Company Announcements

Austin-based startup helps employers anticipate high cost, unexpected health insurance claims with AI-powered insight

AUSTIN, Texas--(BUSINESS WIRE)--Feb. 15, 2024-- Merit Medicine, a health tech startup that helps self-funded employers anticipate high-cost medical spend and specialty drug utilization, and chronic, complex, and rare diagnoses, announces that it has closed a $2M seed round led by LiveOak Ventures.

Founded in 2022, Merit Medicine seeks to bring AI insights to the often-opaque employer-sponsored health insurance market. Employers who self-fund their employees’ health plans face an era of rapidly escalating healthcare costs. With the expansion of high-cost medical spending and the rapid introduction of more targeted and expensive specialty drugs, the seemingly-unpredictable nature of these expenses can decimate budgets and ultimately lead to fewer people getting the care they need.

Company founder and CEO Ali Panjwani, who is a leader in improving market access to treatments for people suffering from complex conditions with stops at Genentech, BridgeBio Pharma, Coherus Biosciences, and Aetion, created Merit Medicine to guarantee everyone has a fair shot at the best care.

“Large self-funded employers cover over a quarter of the US population today,” said Panjwani. “And employer contributions to healthcare now make up roughly $600 billion of annual healthcare spending in the United States. Using AI insights from millions of patients, Merit Medicine ensures a smoother, more predictable budget for employers’ catastrophic healthcare spend, which leads to more people getting affordable access to the care that they need when they need it.”

Stop-loss carriers, responsible for insuring employers against substantial claims arising from these drugs and treatments, handle extensive information to calculate the premiums for employers. In contrast, self-funded employers rely solely on their own employee population.

Merit Medicine levels the playing field by leveraging its extensive dataset, consisting of millions of data points, to generate predictions tailored to the specific population of each employer. The company combines its proprietary models and unique dataset with employer-specific population data to make budgeting more predictable for self-funded employers. Going beyond the industry standard of simply extrapolating from last year’s results to predict this year’s, Merit Medicine empowers benefits leaders with AI-driven predictions based on patient journeys, enabling them to offer the best benefits to their employees.

"Self-funded employers are faced with rising healthcare costs and significant financial risk based on the health of their employee base,” said Mike Marcantonio, who is leading the investment for LiveOak Ventures. “Unfortunately they have very few tools today to evaluate this risk and plan for it.

“When I met the Merit Medicine team, I was inspired by their mission to help employers address this risk by using AI to predict high-cost specialty drug usage and rare, chronic, and complex conditions. The team's domain experience also stood out with experience in drug pricing, market access, and healthcare data analytics.”

About Merit Medicine

Merit Medicine is an innovative health tech startup revolutionizing employer-sponsored healthcare. Leveraging advanced AI insights, the company specializes in predicting high-cost medical spend and specialty drug utilization in rare, chronic, and complex conditions for self-funded employers. Founded by industry visionary Ali Panjwani in 2022, Merit Medicine empowers benefits leaders with AI-fueled predictions, enabling more effective budgeting and ensuring optimal healthcare for every employee. Merit Medicine is headquartered in Austin, Texas, with remote employees across the United States. Visit meritmedicine.com for more information.

About LiveOak Ventures

LiveOak Ventures is an early-stage venture capital firm based in Austin, Texas. With 25 years of successful venture investing in Texas, the founders of LiveOak have helped create nearly $5 billion of enterprise value. LiveOak is a complete life cycle investor focused on technology and technology-enabled service companies. With nearly $500M under management and led/co-led over 60 high-growth investments in Texas-based leaders, such as AmplifAI, DISCO (NYSE: LAW), Eventus, Homeward, OJO Labs, Osano, SchooLinks, Take Command Health, and many more, some starting at inception. The firm was honored at the inaugural Austin A-List Awards in 2022 as the Venture Capital Firm of the Year and received the Austin Gives Charitable Champion award.

View source version on businesswire.com: https://www.businesswire.com/news/home/20240215566856/en/

press@meritmedicine.com

Source: Merit Medicine