Rovi Health

What do they actually do

Rovi Health sells a text-first navigation and care-shopping service to employer health plans (primarily self-funded). Employers connect their plan/claims data, and Rovi guides members to lower-cost, in-network, high-quality providers and handles scheduling and follow-through end to end Rovi employer page YC company profile.

For common conditions, Rovi also offers or is rolling out low-cost virtual care delivered over text or video, helping avoid higher-cost in-person visits when appropriate. They use member incentives to steer toward higher-value options and emphasize fast setup via claims-feed integration Rovi homepage LinkedIn post HuntScreens listing.

Who are their target customer(s)

• Benefits/HR manager at a self-funded employer: Needs to lower plan costs and reduce member friction but lacks tools to reliably steer employees to in-network, lower-cost options and to automate scheduling and follow-up Rovi employer page.
• CFO or head of finance for a self-insured company: Faces unpredictable, high medical spend and wants measurable, near-term savings from benefits vendors rather than long, uncertain paybacks Rovi employer page.
• Benefits broker or consultant: Needs offerings that clearly cut costs, prove ROI, and deploy quickly with minimal integration so they can reduce implementation risk and close deals HuntScreens listing.
• Individual plan members (employees): Confused about where to go, worried about surprise bills, and frustrated by the time it takes to find and book an in-network provider—prefer simple text-based guidance and scheduling help Rovi homepage.
• Small employers or startups with limited benefits staff: Need a low-effort way to control healthcare costs and support members without long onboarding timelines or large minimums HuntScreens listing.

How would they acquire their first 10, 50, and 100 customers

• First 10: Leverage founders’ and YC networks plus targeted outbound to secure fast, low-risk pilots; integrate a quick claims feed and provide white-glove scheduling so employers see early savings and member adoption Rovi employer page HuntScreens listing.
• First 50: Sign referral partnerships with a few benefits brokers/consultants and offer co-branded pilot packages; standardize an onboarding playbook (claims checklist, comms templates, scheduling SOPs) brokers can run with.
• First 100: Scale via channel partners (TPAs, stop-loss carriers, HCM/payroll vendors) and productize claims/API connectors with a self-serve onboarding flow so small employers can launch with minimal lift.

What is the rough total addressable market

Top-down context:

Employer-sponsored insurance covers ~154M non-elderly people, and about 63% of covered workers are in self-funded plans, indicating a very large pool of employer-directed medical spend KFF 2024. Broader private health spending in the U.S. is in the trillions, which aligns with this opportunity’s scale CMS NHE.

Bottom-up calculation:

Estimated self-funded lives ≈ 154M × 63% ≈ 97M. Using ~$512 PMPM (~$6,144/year) as a proxy for annual claims per person yields ≈ 97M × $6,144 ≈ $600B/year in claim dollars that Rovi could influence at the high end KFF 2024 Peterson-KFF HST.

Assumptions:

• Uses a fully insured group claims PMPM as a proxy for self-funded spend per person.
• Assumes uniform average spend across the self-funded population despite employer size/mix differences.
• Treats total self-funded claim dollars as a ceiling; practical, influenceable categories (outpatient/scheduled care) are a smaller subset.

Who are some of their notable competitors

• Included Health: Employer-focused navigation bundled with virtual primary, urgent, behavioral care and expert opinions; overlaps with Rovi on directing members and offering virtual visits Included Health.
• Accolade: Personalized benefits navigation and advocacy (human + platform) that helps employees find providers, resolve billing, and use benefits—similar employer value proposition Accolade.
• Castlight / apree health: Price transparency and employer navigation tools (now combined with Vera/apree health) competing on surfacing lower-cost, in-network options and centralizing benefits guidance Castlight apree/Castlight news.
• Rightway: Clinician-led care navigation paired with virtual care partners; handles scheduling and coordination for employer populations Rightway.
• Quantum Health: Single point-of-contact care coordination for self-insured employers, routing members to in-network providers and managing authorizations and follow-up Quantum Health.