Healthcare organizations are rapidly adopting artificial intelligence technologies but without a clear blueprint for how to measure the business value of these investments.
According to an analysis from Menlo Ventures last fall, the healthcare industry is deploying AI at more than twice the rate of the broader economy. AI dominated the healthcare investment landscape in 2025 as investments in AI healthcare companies represented 46% of total spending, totaling $18 billion, Silicon Valley Bank reported. But many of those AI investments are not producing measurable results.
A July 2025 report (PDF) from MIT's NANDA initiative revealed that 95% of enterprise generative AI pilots failed to deliver measurable return on investment (ROI).
Startup Optura launched a year ago to help healthcare organizations decide where AI dollars actually pay off. The company built a platform for healthcare organizations to quickly assess AI business value and viability, prioritize AI investments and provide clear visibility into an AI’s enterprise impact and return in real time. The company developed a framework, called the return on AI investment (ROAI), to enable enterprises to understand, project and track value creation for technology initiatives.
The company landed a $17.5 million series A round led by Salesforce Ventures, with participation from Echo Health Ventures and continued investment from Susa Ventures, Matrix Partners and HC9 Ventures. Optura has raised $25 million to date. A year ago, the startup pocketed $6.5 million in seed funding from Susa Ventures and Matrix Partners.
Optura co-founders Andy Fanning and Michael Hollis aim to turn AI from a buzzword into a working system and built a platform that gives healthcare organizations control, visibility and real ROI.
"We both found there was an absolute paralysis in the market related to AI adoption. It's less about the ability for AI to technically perform. It's not a technological problem, it's a trust problem," Hollis, who serves as president of Optura, told Fierce Healthcare. "We want to show, quantify and prove that AI can have an impact on these healthcare organizations at scale."
"The hundreds of AI use cases coupled with the introduction of foundational models into healthcare markets, like Claude for Healthcare, are driving AI spend and increasing risk," Fanning, who serves as CEO, said. "It has also created a never-ending menu of point solutions, without an objective framework to help healthcare leaders measure the ROI on their AI investment decisions. We developed Optura to take out that guesswork and help healthcare organizations objectively measure results."
Investor Echo Health Ventures is a strategic venture capital firm that invests in healthcare innovation on behalf of Blue Cross Blue Shield plans.
“AI, and specifically gen AI, is priority one, two and three right now for health plans,” noted Kurt Sheline, partner at Echo Health Ventures. Health insurance companies, like most healthcare organizations, face challenges keeping pace with the rapid evolution of AI tech, integrating it into existing systems and addressing concerns with security and risk, he noted.
Health plans also are evaluating how to quantify the value of AI investments.
“What got us excited about Optura is they are pretty clearly coming to the market offering solutions to the exact pain points that we see firsthand articulated by our health plan partners. It is an AI enablement platform for one of the hardest industries I feel like to get AI adoption in healthcare,” Sheline told Fierce Healthcare.
Fanning spent years at Cigna leading business transformation and AI strategy, while Hollis helped grow Emids into a top digital health firm.
Optura's platform systematically maps an organization's existing data into a unified knowledge layer so every decision is grounded in how that organization works and then scores and ranks use cases against organizational priorities, cost and readiness. The platform can then translate the top priorities into AI agents, trained specifically for healthcare and built directly from workflows and standard operating procedures, according to the company.
Optura's platform simulates the expected return so organizations can determine the projected value before deployment. The company can then deploy AI agents across the enterprise, tracking outcomes, initiatives and projected value in one unified, real-time dashboard to provide clear visibility into AI impact, executives said.
"We help organizations have this 'aha moment' of 'This is how it can actually be applied to my business and how it could be applied to my business unit.' We activate their idea into value," Hollis noted.
The company works closely with organizations' C-suite executives, he added.
"We start with business. We do not start with technology, again, this is not a technological problem. This is a behavioral problem. It's less about what can AI do for them? It's more around, what are you trying to accomplish as a business?" he said. "Everyone's going through a very heavy transformational phase right now. A lot of folks are applying AI at the perimeter problems. We think that's the wrong way to do it. You need to attack these problems at the center, so less on the perimeter, more at the core, which is what our platform allows it to do."
