With early traction among major payers and provider groups, Otter Health's AI-powered model helps reduce unnecessary care and variation without traditional prior authorization.

凭借在主要支付方和医疗服务提供方群体中获得的早期认可，Otter Health 的人工智能驱动模式有助于减少不必要的医疗护理及差异，且无需传统的预先授权。

WASHINGTON

华盛顿

,

，

Oct. 15, 2026

2026年10月15日

/PRNewswire/ -- Otter Health, a healthcare technology company building a model for smarter utilization management and quality that dismantles the administrative arms race, today announced its official launch alongside $8 million in seed funding co-led by Fika Ventures and Evidenced, with participation from Slow Ventures, Metrodora, CoFound Partners, Layout Ventures, Patient Capital, and Semper Virens..

/美通社/ -- 奥特尔健康（Otter Health）是一家医疗科技公司，致力于构建更智能的利用管理和质量模式，以打破行政层面的军备竞赛。该公司今日宣布正式启动，并完成800万美元的种子轮融资。本轮融资由Fika Ventures和Evidenced联合领投，Slow Ventures、Metrodora、CoFound Partners、Layout Ventures、Patient Capital以及Semper Virens等机构参投。

Otter Health delivers a new platform for payers and providers to collaboratively align delivery to the gold standard of care. The company's AI-powered, EHR-agnostic platform helps healthcare delivery organizations and payers identify and reduce low-value, non-evidence based care decisions in real time, replacing the friction of traditional prior authorization with a more transparent approach, grounded with precision against clinical evidence and guidelines.

Otter Health 推出一个新平台，帮助支付方和提供方协同合作，使医疗服务与黄金护理标准保持一致。该公司的人工智能驱动、与电子健康记录（EHR）系统无关的平台，协助医疗交付组织和支付方实时识别并减少低价值、非循证的护理决策，以基于临床证据和指南的更透明方法取代传统事前授权带来的摩擦。

Through immediate and ongoing visibility into care patterns, peer benchmarking and targeted clinician engagement, Otter Health helps align clinicians, administrators and medical management teams around care appropriateness, while surfacing opportunities to improve quality and reduce unnecessary spending..

通过即时且持续地洞察诊疗模式、开展同行基准比对以及实施有针对性的临床医生参与策略，Otter Health 帮助临床医生、管理人员和医疗管理团队在诊疗适宜性上达成一致，同时发掘提升医疗质量并减少不必要支出的机会。

'Healthcare has spent decades trying to contain spend through administrative friction, creating a system that often puts payers and providers on opposite sides of the same problem,' said Keith Florance, co-founder and CEO of Otter Health. 'The real goal was never the authorization step itself, but instead was helping organizations deliver more appropriate, evidence-based care at scale.

“几十年来，医疗行业一直试图通过行政摩擦来控制支出，从而形成了一个常常将支付方和提供方置于同一问题对立面的体系，”Otter Health 的联合创始人兼首席执行官基思·弗洛伦斯表示。“真正的目标从来不是授权步骤本身，而是帮助组织大规模提供更合适、基于证据的护理。”

We're building utilization management and quality around real-time clinical intelligence rather than administrative chokepoints. By giving payers and providers a shared view of the gold standard for quality, we can reduce low-value care, improve outcomes, and create a more collaborative approach to healthcare affordability.'.

我们围绕实时临床智能，而非行政瓶颈，来构建利用率管理和质量体系。通过为支付方和提供方提供关于质量黄金标准的共享视图，我们可以减少低价值医疗护理，改善治疗结果，并建立一种更具协作性的医疗保健可负担性方法。

Historically, prior authorization has served as healthcare's primary tool for managing utilization and cost, while aggravating physician-level decision making. The authorization process became one of the industry's mechanisms for controlling care along with risk-adjusted claims analyses that clashed with clinicians.

从历史上看，事先授权一直是医疗保健领域管理利用率和成本的主要工具，同时也加剧了医师层面决策的复杂性。这一授权过程与风险调整理赔分析一道，成为行业控制医疗服务的机制之一，并与临床医生产生了冲突。

As a result, the underlying goal of ensuring that patients receive appropriate, evidence-based treatment was obscured..

因此，确保患者接受适当、循证治疗这一根本目标被模糊了。

Otter Health takes a different approach by providing continuous, real-time comparison to the evidentiary standard across a much broader range of clinical decisions, including referrals, outpatient procedures, pathway adherence and care transitions. By giving payers and providers a shared view of evidence-based delivery, the platform's AI helps identify opportunities to reduce low-value care, improve quality, create greater accountability and lower costs without relying on administrative friction as the primary means of control.

Otter Health 采取了一种不同的方法，通过对更广泛的临床决策（包括转诊、门诊手术、临床路径依从性和护理过渡）提供与证据标准的持续实时比较。通过为支付方和提供方提供基于证据的医疗服务的共同视图，该平台的 AI 有助于识别减少低价值护理、提高质量、增强问责制并降低成本的机会，而无需依赖行政摩擦作为主要控制手段。

This enables a more collaborative approach to utilization management, aligning payers and providers around the same clinical and financial goals..

