What Open City Labs does

Open City Labs (OCL), founded in 2016 and operating from the New York/New Jersey metro, is a healthcare technology company that builds Navigator360°, a single governed platform connecting eligibility and enrollment automation, FHIR-native care coordination, and billable social care services. Navigator360 screens for 227+ government programs with up to 95% field autofill via AI-powered eligibility logic and routes submissions through a three-lane infrastructure — API integration, web form automation, and PDF/eFax — so that programs at any modernization stage can be processed without manual re-entry. The platform is underpinned by AlignHealthcare.AI, a governance layer providing 16 pre-built consent and privacy policies, rotating AI agent identity certificates, continuous model benchmarking, and an immutable audit ledger that generates H.R. 1-compliant documentation automatically. SHIE (Social Health Information Exchange) extends Navigator360 as a FHIR R4 data exchange layer built on the Gravity Project SDOH Clinical Care data model, connecting clinical and social care organizations across a national directory of 276,000+ organizations and 2.5M+ professionals.

OCL serves four primary customer segments — government agencies, managed care organizations, healthcare providers, and social care providers / community-based organizations — with a secondary focus on AI and technology leaders via the AlignHealthcare.AI platform. The company sells through an enterprise direct field-sales motion with quote-based, multi-year subscription contracts, supplemented by implementation and professional services tied to integration scope and compliance requirements. Pricing is not publicly disclosed and is tailored to organization size, workflow complexity, deployment model, and implementation scope. Named customers and partners include NJ 211, the New Jersey Integrated Care for Kids project, and the AARP Foundation Innovation Program's Massachusetts-based older adults initiative. OCL co-authored the IHE 360x SDOH Closed Loop Referrals specification and created the IX4HS framework, giving it direct influence over the interoperability standards governing social care data exchange. The company is privately held with no disclosed funding rounds, operates with 1-10 employees, and has won recognition including the Social Care Referrals Challenge Grand Prize, a Robert Wood Johnson Foundation 3rd Prize, and a DirectTrust Interoperability Hero designation for its CEO.

Name

Open City Labs

Legal name

Open City Labs, Inc.

Website

https://opencitylabs.com

Company type

Private

Founded year

2016

Operating status

Operating

Headcount range

1–10 employees

Short description

Open City Labs builds Navigator360, an AI-governed, FHIR-native platform automating eligibility and enrollment across 227+ government programs, care coordination, and billable social care services for government agencies, MCOs, health systems, and community-based organizations.

Ownership category

akta.pro rank

Headquarters

HQ city

Jersey City

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, Operations, Marketing or Sales, Infrastructure

Revenue model

1. Navigator360 Platform Licensing: The primary revenue stream is licensing the Navigator360 platform for eligibility, enrollment, care coordination, and billable social care services. Pricing is tailored to organization size, workflow complexity, deployment model, and implementation scope. Given the enterprise sales motion and H.R. 1 compliance features, this likely follows a subscription model with multi-year contracts.
2. Implementation and Professional Services: Implementation timelines depend on integration surface, program mix, and compliance requirements. The company likely generates revenue from implementation services, API integrations, web automation setup, and phased rollout across multiple teams.

Pricing tiers

Go-to-market motion1 record

Distribution channels1 record

Marketing channels6 records

Core offering

Open City Labs builds and licenses the Navigator360° platform, which connects eligibility determination, enrollment, care coordination, and billable social care services for government agencies, managed care organizations, health systems, and community-based social care providers. The platform uses AI agents to screen for 300+ government programs, submit applications through three lanes (API, web form automation, PDF/eFax), and generate H.R. 1-compliant audit artifacts. Underlying Navigator360 is the AlignHealthcare.AI governance layer providing consent policies, AI identity, benchmarking, and an immutable audit ledger.

Product overview

Open City Labs offers a unified platform-plus-governance architecture centered on Navigator360°. Navigator360° is the core product that combines eligibility/enrollment automation (300+ programs), care coordination (dynamic care plans, closed-loop referrals), and billable social care services (CHI and PIN Medicare billing) in a single governed platform. The platform operates through three submission lanes: API integration, web form automation, and PDF/eFax. SHIE (Social Health Information Exchange) serves as the FHIR-native data exchange layer connecting clinical and social care organizations across a national resource directory. AlignHealthcare.AI is the underlying governance layer that provides AI benchmarking, consent policy enforcement, secure AI identity, and immutable audit trails for H.R. 1 compliance.

