As the intelligence layer of the Arbital Health Platform, this first-of-its-kind AI assistant offers a conversational interface that interprets contract data, explains performance drivers, and recommends next steps in plain language that finance, clinical, and actuarial teams can act on with confidence. With Merlin AI, information is no longer locked in spreadsheets or static reports, it becomes part of a living conversation. By connecting directly to the actuarial logic that powers Arbital's adjudication infrastructure, Merlin AI delivers immediate insights that enable earlier patient interventions, effective resource allocation, and stronger results across value-based care programs.
"At Arbital Health we are building the critical infrastructure to make the promise of value-based care a reality. AI plays a critical role in this vision," said Brian Overstreet, President and CEO at Arbital Health. "Merlin AI leverages our dual pillars of data enrichment and actuarial logic to push the industry to new heights. It takes the combined training and intelligence our teams have built over the years and makes it accessible in seconds. Our clients can now move from question to insight to action without waiting for another reporting cycle. That transparency changes how decisions are made in value-based care."
Using a large language model (LLM) trained on Arbital's actuarial logic and drawing from each organization's unified contract data, Merlin AI provides immediate answers to questions such as:
- 'Which contracts are trending toward deficit this quarter?'
- 'What's driving higher utilization in this region?'
- 'Which of my patients are at highest risk of readmission right now?'
From identifying cost drivers to generating member intervention lists, this new capability connects data to immediate operational next steps. For deeper exploration, Merlin AI offers a dedicated Workspace, a clean, creative environment where teams can explore data, generate charts, build dashboards, and collaborate across teams in real time.
Merlin AI's architecture prioritizes transparency and accountability. Unlike opaque systems, every result is backed by a clear line of sight to the underlying data and logic. Built by an expert team of value-based care actuaries and engineers, this responsible, explainable AI model supports actuarial rigor while improving operational agility.
"Merlin AI was built for the people who spend their days navigating risk," said Jesica Freeman, Chief Product Officer at Arbital Health. "Finance and clinical teams have long been confined by the limits of static dashboards. Now, they can work directly with the data, ask questions, trace results to their source, and act on what they learn. Merlin AI is a partner that keeps pace with the complexity of value-based care contracting."
Early users report that critical contract management tasks which once required a week of manual effort (aggregating payer data, reconciling metrics, or forecasting contract performance) can now be completed in seconds. This shift not only accelerates decision-making but strengthens alignment between finance, clinical, and actuarial teams.
Merlin AI is now available within the Arbital Health Platform.
Arbital Health will unveil the feature at the HLTH Conference, October 19–22, 2025, where attendees can meet Merlin AI firsthand and see how conversational intelligence is redefining the future of value-based care.
About Arbital Health
Arbital Health provides the critical infrastructure for providers and payers to successfully manage risk-based contracts. With the industry's leading value-based actuaries and robust AI-powered platform, Arbital Health accelerates contract performance monitoring and decision-making, centralizes fragmented data, and automates contract reconciliation across all major risk models. By reducing complexity and administrative burden, Arbital Health ensures value-based care contracts deliver on their promise of better patient outcomes and sustainable financial performance. Arbital Health is led by a best-in-class team of healthcare actuaries, engineers, and industry veterans, and backed by leading investors Valtruis, Transformation Capital, Shaper Capital, and Healthy Ventures. For more information, visit ArbitalHealth.com.
Contacts
Rachel DiMartino| [email protected]
SOURCE Arbital Health
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