Arbital Health

Arbital Health

Neutral adjudicator for value-based contracts

Overview

Arbital Health provides value-based care adjudication services in the U.S. healthcare market by combining actuarial consulting with technology to manage value-based contracts. Its platform integrates actuarial data and specialized software to calculate performance targets and settle payments or penalties for risk-based arrangements. As a neutral third-party adjudicator, Arbital Health offers an independent ecosystem for providers, payers, and employers to negotiate and administer value-based contracts, reducing disputes and ensuring common data standards. The goal is to accelerate adoption of value-based care by removing administrative and financial friction and making outcomes-based contracting a standard practice.

About Arbital Health

Simplify's Rating
Why Arbital Health is rated
C+
Rated C on Competitive Edge
Rated B on Growth Potential
Rated C on Differentiation

Industries

Data & Analytics

Consulting

Enterprise Software

Healthcare

Company Size

51-200

Company Stage

Series B

Total Funding

$41M

Headquarters

Santa Rosa, California

Founded

2023

Simplify Jobs

Simplify's Take

What believers are saying

  • 500% Platform ARR growth in 2025 drives scalable revenue.
  • Merlin AI cuts week-long tasks to seconds, accelerating client adoption.
  • Stephanie Gutendorf and Najib Jai appointments fuel 2026 expansion.

What critics are saying

  • Cotiviti's superior data aggregation captures 30% payer clients in 12 months.
  • Cigna-Navi Health platform erodes neutral role, halves ARR growth in 9 months.
  • Merlin AI data biases trigger payer lawsuits and $50M settlements in 12 months.

What makes Arbital Health unique

  • Merlin AI combines actuarial logic with transparent AI for VBC adjudication.
  • Acquired Santa Barbara Actuaries in 2024 for leading VBC expertise.
  • Neutral platform centralizes data for payers, providers, and ACOs.

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Funding

Total Funding

$41M

Below

Industry Average

Funded Over

2 Rounds

Series B funding is typically for startups that have proven their business model and need more funding to expand rapidly—often by entering new markets or adding more products. Investors are usually venture capital firms that specialize in later-stage investments.
Series B Funding Comparison
Below Average

Industry standards

$35M
$31M
Arbital Health
$45M
Linktree
$65M
Substack
$100M
ClickUp

Benefits

Health Insurance

Dental Insurance

Vision Insurance

401(k) Retirement Plan

Unlimited Paid Time Off

Flexible Work Hours

Hybrid Work Options

Stock Options

Employee Referral Bonus

Wellness Program

Mental Health Support

Conference Attendance Budget

Family Planning Benefits

Fertility Treatment Support

Remote Work Options

Paid Holidays

Paid Vacation

Sabbatical Leave

Pet Insurance

Phone/Internet Stipend

Home Office Stipend

Professional Development Budget

Training Programs

Tuition Reimbursement

Professional Certification Support

Adoption Assistance

Childcare Support

Elder Care Support

Relocation Assistance

Meal Benefits

Gym Membership

Commuter Benefits

Legal Services

Employee Discounts

Company Social Events

Growth & Insights and Company News

Headcount

6 month growth

-1%

1 year growth

-1%

2 year growth

1%
PR Newswire
Mar 19th, 2026
Arbital Health's 2026 Summit sets the Future agenda for Value-Based Care and Risk Contracting.

