Paperwork and form automation abstracts bureaucracy away to allow people to focus on actual work.
Transforming Medicaid waiver workflows with AI automation
Targeting NYS TBI/NHTD waiver programs with 25K+ eligible participants and $2.1B annual spending
LLM-based plan generation reduces processing time by 50%+ and increases capacity to 25 clients per coordinator
Healthcare technology veterans with deep domain expertise in Medicaid and regulatory compliance
Seeking funding for platform development, regulatory alignment, and pilot operations scale-up
Healthcare technology veterans with deep domain expertise
CEO & Founder
Healthcare technology leader with expertise in Medicaid systems and regulatory compliance
AI & Platform Development
Experienced engineers in AI/ML, healthcare software, and enterprise platform development
Domain Expertise
Licensed clinicians and case managers with extensive experience in TBI and NHTD programs
Manual, fragmented, and error-prone processes delay access to care and overwhelm staff with paperwork.
Formana automates and coordinates Medicaid waiver workflows, increasing velocity and reducing overhead.
Proven results from pilot implementations
Hours of manual work automated per week
Accuracy in regulatory compliance checks
Reduction in ISP processing time
"Formana transformed our workflow - we can now focus on patient care instead of paperwork"
- Case Manager, Regional Provider Agency
Large, underserved market with clear expansion path
| NYS Medicaid LTSS Annual Spending | $15.2B |
| Waiver Programs (TBI + NHTD) | $2.1B |
| Administrative Overhead (15%) | $315M |
| NYS Addressable Market | $315M |
50 states × $315M average = $15.75B total addressable market
Profit share model (split TBD) for SMB clients; enterprise pricing based on org size, staff licensing volume, and workflow requirements
Outpacing legacy systems with modern AI automation
| Capability | Legacy Systems | Formana |
|---|---|---|
| Plan Generation | Manual process (8+ hours) | AI-Automated (30 minutes) |
| Compliance Checking | Manual review, error-prone | Automated validation (95% accuracy) |
| Provider Coordination | Phone/email heavy follow-up | Workflow automation + reminders |
| Audit Trail | Paper-based, manual logging | SQL-audited, user-authenticated |
| Integration | Siloed, limited APIs | Full EHR/billing system integration |
Result: 50%+ cost reduction and 2x capacity increase
Platform-as-a-Service offered to nonprofit, public, and hybrid Medicaid providers
| Workflow | Current | With Formana |
|---|---|---|
| Plan Drafting | Manual .docx | LLM + state-managed |
| Scheduling | Emails, calls | Automated calendar APIs |
| Provider Input | Follow-up heavy | Workflows + auto reminders |
| Versioning | Manual edits, risk of error | SQL-audited, user-authenticated |
| Compliance | Manual pre-checks | Preflight validation workflows |
Clear path to profitability with strong unit economics
ARR by Year 3
Based on revenue share with SMB clients and enterprise pricing for larger organizations
Gross Margins
Scalable AI infrastructure with profit-sharing model
Path to Profitability
Break-even by Q4 2026
$5M Seed Funding
Let's transform access to care—by automating the boring stuff.
Join us in revolutionizing healthcare administration
Why Formana is the right investment opportunity
Large, underserved Medicaid waiver market with clear regulatory barriers to entry
AI automation delivers 50%+ cost reduction and 2x capacity increase
Healthcare technology veterans with deep domain expertise
$2.5M ARR by Year 3 with national expansion roadmap
CEO & Founder
francis@formana.io
Available for follow-up discussions
linkedin.com/in/francissecada
Ready to revolutionize healthcare administration together?