Value-based care can work.
The data infrastructure was
never built to match it.

Value-based care pays the provider to keep people healthy, not to bill more encounters. When the incentive aligns with the patient's long-term health, the model works. The bet is right. What no one built is the data layer it has to run on.

Managing a population's cost of care with data that arrives 90 days late is like navigating by the last known position of a ship. The position is accurate. It's just not now. By the time claims show a patient's trajectory bending, they've been admitted. The cost is spent. The window is gone.

Agilon managed hundreds of thousands of patients with a real data stack, claims fused with partner-practice records. The cost trend still formed where neither could see it: between visits, and outside the primary-care walls. Management caught it only in December 2023; when the miss was disclosed weeks later, $1.8 billion of enterprise value vanished in a single session. Not bad strategy. A structural blindspot in the data they had.

This is the lesson of the 2022–2024 value-based reset. Bright Health, Clover, Cano, Agilon: different proximate causes, one shared exposure. Each was accountable for cost and risk it could not see early enough to manage, least of all what was happening to patients between visits.

The signal was there. The system wasn't looking.

A patient with congestive heart failure doesn't deteriorate in front of a clinician. They deteriorate on a Tuesday afternoon, at home, when their resting heart rate climbs and their step count drops. That signal exists, and it's flowing now, from the wrist of roughly a third of American adults. The question is whether the entity financially accountable for what happens next is looking at it.

Why now, and not before.

Two things had to be true at once, and only just became so. Clinical AI can now read continuous longitudinal biosignal at scale, flagging the precursors to an acute event days before symptoms surface, for a clinician to confirm and act on. And the data opened up: wearable adoption crossed a third of adults, and the ONC's information-blocking rules forced the first real wave of FHIR-compliant APIs into production, so biosignal is finally ingestible alongside the clinical record. None of this held together before 2024, and the window won't stay open long.

We're building the infrastructure to turn continuous between-visit signal into cost-trend intelligence: fused with the clinical record, ranked by care-plan context, surfaced in the workflows of providers that carry real financial accountability for what the signal is telling them. The point is lead-time: a 90-day head start on the rising-risk, cost-driving patient that lagged claims would surface too late. Not a better dashboard on the same old data. A different data substrate that makes value-based care's original promise workable.


We're hiring

We're assembling the team that builds this infrastructure layer from the ground up.

Small founding team. Hard technical problem. We're looking for people who want to work at the intersection of clinical AI, wearable signal processing, and value-based care workflows. People who care about getting the foundations right.

Full Stack AI Engineers Clinical Informaticists Sales / GTM (VBC)