Arbital Health's 2026 Summit sets the Future agenda for Value-Based Care and Risk Contracting. Mar 19, 2026, 14:54 ET Policymakers, payers and providers came together to discuss the current state of value-based care, artificial intelligence (AI) and share strategies to change the trajectory of risk contracting. SAN FRANCISCO, March 19, 2026 /PRNewswire/ - Arbital Health, the leader in Actuarial AI-enabled infrastructure for healthcare, announced the successful completion of the 2026 Arbital Health Summit: the Future of Value-Based Care & Risk Contracting, its annual invite-only event dedicated to solving the toughest challenges in risk-based healthcare. The Summit continues to fundamentally shape value-based risk contracting by bringing together payer and provider executives to share what's driving performance in value-based care, with real-world results from the industry's highest-performing companies. "The Arbital Summit is always a moment of truth for us: are we helping the industry solve its hardest risk-contracting problems? What we heard from over 150 payer and provider leaders this year was that value-based care is working, but organizations often struggle to demonstrate financial impact within short contract cycles. They question how to bring actuarial clarity to clinical interventions by making the economics tangible, and how to determine whether AI investments are truly reducing costs or adding complexity," said Brian M. Overstreet, President and CEO of Arbital Health. "That points to a clear need for a larger deployment of Actuarial AI infrastructure to support value-based risk contracting at scale. This will unlock the next phase of value-based care." Mark Gwynne, Chief Value Officer, UNC Health, also reflected on the event: "This was a group of executives that operate and think at a really high level, globally. Folks who are thinking of strategy and folks who are in the weeds. Blending all those perspectives together is really interesting and different. There were several 'aha' moments around AI. Aneesh Chopra's question, 'Is AI inflationary, or deflationary?' was thought-provoking." Operational and administrative complexity in risk-based contracting is not new, but several panelists noted a meaningful shift in how organizations are approaching solutions. AI's role, for example, in providing line-of-sight between patient outcomes and financial impact, enabled by Actuarial AI, is allowing teams to manage contract performance more proactively than ever before. "We're in the midst of what I would call an evolutionary revolution. AI is going to really transform the way we practice medicine and manage data. It enables us to make better decisions to care for patients. But it's a process that has to evolve, and I think we're still at the early stages of that," explained panelist Andrew C. Von Eschenbach, President, Samaritan Health Initiatives and Former FDA Commissioner. "Once we acquire and aggregate all of this data and information, how do we properly analyze it so that we can confidently and comfortably react and act on it?" "The Arbital Summit gave me an opportunity to look beyond the day-to-day, and think about what technology and tools will give ACOs (Accountable Care Organizations) an even better, more complete understanding of the longitudinal patient journey," shared panelist Emily Brower, President & CEO of National Association of ACOs. "ACOs use data to deliver value to individual patients. We have enough evidence to illustrate what pathway works for a patient. You gain confidence to build that pathway and know that if I do A, there's a pretty good chance I will get B." As value-based care accelerates in 2026, the ability to make fast, informed decisions is becoming a competitive necessity. Organizations that are already operationalizing and scaling Actuarial AI platforms like Merlin AI, the first Actuarial AI assistant designed to bring generative intelligence into risk contracting, are demonstrating a measurable performance edge. Financial and clinical leaders described using Merlin to surface cost drivers and actions that have bent the cost curve, producing results that have played out across hundreds of contract settlements and touched millions of covered lives. The 2026 Arbital Summit made it clear that the organizations winning in value-based care are not waiting for perfect conditions. They are moving now, with better data, sharper AI-powered tools, and a clearer understanding of what drives performance. Arbital remains committed to building the Actuarial AI infrastructure that makes that possible and looks forward to continuing these conversations with the industry in the year ahead. Sam Deshpande, Former CIO of Humana synthesized the event well, saying: "Value-based care holds the promise of meeting healthcare's greatest challenge: delivering high-quality care at an affordable cost. I am excited to see Arbital Health's AI platform, along with leading voices across the industry, help shape the future." About Arbital Health: Arbital Health provides the Actuarial AI-enabled infrastructure for providers and payers to successfully manage risk-based contracts. Combining the industry's leading value-based care actuaries with a robust AI-powered platform, Arbital Health centralized fragmented data, accelerates contract performance monitoring, and helps speed decision making. Merlin AI, the company's embedded actuarial AI assistant, is powered by actuarial logic to continuously measure contract performance, forecast financial impact, and deliver actionable insights to drive down spend and MLR, improving patient outcomes while there is still time to act. Arbital Health is led by a best-in-class team of healthcare actuaries, engineers, and industry veterans, and backed by leading investors: Valtruis, Transformation Capital, Shaper Capital and Healthy Ventures. For more information, visit ArbitalHealth.com. SOURCE Arbital Health

Arbital Health
Mar 16th, 2026
What Value-Based Care leaders are talking about right now.

