Artificial intelligence compliance platform Readily raised $11 million in series A funding to support development of its enterprise oversight platform.
Define Ventures led the funding round, with participation from Y Combinator and the California Health Care Foundation Innovation Fund.
Readily’s platform connects regulatory requirements with policies, assigned actions and supporting evidence to reduce manual research and review processes.
CEO and co-founder Edward Tiong told Fierce Healthcare via email that he used to sell medical coding software to health plans and “kept losing meetings to the same thing.”
“The ops lead would cancel: ‘We just got audited.’ Or, ‘A new rule dropped, I’m underwater,'" Tiong said. "It happened enough that I stopped trying to sell them anything and started asking what was going on. What I found was a trillion-dollar government program running on 10,000 requirements that change 700 times a year, and plans keeping up with binders and spreadsheets.”
Tiong said those responsible “were brilliant and exhausted.”
“Nobody had built them anything,” Tiong said. “That was the opening.”
Readily’s platform seeks to bridge that gap. When the Centers for Medicare and Medicaid Services (CMS) releases new rules, Tiong said, the platform can analyze them against existing policies and contracts “in hours,” identifying gaps and action items for teams.
“Then it tracks whether the work got done and keeps the proof for the auditor,” Tiong said. “The AI does the reading and the matching. The compliance officer decides. That’s the division of labor we think is right, and it’s the one our customers trust.”
The company’s work with healthcare organizations covers more than 25 million covered individuals across 46 states, according to its website. Tiong said revenue has grown 10x.
One of the health plans Readily works with is L.A. Care, the nation’s largest publicly operated health plan.
“They use Readily to streamline administrative compliance work and support regulatory oversight within their existing infrastructure, freeing staff for the work that matters to members,” Tiong said. “If it holds at that scale, the rest of the country is a matter of time.”
Tiong said Readily works with more than 60% of California’s Medicaid managed care plans.
"As the nation’s largest publicly operated health plan, L.A. Care operates in an increasingly complex and evolving regulatory environment,” said Todd Gower, L.A. Care Health Plan's chief compliance officer said in a statement. "We are thoughtfully incorporating technology, including AI-enabled tools, to complement our strong compliance infrastructure and established processes. Our work with Readily is focused on helping our teams streamline administrative activities, support effective regulatory oversight and dedicate more time to higher-value compliance activities that ultimately support our organization and the members we serve."
Define Ventures Principal Hong Truong told Fierce Healthcare that payers “in particular are feeling it from both sides right now.”
“Regulatory scrutiny keeps intensifying while margins keep tightening, and they’re investing more in AI to keep up,” Truong said. “Readily meets them where they are. It starts by helping them get ahead of their regulatory obligations, and over time it becomes the operational backbone of the organization.”