Readily, a two-year-old San Francisco company that uses artificial intelligence to help health insurers navigate a thicket of federal and state regulations, raised $11 million in a Series A round led by Define Ventures. Y Combinator and the California Health Care Foundation Innovation Fund also participated.
The company said Monday that its software now serves more than 25 million covered lives across 46 states, a footprint built largely on the strength of its presence in California's Medicaid managed care market.
The financing arrives at a moment when health insurers are facing a sharp uptick in regulatory scrutiny. Medicare Advantage plans were fined more in the first four months of 2025 than in the previous four years combined, according to Healthcare Dive. A PwC study released earlier this year found that health plans spend roughly $8 million annually on compliance operations, with 93% of surveyed payers saying they believe AI can improve how they manage regulatory risk.
Edward Tiong, Readily's chief executive, previously worked on AI projects at Microsoft and spent time at Akasa, a healthcare revenue-cycle automation company, before studying artificial intelligence at UC Berkeley. He went through Y Combinator's Summer 2023 batch with the earliest version of the product.
Scanning Regulations, Drafting Redlines
Readily's platform monitors regulatory updates from the Centers for Medicare & Medicaid Services and state agencies, then maps those changes to a health plan's existing policies and contracts. The software generates draft policy redlines and assigns tasks to internal teams, often within hours, according to the company. It also prepares health plans for audits by analyzing requirements, pulling supporting evidence from internal documents, and identifying gaps before regulators show up.
The platform covers regulatory change management, audit review, monitoring of delegated entities, and policy version control. Readily said it is SOC 2, HIPAA, and ISO 42001 compliant, though public trust attestations were not immediately available.
The company claims its software saves health plans 90% of the time they would otherwise spend on regulatory analysis, audit oversight, and policy review. One large public plan saved $734,000 annually, Readily said. A multi-state Medicare Advantage insurer increased its audit volume from 20 to 150 using the platform, though the company did not identify that customer.
A Toehold in California Medicaid
Readily said it now works with more than 60% of California's Medicaid managed care plans. That footprint developed quickly. In June 2026, the California Health Care Foundation disclosed a $1 million program-related investment in Readily, noting at the time that the startup served 15 health plans, most of them Medi-Cal managed care organizations. Roughly 70% of the state's local public plans were using the software.
Named customers include L.A. Care Health Plan, the largest publicly operated health insurer in the country. "We are thoughtfully incorporating technology, including AI-enabled tools, to complement our strong compliance infrastructure," said Todd Gower, the plan's chief compliance officer, in Readily's announcement.
In June, Readily hired Elysse Tarabola as chief compliance and product officer. Tarabola previously served as chief compliance officer at Community Health Plan of Imperial Valley and held compliance roles at L.A. Care.
The company's Y Combinator profile lists 20 employees, but this figure lacks a timestamp and may not reflect recent hiring.
Beyond Compliance Tracking
Tiong said the new capital will fund an expansion beyond compliance tracking into what he called "enterprise oversight," a broader platform that connects regulatory obligations with day-to-day execution across call centers, claims processing, utilization management, and delegated provider networks. The company plans to deepen its AI-driven workflows for proactive risk identification and accountability tracking.
"A CEO should be able to ask what changed, who owns the response, and whether the work is done," Tiong said in the announcement. He told MedCity News the funding will help the startup scale to more health plans and "build the next layer of the product."
Hong Truong, a principal at Define Ventures, wrote in a firm blog post that Readily "built the intelligence layer that makes that visible," adding that "regulatory scrutiny keeps intensifying while margins keep tightening."
The total funding reported by MedCity News is $12 million to date, likely including the California Health Care Foundation's $1 million investment from June, though this figure should be treated cautiously as a single-source claim.
A Crowded Field
Readily operates in a market that includes Inovaare, another AI-native compliance platform for Medicaid and Medicare Advantage payers, and YouCompli, which serves provider organizations. The broader healthcare compliance software sector is populated by HIPAA-focused tools from vendors like MedTrainer, Healthicity, and Compliancy Group, though those products generally target provider practices and hospital systems rather than payer operations.
Readily is hiring for roles including forward deployed engineer, full-stack engineer, and compliance program manager, according to its Y Combinator jobs page.
Tiong told FierceHealthcare that building the platform began with fieldwork, not pitch decks. "I stopped trying to sell them anything and started asking what was going on," he said.