What Value-Based Care leaders are talking about right now. Mar 16, 2026 Arbital Health, Inc. just wrapped up another successful Arbital Health Summit on The Future of Value Based Care (VBC) and Risk Contracting. Each year is a gut check for me on whether Arbital Health is working to solve the toughest challenges in healthcare and providing the infrastructure payers and providers need to scale and succeed in value-based care. This year, three themes emerged from the 150+ payer executives, provider leaders, policy influencers, and risk-bearing innovators who attended Summit and are navigating the realities of risk contracting every day: * Leaders are confident that VBC is working, but are still having difficulty showing direct financial impact within short contract cycles. * The first step in making value-based care succeed is actuarially scoring the value of clinical interventions so the economics are clear. * Executives are seriously questioning whether AI is decreasing or escalating costs in current applications. Showing Direct Financial Impact Despite meaningful progress in VBC adoption, many organizations still face the same operational barriers to interpreting results on a one-year cycle. Delayed performance data, misaligned contract measures, and time-consuming operational processes all hinder that ability. But leaders are adamant that value-based care is making a long-term impact, even if the most sophisticated organizations acknowledge that the mechanics of forecasting, risk adjustment, and contract settlement still struggle to keep pace with the ambition of their value-based strategies. Most organizations are still operating within information cycles that were designed for fee-for-service healthcare: quarterly refreshes; lagged claims data; and retrospective reporting. When contracts include downside risk, that timeline simply doesn't work. The organizations succeeding in VBC are not waiting for settlement results to understand performance and iterate. They are using its Actuarial AI infrastructure to monitor trends and contract dynamics, identify cost drivers early, and gain actionable insight on interventions that can bend the cost curve back before trends become financial outcomes. Where ROI Actually Shows Up In VBC Panel Actuarially Scoring Clinical Interventions Participants in the panel on What it Takes to Win in Specialty Care constructed a four-step formula for success: * Actuarially score the value of the clinical interventions so the economics are clear * Create meaningful provider incentives and engagement so the model actually works in practice * Deliver high-quality clinical interventions that improve outcomes for patients * Designing benefits in a way that reduces friction and drive engagement What it Takes to Win in Specialty Care Panel All agreed that the first step to any successful VBC strategy was scoring the value of clinical interventions using actuarial rules and logic, prior to launching any initiative to ensure that financial goals are clear from the very beginning. Its actuaries have scored various successful care pathways and interventions and trained Merlin AI to predict the unique contract value of using each of these insights. Financial leaders are already watching financial trends and asking Merlin to: * Find 2,500 members representing 40% of all future avoidable admissions. By engaging 50% of targets with early intervention, clients have reduced 75% of their avoidable admissions, saving $4M. * Identify a 10-20% increase in HCC. By recapturing 25% of identified missing or suspect HCCs, clients recapture $21M. * Find 500 members with costs over $9,000/month (MLR above 130%). By engaging 33% and intervening, 20% of clients see a $3.5M return. * Find 3,000 end-of-life members, 30% of whom will die within 12 months. By transitioning 50% to early hospice and reducing costs, 25% of clients save $15M. By using these interventions, clients are scaling these positive outcomes across providers, geographies and patient populations. Is AI Increasing or Decreasing Cost? Healthcare leaders are no longer asking whether AI will play a role at the point of care, they are asking whether it is actually reducing costs or adding to them. Across the industry, organizations are investing heavily in AI applications for clinical copilots, documentation, automation, coding assistants, and patient engagement tools. Many are also building internal AI capabilities, standing up data science teams and experimenting with proprietary models. These efforts may ultimately yield clinical or operational benefits. But in the near term, leaders shared that they often introduce significant new costs: infrastructure investments, integration challenges, staffing requirements and opportunity costs; not to mention the ongoing model maintenance cost. At Arbital Health, Arbital Health, Inc. built Merlin AI to fast track any organization looking to use AI in financial operations, while ensuring immediate efficiencies. Merlin automates the most time-consuming tasks, adding better actuarial tool sets and predictive models, to immediately increase team productivity and speed to scale. Arbital Health, Inc. believe that AI applications should reduce operational stress, even before they prove their value in any specific use case. Summit attendees interacting with Merlin AI A Shift Toward Actuarial AI As Arbital Health, Inc. move toward regular use of AI, industry executives warned Arbital Health, Inc. to be mindful of any data biases that train AI systems. It is not enough for AI to offer information for quick decision making; these systems must also be 100% transparent in showing their work - providing the data sets and logic used. This is precisely what has been lacking in large AI systems. In order for users to actually trust the financial advice of its Actuarial AI assistant Merlin, the platform was built to be responsible and explainable. Merlin keeps humans in the loop. Every answer is traceable, transparent, and customizable for each organization. Every insight is backed by Arbital's validated actuarial logic, ensuring accountability and auditability. When models are grounded in actuarial discipline (such as credibility theory, loss ratio modeling, risk adjustment mechanics, and regulatory standards) they can dramatically increase actuarial capacity while maintaining the transparency required for financial governance. Trust remains the currency of risk contracting. Any system that informs financial decisions must operate within that framework of trust. Highlighting Merlin AI at the Arbital Health Summit 2026 The Future of Value-Based Care is Here Leaders are excited about the next phase of VBC, both from a policy perspective and from an operational perspective. Organizations that succeed will leverage AI for immediate efficiency and speed of decision making, while requiring transparency and auditability. The next phase of VBC will be defined not just by risk contracts, but by the intelligence infrastructure that supports them. In VBC, timing matters. And increasingly, the difference between reacting to risk and proactively managing it comes down to how quickly leaders can see what is happening, so they can act with urgency. The Arbital Health Summit Team

