New funding propels Cohere’s expansion of intelligent prior authorization platform to drive better payer-provider collaboration, following CMS Interoperability and Prior Authorization Final Rule

Boston, MA (February 1, 2024) – Cohere Health, a recognized leader in clinical intelligence and prior authorization automation, announced it has closed $50 million in additional equity funding. The funding was led by Deerfield Management, with participation from Define Ventures, Flare Capital Partners, Longitude Capital, and Polaris Partners, and brings the total raised by Cohere to $106 million. The latest round of funding will fuel the company’s expansion to meet the increasing demand for Cohere’s intelligent prior authorization platform.

“The significant growth Cohere has experienced in the last four years demonstrates the high demand we are seeing from health plans and risk-bearing providers to combat antiquated prior authorization processes and to improve patient access and experience,” said Siva Namasivayam, CEO and co-founder of Cohere. “We are seeing even greater traction and growth with both our current portfolio and new clients. From less than 10 individuals in January 2020 to more than 700 employees today, we are thrilled to enter this next growth phase.”

The Centers for Medicare & Medicaid Services Interoperability and Prior Authorization rule, finalized this January, will require health plan investment in advanced technology to ensure compliance with federal prior authorization requirements. Harnessing Cohere’s patented AI-powered technology, Cohere’s solutions assist health plans to meet and exceed these regulations.

“We are thrilled to add to our investment in Cohere as the company continues its rapid growth,” said Michael Greeley, co-founder and general partner at Flare Capital Partners. “The additional capital will help expedite operations expansion to accommodate the explosive growth, which in turn will further Cohere’s leadership position in the emerging intelligent prior authorization space. Most importantly, this cash infusion will accelerate the company’s ability to help patients get access to the right care faster, and with better outcomes.”

Cohere’s AI-driven prior authorization solutions boost health plan savings beyond traditional utilization management programs and ultimately help providers and patients get to ‘yes’ more quickly. Cohere’s unique blend of AI with real-time analytics and deep, evidence-based clinical intelligence reduces prior authorization denial rates and leads to faster patient access to care by five days.

While the use of AI increases the need for accountability, privacy, transparency, and clinical oversight throughout the prior authorization process, Cohere is dedicated to navigating these challenges and revolutionizing the healthcare landscape using responsible and ethical AI with deep clinical expertise to set a higher quality of care.

Currently, Cohere serves five health plans, processing 5.5 million intelligent prior authorizations annually for more than 15 million health plan members and 420,000 healthcare providers nationally.