Rovi Health
Rovi Health provides an employer-plan overlay that gives members access to a licensed nurse who guides their care decisions using clinical data and provider quality information. The platform analyzes medical records, claims, pharmacy data, and other signals to proactively steer members toward high-value providers and coordinate care, while also offering an integrated virtual clinic. Rovi works with self-funded, fully-insured, and level-funded plans and guarantees savings—if the savings aren't delivered, the client doesn't pay.
- Healthcare Technology
- Digital Health
- Insurance Technology
- Software Only
- Data & Analytics
Funding
Founders
Founder details are not available yet.
Product
Problem
Healthcare costs for employer-sponsored plans remain high because price and quality are not correlated—the most expensive providers are rarely the best. Members lack the data and guidance to choose high-value care, leading to unnecessary procedures, hospital visits, and specialist referrals that drive up total cost of care while producing suboptimal outcomes.
Solution
Rovi provides an employer-plan overlay that puts a licensed nurse in every member's pocket through a mobile/web platform. The system analyzes medical records, ADT feeds, labs, claims, pharmacy data, prior authorizations, and provider directories to detect care signals early. Nurses then proactively guide members toward high-quality, cost-effective providers, schedule appointments, and coordinate benefits. Rovi also includes an integrated virtual clinic offering asynchronous text-based care, live video primary/urgent care, and mental health support. The company works with self-funded, fully-insured, or level-funded plans and guarantees savings—if the savings aren't delivered, the client doesn't pay.
Target Audience
Primary customers are self-funded, fully-insured, and level-funded employer health plans, as well as the payors and brokers that administer those plans, seeking to reduce total cost of care while improving member outcomes.
Features
- Clinical signal detection using medical records, ADT feeds, labs, claims, pharmacy fills, prior auth status, and provider network data
- Licensed nurse navigation for provider selection based on quality outcomes, cost data, and convenience, including appointment booking and network checks
- Integrated virtual clinic with asynchronous text care, synchronous video visits, and mental health services
- Provider quality database covering 1M+ providers across clinical outcomes, experience, and appropriateness
- HRA incentive integration to make high-value care free for members
- Automated alerts and proactive outreach, such as flagging medication alternatives, steering surgical referrals to top-decile surgeons, and routing infusions to lower-cost high-quality centers
- Guaranteed savings model with performance-based compensation