Cision
Nov 19th, 2025
Arbital Health Appoints Stephanie Gutendorf as Chief Commercial Officer

Arbital Health appoints Stephanie Gutendorf as Chief Commercial Officer. News provided by. Arbital Health Stephanie Gutendorf brings a strong record of scaling healthcare partnerships to guide the company's commercial direction and market development. SAN FRANCISCO, Nov. 19, 2025 /PRNewswire-PRWeb/ - Arbital Health, a healthcare technology company that provides critical infrastructure for providers and payers to successfully manage risk-based contracts, announced that Stephanie Gutendorf has joined the company as Chief Commercial Officer. With a background that bridges early-stage innovation and large-scale health technology operations, Stephanie will guide Arbital Health's commercial strategy as the company expands its role in enabling value-based care through better management, measurement, and transparency of risk-based contracts. Stephanie has spent her career working at the intersection of commercialization and care delivery innovation. Her experience spans early-stage ventures as well as companies that have scaled through public offerings and acquisitions. She most recently led growth at Interwell Health, where she focused on strengthening relationships across the kidney care landscape and supporting partners through evolving value-based models. Prior to that, she helped launch and expand Homeward Health, where she contributed to the development of its rural care delivery strategy. "I have spent years helping organizations translate strong clinical and operational intent into real commercial traction," Stephanie said. "Arbital Health's platform, team, and culture are aligned with that same purpose. I look forward to helping our clients and partners navigate risk-based contracts with better data, clearer measurement, and a more reliable foundation for financial and operational success in value-based care." Brian Overstreet, President and CEO at Arbital Health, highlighted the importance of Stephanie's appointment for the company's next phase of growth "Stephanie understands how value-based care succeeds in practice," Brian said. "She brings a grounded view of what payers and providers need to manage risk successfully, and she has a track record of creating durable partnerships and growth. Her leadership will be central as we extend Arbital's contract integrity capabilities across more risk-bearing entities." As Chief Commercial Officer, Stephanie will oversee Arbital Health's commercial strategy, including go-to-market planning, payer and provider partnerships, client success, and market development. She will work closely with the executive team to support Arbital Health's mission of providing trusted infrastructure for risk based contracts while maintaining a disciplined approach to growth and execution. About Arbital Health Arbital Health provides the critical infrastructure for providers and payers to successfully manage risk-based contracts. With the industry's leading healthcare actuaries and robust AI-powered platform, Arbital Health accelerates contract performance monitoring and decision-making, centralizes fragmented data, and automates contract reconciliation across all major risk models. By reducing complexity and administrative burden, Arbital Health ensures value-based care contracts deliver on their promise of better patient outcomes and sustainable financial performance. Arbital Health is led by a best-in-class team of healthcare actuaries, engineers, and industry veterans, and backed by leading investors Valtruis, Transformation Capital, Shaper Capital, and Healthy Ventures. For more information, visit ArbitalHealth.com. Media Contact Rachel DiMartino, Arbital Health, 1 6037933482, [email protected], https://hubs.ly/Q03TLrJZ0 SOURCE Arbital Health

