Rainfall Health, an artificial intelligence-driven compliance platform, has successfully closed a $15 million Series A funding round. This investment was led by Two Bear Capital and supported by several notable investors. The timing of this funding aligns with the upcoming launch of the Centers for Medicare & Medicaid Services (CMS) Transforming Episode Accountability Model (TEAM), which is set to take effect on January 1, 2026.
The TEAM initiative aims to incentivize hospitals to enhance patient outcomes in five high-spend surgical procedures. Rainfall Health contends that compliance, often viewed as a financial burden, can serve as a significant revenue generator for healthcare institutions. By adhering to the TEAM quality metrics, hospitals could potentially boost their revenue by as much as 20%, translating into over $100 million in additional revenue per health system.
Understanding the TEAM Model
Effective January 1, 2026, new regulations will alter the payment structure for American hospitals regarding five specific high-cost surgeries. The TEAM model emphasizes accountability for outcomes in the following procedures:
– Lower extremity joint replacement
– Spinal fusion
– Coronary artery bypass graft (CABG)
– Major bowel procedures
– Hip/femur fracture treatment
Under the revised rules, hospitals that meet defined quality metrics—including thorough patient follow-ups and precise recovery instructions—will be eligible for increased payments. For large health systems, this revenue increase could significantly enhance their financial standing.
Rainfall Health’s Innovative Approach
Rainfall Health is positioning its platform as a “digital blueprint” for navigating this new regulatory landscape. The platform replaces traditional methods, such as manual checklists and fragmented spreadsheets, with an AI-driven system that standardizes the collection and reporting of patient outcomes.
This standardization guarantees that every patient interaction, from discharge to recovery, is meticulously tracked and reported in compliance with CMS requirements. The platform also automates complex regulatory processes, allowing healthcare professionals to concentrate on patient care rather than administrative tasks.
In addition, Rainfall Health is advocating for a national standard through its RAIN Compliant designation. This framework aims to help hospitals and payers verify that they meet the stringent requirements of value-based care.
Eddie Qureshi, CEO and Founder of Rainfall Health, emphasized the substantial opportunity for hospitals to enhance their revenues by delivering high-quality post-acute care. “Hospitals have a tremendous opportunity to increase their revenues by delivering high-quality post-acute care that includes consistent check-ins, clear patient instructions, and clinician follow-ups,” he stated.
The recent funding is deemed a crucial step for Rainfall as it strives to establish the first recognized standard for outcome-based care in the United States. By expanding its AI capabilities and implementation teams, the company aims to ensure that its partners capitalize on the opportunities presented by the new CMS regulations while maintaining a consistent patient experience.
As the healthcare landscape continues to evolve, Rainfall Health’s efforts highlight the potential for compliance not only to be a necessary obligation but also a strategic avenue for driving revenue growth in the competitive healthcare market.
