Introducing Arbital Health — A Neutral Umpire for Outcome-Based Contracts

Travis May
3 min readNov 28, 2023

I’m thrilled to announce Arbital Health, one of the first companies incubated at Shaper Capital, partnering with Brian Overstreet as CEO. In the coming weeks, we will be sharing more about the incredible team coming together and some of our early moves to make this vision a reality.

Below is an overview of our vision. We aim to solve one of the most fundamental problems in healthcare — and in turn help unlock a health system with better outcomes, better value, and better experiences for patients.

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The biggest problem in healthcare is misaligned incentives. The healthcare system suffers from low quality, poor experience, high cost, and poor outcomes. The fundamental reason for this is a market failure due to misaligned incentives. Organizations that deliver care and therapy manufacturers have vastly different incentives than organizations that pay for care, who in turn have vastly different incentives than patients. The thousands of middlemen throughout the system only add to the problem. Most other issues in healthcare are downstream of this fundamental problem.

To align incentives, we should move away from fee-for-service pricing towards paying for value. Most healthcare today is provided in a fee-for-service model — the more services delivered, the more you pay. Instead, healthcare should be paid for based on the outcomes delivered. The cost for a drug like Ozempic should be based on weight loss or reduction of diabetes and cardiovascular events, not another high fixed prescription fee. Providers that invest in their patients to prevent chronic disease should be rewarded, not stymied by a system that incentivizes more treatment and quick fixes. A value-based care system can align all parties toward an outcomes-based set of incentives.

But there is a challenge: how do you measure value in care? “Value” is subjective. Even for objective outcomes, the counterparties in a value-based transaction struggle today to reconcile contracts. Data is fragmented, trust is low, analytics are sparse, and incentives remain misaligned. The process of reconciling an outcome-based contract can take several quarters, and can turn into a major renegotiation when the two sides disagree on metrics.

We are launching Arbital Health to be a neutral umpire of outcome-based contracts. We will focus on earning the industry’s trust as a neutral and accurate third party. We will make it easy to design, measure, and adjudicate outcome-based contracts.

In 10 years, we aspire to be the trusted umpire adjudicating every outcome-based contract in healthcare, whether contracts are between life sciences companies and payers, payers and providers, or employers and digital health companies.

By creating Arbital Health, we believe that we will resolve one of the biggest roadblocks to the wide adoption of value-based care. We will make it simple to adjudicate contracts and unlock the trillion-dollar shift to value-based care in America. In doing so, we will help to solve healthcare’s biggest problem.

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Does this sound exciting? Join our team at careers@arbitalhealth.com.

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Travis May

Entrepreneur, Investor, and Board Member. Founder & Fmr CEO of LiveRamp and Datavant.