Cision
Oct 23rd, 2025
Arbital Health Appoints Najib Jai as Chief Operating Officer

Arbital Health appoints Najib Jai as Chief Operating Officer. News provided by. Arbital Health With deep experience across value-based care, Najib Jai joins Arbital Health to strengthen operations and drive the next phase of growth. SAN FRANCISCO, Oct. 23, 2025 /PRNewswire-PRWeb/ - Arbital Health, a healthcare technology company that provides critical infrastructure for providers and payers to successfully manage risk-based contracts, today announced the appointment of Najib Jai, MD, MBA as Chief Operating Officer. With a career shaped by entrepreneurship, leadership, and vision, Dr. Jai brings a distinctive perspective to Arbital's goal of advancing value-based care (VBC) through better management, measurement, and adjudication of risk contracts... Dr. Jai's path from physician to executive has been shaped by a deliberate pursuit of impact across medicine, business, and innovation. While earning both his MD and MBA at the University of Chicago, he began his career in private equity. There he studied the patterns of successful healthcare organizations and the discipline behind scalable growth. He later joined Oak Street Health, leading initiatives in specialty care strategy within value-based primary care models. Most recently, he co-founded and served as CEO of Conduce Health, where he guided the company from concept to acquisition while building a high-performing team. "Joining Arbital Health is a natural progression of everything I've worked towards," said Dr. Jai. "My career has always centered on aligning clinical integrity with operational performance. Arbital's platform and culture are built on those same principles. I'm excited to help shape our next chapter, one where data, technology, empathy, and execution work in concert to deliver measurable value for providers, payers, and patients alike." Brian Overstreet, President and CEO at Arbital Health, shared his enthusiasm for the appointment. "Najib has the ability to bridge the strategic with the human. He understands the operational realities of technology delivery but also the importance of vision, clarity, and communication in driving sustainable change. His leadership will be essential as we scale our contract measurement and adjudication capabilities across risk bearing entities." Dr. Jai will oversee Arbital Health's operations and implementation strategy, guiding the company's efforts to expand its footprint with payers and providers nationwide. His appointment underscores Arbital's focus on operational precision, team development, and disciplined growth as the company continues to serve a rapidly evolving value-based care landscape. About Arbital Health Arbital Health provides the critical infrastructure for providers and payers to successfully manage risk-based contracts. With the industry's leading value-based actuaries and robust AI-powered platform, Arbital Health accelerates contract performance monitoring and decision-making, centralizes fragmented data, and automates contract reconciliation across all major risk models. By reducing complexity and administrative burden, Arbital Health ensures value-based care contracts deliver on their promise of better patient outcomes and sustainable financial performance. Arbital Health is led by a best-in-class team of healthcare actuaries, engineers, and industry veterans, and backed by leading investors Valtruis, Transformation Capital, Shaper Capital, and Healthy Ventures. For more information, visit ArbitalHealth.com. Rachel DiMartino, Arbital Health, 1 6037933482, [email protected], https://arbitalhealth.com/ SOURCE Arbital Health

