Rialtic and Exponential AI Merge to Combat Healthcare's Trillion-Dollar Waste

ATLANTA, GA – May 11, 2026 – In a significant move to overhaul healthcare's financial infrastructure, payment accuracy platform Rialtic and AI decision intelligence leader Exponential AI have announced a definitive merger. The deal unites two of Atlanta's most innovative health-tech firms, creating a single entity poised to tackle the staggering administrative waste that inflates the cost of care for millions of Americans.

This strategic union combines Rialtic's cloud-based, rules-driven platform for preventing improper claim payments with Exponential AI’s advanced agentic technology, which provides real-time, AI-powered decision-making. The newly formed organization aims to deliver a comprehensive, end-to-end solution for healthcare payers and providers at a time when the pressure to reduce costs has never been greater. Under the new structure, Paul Roma will take the helm as Chief Executive Officer, while Rialtic's founder and former CEO, Doug Williams, will transition to Executive Chairman of the Board.

A Strategic Union Against a Trillion-Dollar Problem

The merger is not merely a corporate consolidation; it is a direct assault on a well-documented crisis in American healthcare. A landmark study in the Journal of the American Medical Association (JAMA) estimated that waste in the U.S. healthcare system costs between $760 billion and $935 billion annually—roughly a quarter of all healthcare spending. Projections indicate this figure could swell to an astonishing $1.6 trillion by 2025.

The single largest driver of this waste, according to the research, is administrative complexity, accounting for over $265 billion each year. This category includes the immense friction, inefficiency, and manual effort involved in processing claims, managing payments, handling prior authorizations, and appealing denials. It is this specific, costly problem that the combined Rialtic and Exponential AI entity is engineered to solve.

"As we evaluated our go-forward strategy, Exponential AI emerged as the ideal partner to complement our world-class editing system," said Doug Williams, Executive Chairman of Rialtic. "While Rialtic provides the rules-based precision to prevent improper spend, Exponential’s AI technology allows our customers to go live quickly with specific workflows, significantly accelerating their time-to-value."

Beyond Algorithms: The Power of Agentic AI

The technological synergy between the two companies forms the core of the merger's value proposition. Rialtic has established itself with a platform that provides the foundational, rules-based logic necessary to edit claims before they are paid, catching errors and preventing improper payments at the source. This provides a critical layer of financial defense for payers.

Exponential AI brings a more dynamic and advanced capability to the table: agentic AI. Unlike traditional automation or machine learning models that follow rigid scripts, agentic AI involves autonomous systems that can plan, reason, and execute complex, multi-step tasks with minimal human intervention. These 'Decision Agents' are designed to mimic the problem-solving capabilities of human experts, integrating with existing systems to resolve exceptions, guide human review in real-time, and make consistent, transparent decisions at machine speed.

"By embedding our AI decision agents directly into live workflows to resolve exceptions and guide human review in real-time, we are providing the speed and efficiency the market now requires," stated Paul Roma, the newly appointed CEO. This integration promises to transform cumbersome processes like prior authorization, the resolution of pended claims, and post-payment audits from manual, time-consuming chores into automated, intelligent workflows.

Navigating a Crowded and Complex Market

The healthcare payment integrity space is a competitive field, with established giants like Cotiviti, Optum, and Change Healthcare commanding significant market share. These companies offer broad suites of services aimed at recovering overpayments and ensuring claim accuracy. However, payers often have to stitch together solutions from multiple vendors to cover the entire payment lifecycle, creating new layers of complexity.

The merged entity's key differentiator is its promise of a single, unified platform that spans the entire claim journey—from prepay editing to real-time clinical and quality decision intelligence. This integrated approach aims to eliminate the gaps and handoffs that contribute to administrative drag.

Adding a layer of deep industry credibility is the leadership's track record. Executive Chairman Doug Williams is no stranger to this market; he previously founded iHealth Technologies, which merged with Connolly in 2014 to form Cotiviti, one of the very competitors the new company will face. His experience building a market leader from the ground up provides the new venture with invaluable strategic insight. Complementing this is CEO Paul Roma, whose background includes leading IBM Watson Health's global efforts and establishing Deloitte's Global Analytics Market Offering, giving him a profound understanding of how to deploy AI and analytics at an enterprise scale.

The Human Impact: From Boardroom to Bedside

While the immediate beneficiaries of this technology are healthcare payers and providers, the ultimate mission, as stated by the companies, is to make healthcare "meaningfully more affordable for American families and employers." The connection between reducing administrative waste and improving patient care is direct and profound.

Physicians and their staff are increasingly burdened by administrative tasks, from wrestling with electronic health records to spending hours on the phone appealing claim denials—a phenomenon contributing to widespread burnout. Hospitals and health systems, in turn, spend an estimated $40 billion annually just on billing and collections, with administrative costs now accounting for over 40% of total hospital expenses. By automating these processes and ensuring payments are accurate from the start, the new platform aims to redirect these vast resources—both human and financial—away from paperwork and back toward patient care.

By uniting rules-based precision with the cognitive power of agentic AI, Rialtic and Exponential AI are betting they can create a system that is not only more efficient but also more intelligent. The success of this merger will be measured not just by the return on investment for its clients, but by its ability to remove the costly friction that has long plagued the American healthcare system.