Formana
An AI driven platform that turns program and institutional requirements into lean and automated workflows.
Paperwork and form automation abstracts bureaucracy away to allow people to focus on actual work.
Investment Highlights
Transforming Medicaid waiver workflows with AI automation
$50B+ Medicaid Market
Targeting NYS TBI/NHTD waiver programs with 25K+ eligible participants and $2.1B annual spending
AI-Powered Efficiency
LLM-based plan generation reduces processing time by 50%+ and increases capacity to 25 clients per coordinator
Proven Team
Healthcare technology veterans with deep domain expertise in Medicaid and regulatory compliance
$5M Seed Round
Seeking funding for platform development, regulatory alignment, and pilot operations scale-up
Our Team
Healthcare technology veterans with deep domain expertise
Francis Secada
CEO & Founder
Healthcare technology leader with expertise in Medicaid systems and regulatory compliance
Technical Team
AI & Platform Development
Experienced engineers in AI/ML, healthcare software, and enterprise platform development
Clinical Advisors
Domain Expertise
Licensed clinicians and case managers with extensive experience in TBI and NHTD programs
The Problem
Manual, fragmented, and error-prone processes delay access to care and overwhelm staff with paperwork.
- Disjointed service plan creation and revision
- Manual case documentation and compliance logging
- High caseload pressure + underutilized provider capacity
Our Solution
Formana automates and coordinates Medicaid waiver workflows, increasing velocity and reducing overhead.
- LLM-based plan generation and revisions
- Smart scheduling and intake automation
- Billing export, audit trails, and compliance visibility
Early Traction & Validation
Proven results from pilot implementations
150+
Hours of manual work automated per week
95%
Accuracy in regulatory compliance checks
67%
Reduction in ISP processing time
Provider Feedback
"Formana transformed our workflow - we can now focus on patient care instead of paperwork"
- Case Manager, Regional Provider Agency
Market Opportunity
Large, underserved market with clear expansion path
Bottom-up Market Calculation - New York State
| NYS Medicaid LTSS Annual Spending | $15.2B |
| Waiver Programs (TBI + NHTD) | $2.1B |
| Administrative Overhead (15%) | $315M |
| NYS Addressable Market | $315M |
National Expansion
50 states × $315M average = $15.75B total addressable market
Revenue Model
Profit share model (split TBD) for SMB clients; enterprise pricing based on org size, staff licensing volume, and workflow requirements
Test Case: Medicaid Long-Term Care in New York State
Reduce program complexity by automating the boring stuff
Simplified TBI Waiver Flow
TBI Waiver Service Lifecycle
Optimized ISP
Competitive Advantage
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
Business Model
Platform-as-a-Service offered to nonprofit, public, and hybrid Medicaid providers
- Subscription licensing with compliance support
- Integration-based revenue with billing & calendaring APIs
- Optional hosting and workflow customizations
Revenue & Efficiency Impact
- Processing cost reduction: 50%+
- Case capacity: Increase from 12–15 → 25 clients per coordinator
- Revenue lift per coordinator: $207K/year (maxed)
| 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 |
Financial Projections
Clear path to profitability with strong unit economics
TBD
ARR by Year 3
Based on revenue share with SMB clients and enterprise pricing for larger organizations
40%
Gross Margins
Scalable AI infrastructure with profit-sharing model
24mo
Path to Profitability
Break-even by Q4 2026
Key Assumptions
- Customer Acquisition: 15 new providers/quarter by Year 2
- Revenue Model: Profit share with SMB clients, enterprise pricing for larger orgs
- Churn Rate: <5 % annually (sticky mission-critical software)
- Market Expansion: 3 additional states by Year 3
- Product Evolution: Additional modules increase value proposition
- Enterprise Pricing: Based on org size, staff licensing, and workflow complexity
The Ask
$5M Seed Funding
Use of Funds
- $2.0M - Product development & AI enhancement
- $1.5M - Regulatory compliance & certification
- $1.0M - Pilot program expansion (5 states)
- $500K - Team scaling & operations
18-Month Milestones
- 50+ provider organizations onboarded
- $1M+ ARR achieved
- 3 states with regulatory approval
- Series A readiness ($10M+ round)
Let's transform access to care—by automating the boring stuff.
Join us in revolutionizing healthcare administration
Investment Highlights Recap
Why Formana is the right investment opportunity
$50B+ Market
Large, underserved Medicaid waiver market with clear regulatory barriers to entry
Proven Technology
AI automation delivers 50%+ cost reduction and 2x capacity increase
Experienced Team
Healthcare technology veterans with deep domain expertise
Clear Path to Scale
$2.5M ARR by Year 3 with national expansion roadmap
Let's Connect
Francis Secada
CEO & Founder
francis@formana.io
Available for follow-up discussions
linkedin.com/in/francissecada
Ready to revolutionize healthcare administration together?