这使得利用管理更加协同，使支付方和提供方在相同的临床和财务目标上保持一致。

'We have a great opportunity to support clinicians in the thousands of decisions they make every day,' said Kate Goodrich, Executive in Residence at Optum, former Humana Chief Medical Officer and Director of the CMS Center for Clinical Standards and Quality. 'Creating greater visibility into evidence-based practice through guidance and tools can empower a more proactive and collaborative approach in supporting clinicians to deliver the highest quality care while effectively managing cost and improving access.'.

“我们有一个绝佳的机会，可以在临床医生每天做出的数千项决策中为他们提供支持，”Optum驻场高管、前Humana首席医疗官兼美国医疗保险和医疗补助服务中心（CMS）临床标准与质量中心主任凯特·古德里奇表示。“通过提供指导和工具，提高基于证据的实践的透明度，能够促使我们以更主动、更协作的方式支持临床医生，在有效控制成本并改善就医可及性的同时，提供最高质量的照护。”

Otter Health is already working with multiple healthcare organizations across the payer and provider ecosystem to identify opportunities to reduce low-value care, improve evidence-based decision-making and create a more collaborative approach to utilization management. They've shown that by removing prior authorization with the right engagement through the Otter Health platform, they can limit non-concordant decisions to less than 5% and capture substantial savings on low-value care that prior authorization never touched..

Otter Health 已与支付方和提供方生态系统中的多家医疗保健组织合作，以识别减少低价值护理、改善基于证据的决策以及创建更协作的利用管理方法的机会。他们表明，通过 Otter Health 平台进行适当的互动并取消事前授权，他们可以将不一致的决策限制在 5% 以下，并在事前授权从未触及的低价值护理方面实现显著的成本节约。

Otter Health launches amid growing scrutiny of traditional prior authorization. According to the

在传统事先授权审查日益加剧的背景下，Otter Health 正式成立。根据

American Medical Association

美国医学会

, physicians complete nearly 40 prior authorizations per week, 93% report that prior authorization delays necessary care, and 82% say it can cause patients to abandon treatment altogether. At the same time, Otter estimates that over 60% of low-value healthcare spending occurs outside traditional authorization controls, representing millions of dollars in avoidable annual spending per 1,000 lives.

医师每周需完成近40项事先授权，93%的医师表示事先授权会延误必要的护理，82%的医师称这可能导致患者完全放弃治疗。与此同时，Otter估计，超过60%的低价值医疗支出发生在传统事先授权控制之外，这意味着每1,000人每年会产生数百万美元的可避免支出。

By evaluating care decisions across outpatient procedures, referrals, pathway adherence, and post-acute transitions, Otter provides a more continuous, real-time approach to managing care appropriateness as value-based care shifts utilization risk to providers..

通过评估门诊手术、转诊、临床路径依从性以及急性期后过渡等环节的护理决策，Otter 提供了一种更为连续、实时的方法，以管理护理适宜性，顺应基于价值的医疗模式将利用风险转移至提供方的趋势。

'Healthcare has spent decades investing in the mechanisms used to control utilization,' said Bryan Sivak, Managing Partner of Evidenced and former CTO of the US HHS. 'Otter Health is taking a different approach by creating better visibility into care appropriateness itself. By helping payers and providers operate from the same evidence-based understanding of clinical decisions, the company is creating an alternative to the conflicts that historically defined utilization management.

“医疗保健行业数十年来一直投资于用于控制医疗利用的机制，”Evidenced 的管理合伙人、美国卫生与公众服务部前首席技术官 Bryan Sivak 表示。“Otter Health 则采取了一种不同的方法，通过提高对医疗适当性本身的可见度来实现变革。通过帮助支付方和提供方基于对临床决策的同一循证理解开展工作，该公司正在为历史上以冲突为特征的医疗利用管理提供一种替代方案。”

We believe that kind of transparency can reduce waste, improve quality and fundamentally reshape how healthcare organizations manage quality and clinical variation.'.

我们相信，这种透明度可以减少浪费、提高质量，并从根本上重塑医疗机构对质量和临床差异的管理方式。

About Otter Health

关于 Otter Health

Otter Health is a healthcare technology company reimagining utilization management and quality by replacing administrative friction with real-time clinical intelligence. The company's AI-powered platform provides payers and providers with a shared, evidence-based view of care appropriateness, helping reduce low-value care, improve quality and lower unnecessary healthcare spending.

Otter Health 是一家医疗科技公司，通过以实时临床智能取代行政摩擦，重新构想利用率管理和医疗质量。该公司的人工智能平台为支付方和提供方提供基于证据的护理适宜性共享视图，帮助减少低价值护理、提高医疗质量并降低不必要的医疗支出。

Founded by healthcare operators and clinicians with expertise in utilization management, clinical quality and healthcare technology, Otter Health is backed by Fika Ventures, Evidenced, Slow Ventures, Metrodora, CoFound Partners, Layout Ventures, Patient Capital and Semper Virens. For more information, visit .

Otter Health 由在利用管理、临床质量和医疗技术方面拥有专业知识的医疗保健运营商和临床医生创立，并获得 Fika Ventures、Evidenced、Slow Ventures、Metrodora、CoFound Partners、Layout Ventures、Patient Capital 和 Semper Virens 的支持。欲了解更多信息，请访问。

www.otter-health.com.

www.otter-health.com

CONTACT:

联系方式：

[email protected]

[email protected]

SOURCE Otter Health

来源：Otter Health

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