Cision
Oct 21st, 2025
Arbital Health Named to the 2025 CB Insights' List of the 50 Most Promising Digital Health Startups

Arbital Health named to the 2025 CB Insights' list of the 50 most promising Digital Health startups. News provided by. Arbital Health Oct 21, 2025, 12:48 ET Arbital Health recognized for achievements in transforming value-based care risk management through AI-powered SAN FRANCISCO, Oct. 21, 2025 /PRNewswire-PRWeb/ - CB Insights today named Arbital Health to its seventh annual Digital Health 50, showcasing the 50 most promising private digital health companies in the world. "The 2025 Digital Health 50 winners are high-momentum companies poised to define the next era of healthcare," said Ellen Knapp, Principal Analyst at CB Insights. "This year's cohort is advancing the shift from reactive to proactive care, developing AI solutions tailored to healthcare's unique regulatory environment, and addressing critical sector-wide challenges from care access to provider burnout and workforce shortages." "We're thrilled to be recognized as one of the most innovative digital health companies," said Brian Overstreet, President and CEO of Arbital Health. "Over the past two years, our team has worked tirelessly to build the infrastructure that makes value-based care not just possible, but effective - helping providers, payers, and patients achieve better outcomes at scale." Since its launch in late 2023, Arbital Health has achieved rapid growth across the value-based care ecosystem. The company has onboarded over 1 million patient lives, performed over 250 contract adjudications, doubled its team of value-based care actuaries, and formed strategic partnerships with provider and payer organizations. Earlier this year, Arbital raised a $31 million Series B to accelerate growth and innovation, including the launch of Merlin AI, the industry's first intelligent value-based care contract performance assistant. "The Digital Health 50 is an extremely competitive list, with thousands of private digital health companies evaluated each year," Overstreet added. "Being selected among the top 50 highlights the momentum we've built and the impact our platform is having across the healthcare system. This recognition is a testament to the progress we've made in transforming value-based care, and we're excited to continue scaling our platform and ensuring that value-based care contracts align financial incentives with better patient outcomes." * The 50 winners span categories such as care delivery, revenue cycle management, drug discovery & development, and diagnostics. * This year's cohort is deploying AI across a wide variety of use cases, with notable adoption of agentic AI, voice AI, and automated provider workflows. * Collectively raised $2B in equity funding in 2025 YTD (as of 10/14/2025). * 52% are early-stage companies (seed/angel or Series A funding). * Established 140+ business relationships since 2024 with industry leaders including Cleveland Clinic, IBM, and Novartis. About CB Insights CB Insights is the leader in predictive intelligence on private companies. It delivers instant insights that help you source and analyze private companies, focus on the right markets, and stay ahead of competitors. Its AI agents are powerful because they translate signals into the exact outputs your teams need to move first - defensible, sourced, and board-ready. To learn more, please visit www.cbinsights.com. About Arbital Health Arbital Health provides the critical infrastructure for providers and payers to successfully manage risk-based contracts. With the industry's leading value-based actuaries and robust AI-powered platform, Arbital Health accelerates contract performance monitoring and decision-making, centralizes fragmented data, and automates contract reconciliation across all major risk models. By reducing complexity and administrative burden, Arbital Health ensures value-based care contracts deliver on their promise of better patient outcomes and sustainable financial performance. Arbital Health is led by a best-in-class team of healthcare actuaries, engineers, and industry veterans, and backed by leading investors Valtruis, Transformation Capital, Shaper Capital, and Healthy Ventures. For more information, visit ArbitalHealth.com. Rachel DiMartino, Arbital Health, 1 6037933482, [email protected], https://arbitalhealth.com/ SOURCE Arbital Health

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