Bluespine, an AI-driven claims cost reduction platform for self-insured employers, announced it raised $7.2 million in seed funding.
The round was led by Team8 with participation from strategic partners.
WHAT IT DOES
Bluespine is an AI-driven claims cost reduction platform that aims to help self-insured employers reduce annual healthcare spending while mitigating financial and legal risks around plan administration.
The company’s mission is to reduce wasteful healthcare spending and empower companies to better serve their employees’ health needs.
“Over the past year, we have onboarded dozens of self-insured enterprises as clients, including Mattel and DavidShield,” David Talinovsky, cofounder and CEO of Bluespine, told MobiHealthNews in an email.
“We have a strong pipeline of new customers and partners, and we are in discussions with some of the largest technology companies in the country about using Bluespine. The funding will strengthen our R&D capabilities and go-to-market teams as we plan to double our headcount.”
Tapilovsky added the market for healthcare cost management solutions broadly includes traditional claim auditors and newer technology players.
“Bluespine’s approach is unique in that we’re applying AI to analyze 100% of claims (versus the traditional 1% review) and leveraging multiple data sources for a more comprehensive analysis,” he added.
MARKET SNAPSHOT
Another company that operates in this space is data company 4C, which offers independent financial oversight, control and accountability for large states and corporations with self-insured health plans.
The Centers for Medicare & Medicaid Services (CMS), urges people to review their medical bills for accuracy to make sure that they match medical records, and that the people are not being billed twice for the same service.
The General Accounting Office (GAO) estimates that healthcare fraud, waste and abuse may account for as much as 10% of all health care expenditures. The GAO says that, because health care expenditures currently exceed one trillion dollars each year, more than $100 billion may be lost in fraud, waste and abuse annually.
According to the Kaiser Family Foundation, the average contribution rate for covered workers in small firms is lower than the average contribution rate for covered workers in large firms for single coverage (14% vs.16%) but higher than the average contribution rate for covered workers in large firms for family coverage (33% vs. 23%).
