For investors
almyhealth is a voice-first clinical intelligence platform for the post-discharge gap in senior care. We are pre-launch, building toward first pilots in Texas.
This page is a summary. The detailed business plan, financial model, regulatory analysis and go-to-market plan are available under NDA.
The problem is large, expensive and measurable
Medication non-adherence is one of the most costly solved-on-paper problems in American healthcare. Nearly half of patients do not take their medications as prescribed.
Among adults 65 and older, the cost concentrates sharply:
- one in tenPrimary citation required before publicationa quarterPrimary citation required before publicationNon-adherence is implicated in roughly one in ten hospitalizations among older adults, and is associated with up to a quarter of all hospitalizations overall.
- $43,404Primary citation required before publication22% to 37%Primary citation required before publicationFor severely non-adherent patients, unadjusted total healthcare costs reach as high as $43,404 per person. Inpatient care accounts for 22% to 37% of adherence-failure costs.
- $3 billionPrimary citation required before publication$16,000Primary citation required before publicationRehospitalizations originating from skilled nursing facilities generate over $3 billion annually in excess costs to Medicare, with a single 30-day readmission episode costing more than $16,000.
- Estimates of avoidable annual hospital costs from non-adherence in the 65 and older population run to tens of billions of dollars.
The cost is not only borne by hospitals. Under the Hospital Readmissions Reduction Program, CMS penalizes hospitals up to 3% of Medicare inpatient revenue for excess 30-day readmissions in conditions including heart failure, COPD and joint replacement.
And the buyer's incentive just changed. The Inflation Reduction Act's $2,000 annual cap on Part D out-of-pocket spending, effective 2025, transferred the financial consequence of an unfilled prescription from the beneficiary to the plan. Plans now carry the risk that an unused medication converts into an acute care liability.
The market
The global AI in healthcare market was valued at $39.34 billion in 2025 and is projected to reach $56.01 billion in 2026, growing to over $1 trillion by 2034 at a compound annual rate of nearly 44%. North America held 44.5% of that market in 2025. Hospitals and clinics are the largest adopter segment.
Our beachhead is Texas, chosen for specific structural reasons rather than convenience:
- 4.5 millionPrimary citation required before publicationTexas is the second-largest healthcare market in the United States, with roughly 4.5 million Medicare beneficiaries.
- 51.5%Primary citation required before publicationMedicare Advantage penetration in Texas is 51.5%, which concentrates risk in organizations that are paid to prevent admissions.
- Large rural areas function as healthcare deserts where voice is the only viable delivery channel.
- The state has a dense ecosystem of independent physician associations pursuing revenue through value-based care.
In Harris County alone, approximately 250,000 seniors are enrolled in Medicare, and nearly 58,000 high-need patients participate in special needs plans. Our market analysis identifies 463 specific Houston healthcare entities across three tiers: roughly five major payvider systems representing over 250,000 at-risk senior lives, six to eight aggregator networks representing over 150,000, and 400 to 500 independent clinics representing roughly 100,000 more.
Our approach, and why we think it wins
We removed the adoption barrier instead of designing around it. Competing products require a smartphone, an app, a wearable or a shipped device. Every one of those is an onboarding step that loses patients, and the losses concentrate precisely in the highest-risk population: low digital literacy, no broadband, early cognitive decline, rural. We use the telephone that is already in the house. Nothing to ship, nothing to install, nothing to charge.
We built for engagement, not compliance theater. Automated reminder calls get hung up on. Alma is designed around acknowledging a patient's emotional state before delivering clinical content, and around shifting her behavioral role to fit the task. Engagement is the precondition for data, and data is the entire product.
We fit the culture of the patient. Designed for bilingual and multicultural seniors with models trained on regional dialects, rather than generic translation layered onto an English product.
We sell workforce capacity, not software. Health systems do not have a shortage of dashboards. They have a shortage of staff. We position almyhealth as an additional layer of workforce capacity that lets clinical teams cover a panel they cannot currently reach.
We monetize on both sides of the value-based care line. For independent clinics, we enable remote therapeutic monitoring revenue immediately. For risk-bearing plans, we protect margin. Same platform, two economic stories.
Business model
Two models, matched to two buyer types.
Model A: Remote therapeutic monitoring
Sold to independent specialists and physician groups in high chronic-volume specialties. Providers bill Medicare under remote therapeutic monitoring codes. almyhealth charges a flat fee per active patient and the provider retains the balance of the reimbursement.
Medicare's 2026 Physician Fee Schedule materially expanded this opportunity, adding device-supply codes that reimburse on two to fifteen days of data in a 30-day period, and treatment management codes covering ten to nineteen minutes of staff time. Short-term recoveries, episodic flare-ups and lower-adherence patients became billable for the first time.
Sales cycle is short, typically weeks, because the decision maker is the owner-physician and the motivation is cash flow.
Model B: Per-member-per-month, at risk
Sold to health plans, payviders and integrated systems. A flat monthly fee per enrolled patient, tiered by population volume, targeted at high-risk seniors. The pitch is margin protection: a predictable fixed cost against an unpredictable readmission liability, with performance tied to healthcare KPIs including readmissions and CMS Star Ratings.
Gross margin on the model is projected at 85%.
Moat
No single element below is defensible alone. The combination, in this specific population, is.
Distribution through a channel nobody else wants. Voice-only, landline-compatible delivery is unglamorous and technically unfashionable. It is also the only channel that reaches the highest-cost patients in the system.
Regulatory positioning as an asset. We have mapped our position deliberately: a wellness and adherence companion outside FDA device regulation for now, with the crisis detection, data segregation and human-in-the-loop architecture of a more heavily regulated product built from day one. That means the option to move up the regulatory ladder later without rebuilding, and it means enterprise procurement conversations that most early competitors cannot survive.
Compliance depth as a sales accelerant. Health system security review is the real gatekeeper to contracts. A documented compliance program shortens that cycle substantially, which turns a cost center into a commercial advantage.
Cultural and linguistic fit. Bilingual capability built into the model rather than bolted on, in a market where the senior Hispanic population is large, underserved and expensive.
Longitudinal voice and adherence data. Over time, a per-patient record of adherence behavior, response patterns and voice signal that no competitor entering later can reconstruct. Note that this asset is constrained by design: we do not retain voiceprints indefinitely, and we do not permit vendor training on patient voice.
The ask
The detailed business plan, financial model, regulatory analysis and go-to-market plan are available under NDA.