Closing a $140B Blind Spot: why we’re excited about Onos Health

Behavioral health is one of the trickiest segments in healthcare because it’s so hard to measure. Demand keeps surging, spend keeps climbing, and payers still have no reliable way to tell whether the care they are paying for is working. The tooling was never built for it. Legacy utilization management software was designed for structured claims data, not for the qualitative, multimodal, document-heavy reality of behavioral health. These are the issues Onos Health is being built to address, and why we’re so excited to have led their $17m Series A, joined by Flare Capital Partners and CVS Health Ventures. Onos is building the AI infrastructure that makes clinical quality in behavioral health measurable at scale, so health plans can see what is actually working and partner with the providers delivering great care.

A 20-year measurement gap

Behavioral health is roughly 20 years behind physical medicine on measurement. There's no blood pressure equivalent. Newer clinical frameworks like LOCUS and ASAM can help providers determine the appropriate level of care, but most don't report against them. So health plans approve billions of dollars of care a year with almost no visibility into whether patients are getting better.

The key challenge is that more than 70% of the quality signal sits in unstructured notes. A provider who drops a patient's treatment goals and replaces them with 15 new ones at the next authorization period looks perfectly clean in the claims data, unless someone is actually reviewing the chart.

Behavioral health is also one of the leakiest spend categories in healthcare, which telehealth has amplified. Spending is growing ~30% year over year, and most health plans still don't have the data systems to see clearly into the quality of care being delivered across their populations.

That's the gap Onos was built to close.

What Onos actually does

Onos pulls hundreds of pages of clinical documentation, extracts the assessments and scores buried inside them, maps them to plan criteria, and gives reviewers citations and traceability back to the source note. But their real differentiator is that they understand the actual clinical pathways of care, not just the paperwork. 

The results speak for themselves. Health plans on the Onos platform have improved 35% in clinical standard adherence and 75% in clinical review efficiency, resulting in fewer delays in care. Onos' AI-powered clinical accuracy rate is 90%, nearly 30 points above the behavioral health industry standard. It's a clear example of what the team is really building: AI infrastructure for higher quality, more affordable care, where better outcomes and lower costs come from getting the clinical picture right, not from cutting corners.

Why this market, why now

Selling to health plans is not for the faint of heart. Distribution is slow, the stakes are high, and there's no room to get it wrong. Onos’ co-founders, CEO Akshay Agrawal, CPO Josh Levitan, and CTO Suhaas Prasad, understand this better than almost anyone. Akshay and Josh both helped Health Experience & Insights leader mPulse grow to ~$50 million in revenue, and Suhaas is a top-tier operator known for hiring and building AI technical teams. From our first conversation with them, it was clear they brought a level of seriousness, rigor, and strategic thinking that a problem of this size requires. Together, the Onos founders have a rare combination of real technical depth paired with significant payer sales experience to get this into production at scale. That combination is exactly what we look for in founding teams.

Sales cycles in this market are long. But the prize once you're in is significant, and behavioral health is just the starting point. The same clinical intelligence layer extends naturally into outpatient therapy, serious mental illness, and substance use disorder workflows, and over time into utilization management well beyond behavioral health.

Onos already has real validation from large health plans. Trusted by three of the six largest health plans in the country, including Aetna, Onos is built on what the team believes is the largest quality database in behavioral health.

Why we're excited

This fits squarely into our healthcare thesis around Fraud, Waste, and Abuse, which we published last year, under intelligent monitoring and pre-payment reconciliation for payers. We've long believed that disconnected data systems and opaque processes among payers, providers, and regulators create exploitable gaps, and we've seen first-hand how hard behavioral health outcomes are to measure in the first place.

Akshay and team are truly special and we believe they have the opportunity to build a company that changes how health plans and providers think about monitoring outcomes and ultimately delivering a better patient experience, all while making behavioral healthcare more affordable.