While Optura's technology platform is complex "under the hood," Hollis outlined the company's focus as helping healthcare organizations identify where AI can have an impact and then organize those ideas around what value matters to them.
"We're not pitching innovation theater. We're not pitching point solutions. We're talking to them about what value matters to them—if it's EBITDA, it's revenue growth, if it's member satisfaction, whatever those core value points are, that's where we configure the system, and then we operationalize it. That is the art of the science, how we operationalize it. We're helping them, through the platform, bring these ideas to life, agentically," Hollis said.
Optura offers a "single pane of glass" to give C-suite executives a view on the health of their AI programs across the organization, he said.
"Folks are really excited about the opportunity of AI, but they want to quantifiably show and know where AI is going to have an impact, and that's what we do as a platform and what we do as a business," Hollis said.
In the past year, the startup has gained significant traction with enterprise health plans and providers, which include Independence Blue Cross, Prime Therapeutics and Ardent Health. Optura claims that more than $2 billion in AI initiatives currently run on its platform, with $120 million in tracked value at 700% return on AI investment on in-flight initiatives. The company has identified 250 new AI use cases.
"Optura delivered realized value faster than we anticipated," Marty Bonick, president and Chief Executive Officer of Ardent Health, told Fierce Healthcare. "Across marketing, contracts, and finance, we went from ideation to agentic AI in days, not months. That kind of speed, along with real accountability, changes what's possible for a health system like ours."
"Healthcare organizations are under growing pressure to move beyond AI experimentation and deliver measurable business outcomes,” said Katie Thiry, managing director at Salesforce Ventures. “Optura is helping customers bring greater rigor and visibility to AI investment decisions – identifying high-value use cases, measuring impact and accelerating time to ROI. As enterprises look for more disciplined approaches to AI adoption, we believe Optura is well positioned to help lead that shift.”
The startup counts several top health insurance executives among its early investors, including Bruce Broussard, the former CEO of Humana, Susan Diamond, former chief financial officer of Humana as well as Mario Schlosser, co-founder and former CEO of Oscar Health, now chief technology officer.
“The question for health plans is no longer whether to invest in AI; it's whether those investments are actually delivering better outcomes for members,” said Michael Vennera, executive vice president and chief strategy, technology and operations officer at Independence Blue Cross, in a statement. “Optura answers that question for an organization like IBX, where every decision connects back to the people we serve, that kind of accountability and visibility isn't optional; it's how we ensure AI creates real value where it matters most.”
Optura plans to use the fresh funding to invest in expanding AI capabilities, growing platform teams and scaling large language model partnerships.
"More platform capabilities aligning more strategically to the models, so both OpenAI and Anthropic, we've got some material conversations happening," Hollis said.
Optura also sees opportunities to work with Salesforce. "We're going to be investing in some of the partner channel management and expanding those capabilities and that team to take advantage of what's in front of us," he said.
As Optura works with health plans and providers, it has a clear view to how healthcare organizations are adopting AI. Despite unique operating environments, both provider and insurance organizations are struggling to determine if AI investments are creating ROI, Hollis noted.
"On the payer side, lots of health plans like to build a lot, so there's a lot of customizations and a lot of tweaking that they've done and investments they've done to sustain those customizations. There's a lot of build functionality in the mindsets of health plans. On the provider side, it's a lot less. It's a lot of buying off the shelf, so a lot of dependency on off-the-shelf providers, a lot of tooling, a lot more point solutions," Hollis said. "But each CFO has the same headache. One is saying, my team wants to hire more people, they want to build more things and I can't tell if what we're doing is actually working or not. Thus, I'm not going to invest anymore. Same thing goes on the CFO provider side, who says my team wants to buy more things. We have a bunch of stuff that's in our ecosystem. I have teams going to conferences and swiping credit cards and coming back with agents that I don't even know if they work together well. And we definitely don't have security wrapped around it like we we should, and we definitely don't have anything related to ROI capture."
He added, "We at Optura become a catalyst to bring this activation to life, but do it with a plan and the ability to go at scale so we can have an impact in healthcare."