Fortuna Health: TurboTax for Medicaid

TLDR - Fortuna Health is TurboTax for Medicaid. We simplify Medicaid application filing so consumers can easily check eligibility, enroll, and renew their coverage.

The Problem

Today, ~90M Americans on Medicaid face acute challenges with eligibility screenings and (re)enrollment. It takes hours for consumers to navigate glitchy websites and long, paper Medicaid forms.

The experience is so poor that procedural reasons (e.g., form errors, missing a notice in the mail) account for a staggering 75% of disenrollments. This is terrible for consumers who lose coverage and produces huge downstream consequences: Medicaid health plans (MCOs) lose over $30B from churn, providers suffer $13B in lost patient revenue and uncompensated care, and states waste $8B on administrative costs.

More than ever before, Medicaid enrollment demands immediate attention given the ongoing Medicaid redetermination crisis putting 15M enrollees at risk of losing coverage in the next 18 months.

Our Solution

Fortuna solves the $57B enrollment problem with a consumer product (beautiful, simple state Medicaid filing experience just like Turbotax is for taxes). By making products that consumers want to use, we unlock immense value for providers and health plans.

Our unique approach provides consumers with a seamless web experience, eliminating the need to interact with state portals. We offer 60-second eligibility checks and 5-minute (re)enrollment in 7 languages. To accelerate completing applications, we allow consumers to connect accounts that auto-populate their filings, provide a "virtual" mailbox for state and health plan communications, and send text notifications for urgent actions.

Providers and health plans have had limited real-time visibility into enrollment and revenue risk until now. The Fortuna platform allows providers and health plans to seamlessly monitor Medicaid enrollment status and consumer next steps, receive real-time updates on contact information, and benefit from comprehensive analytics.

Our vision is to transform the enrollment experience and expand our products to become the consumer-facing digital infrastructure that powers the $800B+ Medicaid ecosystem.

The Team

We’re all former operators and engineers with experience scaling early and mid-stage healthcare startups that covered Medicaid.

• Cydney is a former management consultant who helped scale a health tech company from seed to Series C as General Manager and VP of Operations and Strategy. 30% of the company’s patients were Medicaid beneficiaries.
• Ben was the first software engineer at behavioral health revenue cycle startup Juniper (YC W21) and helped grow the engineering team to 12. Almost 40% of children in the US are covered under Medicaid/CHIP.
• Nikita started her career at Oscar Health and spent the past 2 years at Truepill (YC S17) building pharmacy solutions for community health centers and FQHCs that served Medicaid patients. She was born on public assistance.

The Ask

Know any health plans, hospitals, and provider organizations with large Medicaid populations? Please reach out to founders@fortunahealth.com