Cohere Health closed a Series C $90 million funding round on Wednesday, taking its total funding to date to $200 million.
The Boston-based company, which was founded in 2019, aims to fix the inefficiencies and administrative burden associated with the traditional prior authorization process. By streamlining this process, Cohere seeks to decrease treatment delays and reduce healthcare providers’ workload, said CEO Siva Namasivayam.
The startup automates prior authorization by digitizing authorization requests and assessing them against medical guidelines using AI, he explained. This system integrates with a provider’s EHR — which enables faster submissions from providers, as well as faster care decisions from clinicians, Namasivayam pointed out.
A 2024 survey from the American Medical Association showed that 93% of physicians say prior authorizations lead to care delays for patients — and that 1 in 4 say prior authorization has led to a serious adverse event for a patient in their care.
Cohere sells its platform primarily to health plans and at-risk providers. The company has health plan customers in all 50 states, Namasivayam stated. These consist of national and regional plans, including Geisinger Health Plan and Medical Mutual, as well as Blue affiliates, he added.
He also noted that Cohere is working with nearly 600,000 providers — and it processes more than 12 million prior authorization requests annually.
Namasivayam identified legacy utilization management vendors as Cohere’s main competitors and said that his startup differentiates itself from these companies through the quality of its technology.
“What sets Cohere apart is its clinically intelligent, precision approach to AI and its tailored approach — supporting providers in the moment with curated experiences to improve health outcomes for patients. Cohere’s technology is designed to accelerate approvals, never to deny care — those decisions always remain with a human clinician,” he remarked.
Cohere’s Series C round was led by Temasek, with participation from Flare Capital Partners, Deerfield Management, Define Ventures, Longitude Capital and Polaris Partners.
In his Wednesday newsletter, Flare Capital General Partner Michael Greeley said that the high level of investor interest in Cohere was due to two main factors — the clinical and technical expertise of the leadership team, as well as the “large and obvious” market opportunity to reduce the expense and burden associated with prior authorization.
“Being a recognized innovative category leader with a relevant and sophisticated investor syndicate going up against legacy vendors ensured that potential clients felt that they had to engage with the company to see the ‘art of the possible,’ which generated a significant sales pipeline with well-heeled impressive clients,” Greeley wrote.
In his view, this significant round of financing cemented Cohere as the emerging winner in the prior authorization tech category.
Photo: Andranik Hakobyan, Getty Images
