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Why I started Kubera
I trained as a medical doctor intending to spend my life caring for patients with terminal illness. After leading research trials, and working inside Humana and Commonwealth Care Alliance on clinical strategy and value-based care, I found that the hardest problems weren't clinical. They were financial — the plumbing underneath how care gets paid for.
Contracts determining how billions of dollars moved between payors and providers were sitting in shared drives. Sophisticated organizations on both sides of the table were making strategic decisions in the dark, and discovering payment problems months, sometimes years, after the fact. It gets worse the more ambitious the arrangement.
Patients and clinicians deserve an administrative and financial system that scales good care, not friction. That's the system Kubera is building: the infrastructure that connects every contract to every payment.
The cost of the status quo
Providers lose 3–10% of net revenue annually to inaccurate payments — money they are contractually owed but never collect. Payors spend billions on reconciliation and dispute workflows that exist because contractual rules and claims are disconnected systems.
The industry's response has been to add staff, and more recently, AI. Payors are training models to deny and issue new policies faster and providers are deploying solutions to re-code and call in response; meanwhile, costs continue to climb. The Healthcare Financial Management Association calls it the Battle of the Bots. The AI arms race has become the newest source of administrative friction. The solution is payment accountability infrastructure.
Where we started, where we're going
Most companies in this space would have started with the recovery wedge — go to hospitals or payors, find them money, charge a contingency fee. We started with infrastructure on purpose. The contract intelligence, the modeling, the auditing logic came first. We built Kubera to be the contract-to-payment system of record for American healthcare, turning every contract, rate schedule, amendment, and policy into structured logic that runs continuously against claims and payment data. Recovery without infrastructure is a services business that gets paid more when the system stays broken. We wanted to build the foundation for something different.
To date, the platform has processed over $3 billion in payments, with 100% of customers expanding their relationship with us — through pilot conversion, additional module adoption, or both. Now that the infrastructure is in place, we're investing in two specific focus areas with this round:
VBC contract management. Every organization managing or stepping into risk surfaces the same gap: they're betting their business on contracts they can't model, monitor, or enforce structurally. We're building the layer that makes complex VBC contracts operable in real time.
Agentic payment recovery and auditing. Recovery has always been reactive — analysts hunting underpayments after the fact. Agentic systems on top of structured contract intelligence make it continuous, scalable, and preventative.
The same infrastructure extends to innovative contract structures, integrated health plans, and faster, accountable payments across every party in the system.
Why this moment
Healthcare contracts have outgrown the old approach. Value-based care and new CMS models have been layered onto legacy solutions never built for this complexity. Hospital bad debt is up 10% in 2025. CommonSpirit walked away from its $1.9B Conifer contract to bring revenue cycle in-house and own the AI strategy. Many systems want to make similar moves but lack the infrastructure to support them.
We're building Kubera AI-first because this problem requires continuous reasoning over contract and payment data at scale. The work is unusually hard — processing billions of dollars in production, designing agents on top of complex business rules — and we're hiring builders who want that.
Thank you
To our founding team and early customers — working with you has been the best part of this. Our product exists because of your belief in Kubera when we were still proving the thesis. And to our investors, thank you for backing us when most of it was still on paper.
The clinical work in healthcare is hard enough. The financial system underneath it shouldn't be.
Roja Garimella, MD
Founder & CEO, Kubera Health