medicare Quality, Risk Adjustment & Stars Analytics/Services

Financial & Insurance/Insurance — Life & Health/Medicare Advantage & Medicare Supplement (Medigap)

SECONDARYHLAFAGAF

Value-Based Primary Care Organizations (Risk-Bearing)

Healthcare & Life Sciences/Healthcare Providers & Systems/Primary Care & Community Health Providers

SECONDARYHLAEAEAC

Aged, Blind & Disabled (ABD) Managed Care Plans

Healthcare & Life Sciences/Health Insurance & Managed Care/Medicaid Managed Care (MMC) Plans

Keywords

• Value-based care enablement
• Population health analytics
• Risk contracting platform
• Healthcare consulting services
• Agentic AI healthcare

Headquarters

HQ city

Los Angeles

HQ country

United States

HQ region

North America

Offices2 records

Markets served

GTM type

B2B

Offering type

Services

Cost components

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

Revenue model

1. Platform/SaaS Subscriptions: Analytics platform licensing for payers and providers operating in value-based care arrangements. The ARC platform is offered as a technology enablement solution with ongoing platform access and updates.
2. Professional Services: Advisory services, implementation support, and operational consulting for health plan build, restructuring, optimization, interim management, and ongoing VBC enablement.

Pricing tiers

Go-to-market motion1 record

Distribution channels3 records

Marketing channels6 records

Core offering

COPE Health Solutions is a national, technology-enabled platform and services company that powers payer and provider performance in risk arrangements. It sells the ARC (Analytics for Risk Contracting) SaaS platform and the ARCi agentic AI suite for population health management, risk adjustment, utilization management, and care coordination, delivered alongside advisory, implementation, interim management, and operational services for value-based care enablement.

Product overview

COPE Health Solutions offers a unified platform-plus-services portfolio anchored by its ARC (Analytics for Risk Contracting) platform and the newer ARCi™ agentic AI suite. The ARC platform provides population health analytics and risk stratification, while ARCi extends the platform with autonomous AI agents for administrative workflow automation including Medicaid redetermination. The company delivers these through modular add-on solutions targeting providers (value-based care enablement), health plans (end-to-end operational alignment), and state/federal programs, complemented by workforce development offerings like the COPE Health Scholars Program.

Differentiator

Problem solved

Functional benefit

Brands

• ARC: Analytics for Risk Contracting platform that transforms fragmented data into clear performance insights and actions, helping organizations improve care coordination, risk adjustment accuracy, utilization management, and contract performance.
• ARCi

Products and services

• ARC Platform (Analytics for Risk Contracting) A unified analytics SaaS platform that transforms fragmented payer and provider data into intelligent, actionable workflows across clinical, financial, and administrative domains. It enables care coordination, risk adjustment accuracy, utilization management, and contract performance for health plans and risk-bearing providers.
• ARCi (Agentic AI Suite) An enterprise suite of agentic AI solutions that augments care teams by automating administrative workflows across voice, SMS, and email channels. First commercial use case is Medicaid redetermination outreach, with planned capabilities for care gap closure, clinical documentation, and autonomous enrollment and authorization assistance across Medicare Advantage, ACOs, and dual-eligible populations.
• Value-Based Care Enablement Solutions for Providers Full enablement services equipping providers (health systems, FQHCs, IPAs, CINs, ACOs) with expertise, data, ARC platform access, and complete operational coverage to succeed in value-based care, improve quality, and maximize financial upside.
• Health Plan Solutions Fully integrated, end-to-end services and platform solution for health plans driving operational alignment across clinical, administrative, and financial performance. Includes health plan build, restructuring, optimization, interim management, and ongoing VBC enablement.
• State & Federal Programs Advisory Advisory and operational support for navigating complex Medicaid, Medicare, MSSP ACO, CMMI, CalAIM, 1115 Waiver, and other multi-agency programs and value-based payment models.
• COPE Health Scholars Program Workforce development program operated in partnership with healthcare institutions to develop talent for the healthcare industry, including a pediatric track launched with CHOC.

Named customers6 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 capability6 records

Feature3 records

Partnerships

Two partnerships are on record, tiered core.

• AoncoreStrategic or Co-development PartnerCOPE Health Solutions has partnered with Aon to de-risk and improve performance in advanced risk arrangements. COPE Health Solutions provides health plan, IPA, CIN and other risk vehicle build, restructuring, optimization, interim management advisory/implementation and its Analytics for Risk Contracting data analytics and reporting platform with pop health EDW services alongside Aon's re-insurance and stop-loss solutions.
• HealthAxiscoreStrategic or Co-development PartnerCOPE Health Solutions and HealthAxis collaborate to blend end-to-end BPaaS with advanced population health analytics to help mid-market plans cut operational strain, boost visibility across their member populations, and scale with confidence.

Scale indicators3 records

Recent moves7 records

Expansion highlights5 records

Direct peers

• Innovaccer: Healthcare data platform unifying clinical, claims, and social data for population health, risk adjustment, and VBC contracting; competes head-to-head with COPE's ARC platform for payer and provider customers.
• Aledade: Value-based care enablement company supporting primary care practices, FQHCs, and ACOs in risk arrangements; comparable to COPE's provider-facing VBC enablement solutions.
• Health Catalyst: Healthcare data and analytics platform serving health systems and payers with population health, risk, and quality analytics; overlaps COPE in risk-bearing provider and payer analytics use cases.
• The Chartis Group: Healthcare consulting firm with deep value-based care, payer, and provider strategy practices; mirrors COPE's professional services and advisory revenue stream.
• Lightbeam Health Solutions: Population health management and VBC analytics vendor for ACOs, health systems, and payers, offering risk stratification, care management, and quality reporting comparable to COPE's ARC.
• Inovalon: Cloud-based healthcare data analytics platform focused on payer-side risk adjustment, quality, and outcome analytics; directly comparable to COPE's payer-facing capabilities.
• Cedar Gate Technologies: Value-based care analytics platform for payers, providers, and ACOs offering risk contracting, bundled payments, and population health performance management.
• Arcadia: Population health management and value-based care analytics platform serving health plans and risk-bearing providers with similar use cases in risk adjustment, utilization, and contract performance.

Broad incumbents

• Optum (UnitedHealth Group): Incumbent healthcare analytics, consulting, and risk-bearing services arm of UnitedHealth Group; competes broadly with COPE across payer analytics, VBC enablement, and population health.
• Premier Inc. Healthcare performance improvement company offering consulting, analytics, and network services to health systems; overlaps COPE's provider enablement and VBC advisory work.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat4 records

Key highlights6 records

Customer concentration

• YouTubeyoutube.com/channel/UC7XXK_2Pd-Z3AIG8ChcIZYw
• LinkedInlinkedin.com/company/cope-health-solutions
• Xx.com/COPEHS
• Facebookfacebook.com/copehealthsolutions

Compliance4 records

Revenue estimate

Valuation estimate

Number of profiles

Profiles9 records

Funding overview

Funding rounds1 record

Investors2 records

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

M&A

Investments

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

Frequently asked questions about COPE Health Solutions