Readily, a platform designed to track regulatory changes for health plans, announced last week that it secured $11 million in Series A funding. The San Francisco-based company helps organizations manage federal and state compliance requirements by scanning updates and analyzing audit needs. It aims to catch errors before audits begin.
The funding round
The Series A round was led by Define Ventures, with participation from Y Combinator and the California Health Care Foundation Innovation Fund. In total, Readily has raised $12 million. The capital will allow the company to expand its reach and build a new layer for the product.
Edward Tiong, co-founder and CEO of Readily, explained how the tool functions. The system maps new regulations or state guidance against a plan’s existing policies and workflows. It identifies what changed, which documents are affected, who is responsible for the fix, and what evidence is required.
According to Hong Truong, a principal at Define Ventures, Readily is developing what it calls the “AI-native operating system for healthcare organizations that live under heavy regulation.” Truong noted that leaders have often made high-stakes decisions without the necessary data or oversight. He argued that compliance is the function connected to everything else; getting it right brings the rest of the organization into view.
Market conditions
The need for such tools has grown as fines increase. CMS data shows that federal fines against Medicare Advantage and Part D insurers in the first four months of 2025 surpassed the combined total from 2021 to 2024. Additionally, annual payer compliance spending is estimated to be about $8 million, according to a study from PwC.
Readily currently operates in 46 states across Medicare, Medicaid, and the commercial market. Tiong described the structure of government healthcare oversight, noting that Medicare and Medicaid are trillion-dollar programs run through a chain of oversight. CMS oversees 50 states, states oversee hundreds of managed care organizations, and those oversee thousands of delegated providers. Every link in that chain relies on the same raw material: rules, policies, and proof of adherence. Tiong stated that the company is building the infrastructure that chain never had.
