NantHealth

What NantHealth does

NantHealth is a publicly traded (NASDAQ: NH) healthcare technology company that builds payer-provider collaboration platforms and evidence-based clinical decision support tools for oncology and autoimmune care. Founded in 2007 and headquartered in Culver City, California, the company operates from additional offices in Lewisville, Philadelphia, Winterville, and Morrisville with 251-500 employees. Its portfolio is anchored by NaviNet, a secure multi-payer portal connecting 420,000 registered provider users to 1,200+ health plans for real-time administrative, financial, and clinical information exchange, and Eviti Connect, an evidence-based treatment validation platform containing 4,800+ oncology regimens and 9,500+ clinical trials. Eviti Advisor provides clinicians with unbiased point-of-care decision support for cancer treatment, and the wholly-owned OpenNMS subsidiary offers enterprise IT network monitoring.

The company generates revenue through a combination of SaaS subscriptions, volume-based transaction fees, and per-authorization processing. NaviNet AllPayer is sold in four tiers ranging from a free Standard tier to Ultimate at $200+ per month with claim submission access to 8,100+ plans. Eviti Connect is sold via payer subscriptions for treatment plan validation in oncology and autoimmune care. Distribution combines direct enterprise field sales to payers and providers, freemium self-serve onboarding for NaviNet Standard, health plan partner sponsorship of NaviNet workflows to their provider networks, and a CoverMyMeds integration for drug prior authorizations. The company also holds HITRUST, URAC, NCQA, and CAQH certifications relevant to enterprise healthcare procurement.

Recent financial signals indicate ongoing stress: revenue declined from approximately $89M in 2018 to roughly $67M in 2022, the company executed a 1-for-15 reverse stock split in December 2022, and raised $22.5M in debt financing in March 2023. To counter this, NantHealth launched new NaviNet AllPayer subscription tiers with claim submission in January 2025, added a CRO and CLO in 2024, and continues to invest in regulatory certifications and product expansion.

Name

NantHealth

Legal name

NantHealth, Inc.

Website

https://nanthealth.com

Company type

Public

Founded year

2007

Operating status

Operating

Headcount range

251–500 employees

Short description

NantHealth provides payer-provider collaboration platforms (NaviNet) and evidence-based oncology treatment decision support (Eviti Connect, Eviti Advisor) to health plans, providers, and hospitals via subscription and transaction-based SaaS pricing.

Ownership category

akta.pro rank

Product category

Healthcare Payer-Provider Interoperability Software

NAICS

Software Publishers (5132), Computing Infrastructure Providers, Data Processing, Web Hosting, and Related Services (51821), Software Publishers (513210)

SIC

Services-Prepackaged Software (7372), Hospital & Medical Service Plans (6324)

akta.pro primary industry

Payer-Provider Data Exchange (X12, prior auth, claims/clinical attachment) (HLACABAK)

akta.pro secondary industries

Claims Management, Scrubbing & Clearinghouse (HLACACAB), Decentralized/Hybrid Trial Enablement (DCT) Platforms (HLACAOAL), Healthcare Data Lakes, Lakehouses & Cloud Warehouses (HLACAIAA)

Keywords

• Payer-provider collaboration
• Clinical decision support
• Treatment authorization platform
• Healthcare interoperability software
• Utilization management platform

Headquarters

HQ city

Culver City

HQ country

United States

HQ region

North America

Offices4 records

Markets served

GTM type

B2B

Offering type

Software

Cost components

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

Revenue model

1. NaviNet AllPayer Subscriptions: Monthly subscription fees for NaviNet AllPayer platform access with tiered pricing based on features (Standard free, Basic $75+, Premium $100+, Ultimate $200+). Base price includes up to 250 transactions with additional volume-based fees.
2. Transaction-based Fees: Tiered transaction fees for eligibility & benefits checks, claim status inquiries, and claim submissions beyond included allowances. E&B: $0.14 per transaction for high volume; CSI: included in Premium tier with additional fees; Claim submission: $0.40 per transaction over 250.
3. Eviti Connect Authorization Platform: SaaS platform for payers enabling treatment plan validation and authorization for oncology and autoimmune care. Revenue derived from payer subscriptions and per-authorization processing.

Pricing tiers

Go-to-market motion1 record

Distribution channels4 records

Marketing channels9 records

Core offering

NantHealth builds and sells cloud-based SaaS platforms that enable healthcare payers and providers to exchange administrative, financial, and clinical information in real time (NaviNet), validate oncology and autoimmune treatment plans against an evidence-based medical library (Eviti Connect), and provide point-of-care clinical decision support for oncologists (Eviti Advisor). It also operates OpenNMS, an open-source enterprise network monitoring subsidiary. Revenue is generated through tiered SaaS subscriptions, per-transaction fees, and enterprise licenses sold to health plans, hospitals, and physician practices.

Product overview

NantHealth offers a unified platform-plus-modules architecture focused on healthcare payer-provider collaboration and oncology care management. The core portfolio consists of NaviNet (payer-provider collaboration platform with free and AllPayer subscription tiers), Eviti Connect (treatment validation platform for oncology and autoimmune diseases), Eviti Advisor (clinical decision support for oncology), and OpenNMS (network monitoring, operated as a subsidiary). NaviNet AllPayer APIs extend platform capabilities to developer access. The platform serves healthcare payers, providers, and hospital/health systems with interoperability, authorization, and claims management solutions.

