Fixing Fragmentation: The Reason We Built Arbiter
Arbiter makes healthcare work as one.
By Michelle Carnahan, Co-Founder and CEO
The Problem Isn’t Effort
After more than twenty-five years in healthcare, it’s become clear the challenges we face aren’t rooted in a lack of commitment, but in a system defined by fragmentation.
Across pharma, provider systems, and digital health, I’ve seen extraordinary clinicians, scientists, and operators doing everything they can. But dedication can’t overcome a landscape where data, decisions, policies, and incentives move on separate tracks.
That structural fragmentation is what causes patients to fall through the cracks - and it’s exactly why we built Arbiter - to make healthcare work as one.
Innovation Has Outpaced Integration
For all its promise, technology has too often made care more complicated instead of more connected. Every “smart” solution adds another login, another portal, another layer of friction. The result? Nearly a trillion dollars wasted each year, one in four patients abandoning treatment due to delays, and clinicians burning out faster than ever. These aren’t individual failures; they’re systemic breakdowns that cost lives, money, and trust.
Introducing Arbiter: A System Built to Work as One
Arbiter unites everyone involved in a patient’s journey — clinicians, care teams, payers, and patients themselves — on one intelligent platform. Its foundation is what we call the Record–Action–Alignment model, a continuous loop that keeps information, decisions, and actions moving in sync:
- Record: A longitudinal patient record that integrates clinical, financial, and contractual data into a single source of truth
- Action: AI-powered workflows that surface insights and trigger next best steps, whether that’s closing a quality gap, approving an authorization, or scheduling an appointment
- Alignment: Real-time feedback loops that keep patients, providers, and payers connected and moving in the same direction
When systems move together, everything changes. Authorizations take hours instead of weeks, referrals stay in-network, clinicians spend more time with patients, and care moves at the speed of need. That's what Arbiter is built to do: ensure every person receives the right care, in the right place, at the right time.
What Makes Us Different: We’re the Conductor
Delivering on that mission requires a platform that sits between payers and providers, with real-time access to both sides. While most are building another instrument for the orchestra - a prior auth tool here, an analytics dashboard there - we’re the conductor.
When a patient needs a mammogram, we can instantly answer: in-network, best quality, best value, shortest wait time, approved authorization - because we have the clinical data from providers, the policy data from payers, and the financial data from both. Then our AI agents execute: schedule the appointment, notify the patient, close the loop. No back-and-forth, no delays, no leakage.
That's the unlock: we connect the people making decisions and align their actions as care is delivered. And we have the expertise and distribution to scale it nationally.
Built by Operators — Not Outsiders
I’m proud to share that we’ve launched with $52 million in seed funding, backed by TriEdge Investments and MFO Ventures, together with WindRose Health Investors and other leading operators, at a $400 million valuation.
Arbiter reflects a lifetime of observing what works—and what doesn’t—inside healthcare. It is built by people who have lived healthcare’s complexity from every angle: clinicians, executives, and technologists who know the system’s pain points firsthand. We’re operators building for operators, with patients at the center.
Our success won’t be measured in valuations or headlines, but in moments - when care arrives in time, when a doctor can focus on medicine instead of admin, and when the system finally works as it should.
Because patients deserve the care they need without delay. Providers deserve technology that works for them, not against them. And payers deserve to invest in outcomes, not waste.
That’s a future worth building. And Arbiter is how we get there.
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