How Prosper AI Hopes To Shake Up US Healthcare For Good
Administrative costs consume as much as 25% of US healthcare budgets, numerous studies have revealed , implying that the sector could be spending more than $1 trillion a year on administration. No wonder healthcare professionals are so excited about the potential of artificial intelligence to reduce their costs and free up funding for front-line services; the AI for patient management market is now growing at a rate of 30% a year according to Precedence Research. Gartner, meanwhile, has predicted AI agents could be handling 80% of healthcare inquiries by 2028 .
So far, however, most of the leaders in this market have chosen to focus on specific areas of the patient experience – appointment scheduling, say, or dealing with insurers – arguing that America’s healthcare system is too complex for an all-in-one solution. But Prosper AI , which is announcing a $30 million fundraising round, thinks that is too timid a response to the scale of the problem.
“Providing an end-to-end process is important because it will underpin the provision of more universal healthcare,” argues Xavier de Gracia, co-founder and CEO of the New York-based start-up. “At the moment, it’s really difficult for patients to even find out what a procedure or treatment might cost, and many of them give up.”
Accordingly, Prosper AI’s platform offers healthcare providers access to a suite of AI voice agents that are capable of managing the whole process of an interaction between a patient and the healthcare sector. Agents can answers calls from patient calls, schedule appointments with healthcare professionals, verify their insurance benefits and automate billing once treatment is complete.
A step change in the quality of voice agents has made this possible, says Josep Mingot, who co-founded the business alongside de Gracia. “The patient experience has been transformed,” he says. “While patients can ask to speak to a human operator at any time, our AI agents now deal with 50% of calls in their entirety and we expect that percentage to grow.”
Healthcare organizations, which have often been skeptical about the benefits of AI, are now embracing Prosper, de Gracia adds. It has added more than 40 new organizations to its customer list in the past six months, with revenues growing five-fold. The platform now supports more than $7 billion worth of patient care.
There had been a sense that healthcare providers would be late adopters of AI because of concerns about confidentiality and patient sensitivities. “Actually, it turns out that the sector has been waiting for a solution it believes can generally create value,” says de Gracia. “Healthcare providers want a single platform capable of managing the workflows that determine whether care happens and whether providers ultimately get paid.”
Too many technology companies have over-promised and under-delivered, agrees, Noah England, COO of Piedmont Dermatology, one provider that has signed up to Prosper’s platform. “Many organizations using other AI solutions remain stuck at 20–30% automation because those systems stop at scheduling,” he says. “Out of the gate, Prosper was handling more than 50% of our patient conversations end-to-end, including complex cases involving real-time benefits verification.”
Other customers, including Jackson Memorial Hospital, the second-largest hospital in Florid, and electronic health records platform Athenahealth, have also been enthusiastic, prompting significant investor interest in Prosper.
The firm’s $30 million Series A round is led by Andreessen Horowitz, with participation from Base10, and from existing investors Emergence Capital, Y Combinator and Company Ventures.
“AI should make healthcare infinitely accessible,” says Jay Rughani, partner at Andreessen Horowitz. “Prosper stood out because of the scope of their ambition: it wants to eliminate every administrative friction point between a patient and the care they need.”
Adeyemi Ajao, co-founder and managing partner at Base10 Partners, adds: “Prosper is leveraging agentic AI to transform the way provider groups and hospitals engage with patients, driving not only savings, but increased revenue and better patient experience.”
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