Differentiator

Problem solved

Functional benefit

Brands

• NaviNet Open: Secure multi-payer portal and payer-provider collaboration platform enabling real-time exchange of administrative, financial, and clinical information.
• NaviNet AllPayer
• Eviti Connect
• Eviti Advisor
• OpenNMS

Products and services

• NaviNet Secure multi-payer portal and payer-provider collaboration platform enabling bi-directional exchange of administrative, financial, and clinical information in real time. Sold to health plans and providers.
• NaviNet AllPayer Provider subscription offering nationwide multi-payer access via a single login with eligibility & benefits (1,270+ plans), claim status inquiry (660+ plans), and claim submission (8,100+ plans) workflows.
• NaviNet Open Core NaviNet platform enhancing payer-provider communication, operating efficiency, and cost reduction via real-time exchange of administrative, financial, and clinical information.
• Eviti Connect Evidence-based treatment validation and authorization platform that connects health plans and practices to verify oncology and autoimmune disease treatments in real time, returning 6:1 ROI to payer customers.
• Eviti Advisor Web-based oncology clinical decision support that empowers clinicians with a comprehensive library of unbiased, clinically-proven treatment options at point of care, displaying no financial interest in prescribed drugs.
• OpenNMS Open source network monitoring platform (operated as wholly-owned subsidiary The OpenNMS Group, Inc.) designed for enterprise-scale networks, providing fault and performance monitoring, traffic analysis, and event management.
• OpenNMS Meridian Enterprise distribution of OpenNMS with long-term support, packaging the most stable and secure features from the Horizon community release.
• NaviNet AllPayer APIs APIs providing secure programmatic access to eligibility & benefits verification, claim status inquiry, and claim submission across 1,000+ health plans for cost-effective and scalable payer-provider workflows.

Quantifiable outcome

• 6:1 ROI returned to customers via Eviti Connect for Oncology
• +4 more outcomes

Named customers1 record

Segments3 records

Ideal customer profiles3 records

Technology focussed Yes

API detail

Has API

Yes

API docs

API detail

Core technology

AI maturity

App detail

Integration1 record

AI capability2 records

Feature4 records

Partnerships

One partnership is on record.

• CoverMyMedscoreTechnology or IntegrationCoverMyMeds serves as NantHealth's partner for electronic drug prior authorization submissions within the NaviNet platform. This integration enables providers to submit unlimited prior authorizations at no cost through NaviNet Drug Authorizations, covering any drug under any health plan including Medicaid and Medicare.

Scale indicators10 records

Recent moves7 records

Expansion highlights6 records

Direct peers

• Availity: Availity is a leading multi-payer provider portal serving eligibility, claim status, prior authorization, and submission workflows. Like NaviNet, it monetizes a national health plan network through subscription tiers and transaction fees, making it a head-to-head competitor.
• Change Healthcare (Optum): Now part of Optum, Change Healthcare operates the largest payer-provider data exchange and claims clearinghouse network in the US. Direct overlap with NaviNet on eligibility/benefits, claim status, and claim submission workflows makes it the closest comparable competitor.
• CoverMyMeds (McKesson): CoverMyMeds is the dominant electronic prior authorization platform for medications and an existing NantHealth integration partner. It overlaps directly with Eviti Connect's drug authorization workflows and is owned by McKesson.
• Wolters Kluwer Clinical Decision Support: Wolters Kluwer's Clinical Solutions (formerly Health Language and Sentri7) provide evidence-based clinical decision support to providers and payers. Competes directly with Eviti Advisor in oncology and therapeutic drug monitoring decision support.
• Inovalon: Inovalon offers a payer-provider data analytics and connectivity platform (formerly Avality-adjacent) used by health plans for risk adjustment, quality, and eligibility workflows. Overlaps with NaviNet's payer-side interoperability and Eviti Connect's utilization management use cases.
• Cotiviti: Cotiviti provides payment integrity and risk adjustment analytics for payers, with deep workflow integrations into payer-provider data exchange. Overlaps with NantHealth's payer-focused RCM and utilization management positioning.
• Experian Health: Experian Health provides patient access, eligibility, claim status, and prior authorization solutions for hospitals and providers. Competes with NaviNet AllPayer in the provider-facing transaction and identity layer.

Emerging players

• National Decision Support Company (NDSC): NDSC provides clinical decision support and imaging decision support used by health systems. Although smaller than Eviti, it competes in the same evidence-based workflow layer where NantHealth serves payers and providers.
• Flatiron Health: Flatiron Health (Roche) provides oncology-specific clinical data, EHR, and decision support tools. Overlaps with Eviti Advisor in evidence-based oncology treatment workflows, though Flatiron is more focused on real-world data than payer authorization.

Broad incumbents

• Oracle Health (Cerner): Oracle Health (formerly Cerner) is a dominant EHR and healthcare IT incumbent offering broad payer-provider interoperability, utilization management, and population health capabilities. Adjacent rather than direct in NaviNet's niche, but competes for the same payer wallet share.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat5 records

Key risks6 records

Key highlights7 records

Customer concentration

• Xx.com/nanthealth
• LinkedInlinkedin.com/company/nanthealth
• Facebookfacebook.com/nanthealth

Compliance4 records

Revenue estimate

Valuation estimate

Number of profiles

Profiles16 records

Subsidiaries1 record

Funding overview

Funding rounds11 records

Investors9 records

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

M&A9 records

Investments2 records

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

Frequently asked questions about NantHealth