Differentiator

Problem solved

Functional benefit

Brands

• SHIE (Social Health Information Exchange): The data exchange layer enabling Navigator360 to connect clinical and social care organizations at the network level. Built on FHIR standards and the Gravity Project's SDOH Clinical Care data model.
• Navigator360°

Products and services

• Navigator360° A single governed platform for eligibility, enrollment, care coordination, and billable social care services. Supports screening across 300+ government programs with AI-powered eligibility logic and up to 95% field autofill. Features three submission lanes (API, web form automation, PDF/eFax), dynamic care plans, closed-loop referral management, customizable assessments (PRAPARE, AHC HRSN), and FHIR-native data exchange with EHRs and HIEs. Built on the AlignHealthcare.AI governance layer. Sold to government agencies, managed care organizations, health systems, and social care providers.
• SHIE (Social Health Information Exchange) The FHIR-native data exchange layer enabling Navigator360 to connect clinical and social care organizations at the network level. Built on HL7 FHIR R4 and the Gravity Project SDOH Clinical Care data model. Connects HIEs, EHRs, state eligibility systems, and community-based organizations through a national crowdsourced resource directory of 276,000+ health and human service organizations and 2.5M+ professionals. Supports person records, referrals, care plans, and outcome data sharing across system boundaries.
• AlignHealthcare.AI An AI governance platform providing 16 pre-built consent and privacy policies, rotating certificates for secure AI agent identity, a continuous benchmarking engine validating model performance against healthcare standards, and an immutable audit ledger recording every AI-assisted action with full provenance — exportable for legal and regulatory review. Marketed to CIOs, innovation leaders, and AI builders deploying agentic AI in regulated healthcare environments.

Quantifiable outcome

• 47% reduction in SNAP application denials (AARP Foundation trial)
• +4 more outcomes

Named customers3 records

Segments5 records

Ideal customer profiles5 records

Technology focussed Yes

API detail

Has API

Yes

API docs

API detail

Core technology

AI maturity

App detail

Integration1 record

AI capability6 records

Feature8 records

Partnerships

Three partnerships are on record, tiered core.

• NJ 211coreStrategic or Co-development PartnerPartnered with NJ 211, New Jersey's statewide health and human services information and referral service, expanding the reach of Navigator360's resource directory across the state.
• New Jersey Integrated Care for KidscoreStrategic or Co-development PartnerAwarded contract for the New Jersey Integrated Care for Kids project, connecting pediatric care coordination with social services across the state.
• AARP FoundationcoreStrategic or Co-development PartnerAccepted into AARP Foundation Innovation Program for a Massachusetts-based project expanding benefit access for older adults through automated eligibility and enrollment, validating Navigator360's capabilities at scale.

Scale indicators8 records

Recent moves6 records

Expansion highlights6 records

Broad incumbents

• Innovaccer: Innovaccer offers a healthcare data activation platform used by health systems, payers, and government entities, addressing adjacent needs around care coordination, SDOH, and value-based care infrastructure that overlap with Navigator360's MCO and provider use cases.
• Health Catalyst: Health Catalyst offers enterprise healthcare analytics and data platforms used by health systems and MCOs, addressing adjacent value-based care and population health needs that overlap with Navigator360's care coordination and eligibility use cases.
• Arcadia: Arcadia is a healthcare data analytics platform with deep EHR integration and value-based care capabilities; broader than Open City Labs but competing for similar health-system and MCO budgets around SDOH and population health workflows.

Direct peers

• Unite Us: Unite Us operates a social care coordination network connecting health systems, government agencies, and CBOs — directly competing with Navigator360 on closed-loop referrals, SDOH screening, and care coordination across multiple states with established funding and network scale.
• Findhelp (formerly Aunt Bertha): Findhelp runs one of the largest national social care resource directories and closed-loop referral platforms, competing directly with Open City Labs' SHIE directory and Navigator360 referral workflows across payers, providers, and government agencies.
• NowPow: NowPow (acquired by Unite Us) built a community resource directory and closed-loop referral platform, directly comparable to SHIE and Navigator360's resource directory and referral infrastructure for healthcare and social service organizations.
• Altruista Health: Altruista Health (now part of Constellation) provides care management and utilization platforms for managed care organizations, directly comparable to Navigator360's MCO-focused eligibility, care coordination, and compliance documentation capabilities.
• Healthify: Healthify provides SDOH screening, referral management, and a community resource directory — closely overlapping Navigator360's social care coordination, closed-loop referrals, and CHI/PIN-style billing enablement for MCOs and providers.

Emerging players

• Socially Determined: Socially Determined focuses on SDOH analytics and risk stratification for health plans and government agencies, overlapping with Navigator360's AI-powered eligibility and SDOH-driven care coordination use cases but with a more analytics-centric product.
• Color (Population Health): Color provides population-scale health programs and infrastructure for government agencies and health plans, with overlapping positioning around eligibility automation, large-scale screening, and auditable workflow infrastructure.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat5 records

Key risks6 records

Key highlights7 records

Customer concentration

Compliance3 records

Revenue estimate

Valuation estimate

Number of profiles

Profiles1 record

Funding overview

Funding rounds

Investors

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 Open City Labs