Oncology Ventures: Announces Investment in RISA + Rental Car Comedy
Oncology Ventures invests in healthcare data startups that enhance cancer care and research.
Thesis on Oncology Ventures’ Investment in RISA
Current State of one of Healthcare’s Most Significant Bottlenecks, Prior Authorization
The idea behind Prior Authorization (“PA”) is simple: before doctors can administer certain treatments, they need approval from the insurance company. This was supposed to ensure patients receive medically necessary treatments while controlling costs. In reality, it’s turned into a bureaucratic nightmare that costs billions, wastes hours of physicians’ time, and delays life-saving therapies—particularly for cancer patients.
PA remains one of the least automated parts of our healthcare system. Only 31% of the process is fully electronic, compared to 94% for eligibility verification and 73% for claims payments. This inefficiency manifests in physicians spending up to 14 hours per week on PA. And, even with all of that time spent, 94% of physicians still report consistent care delays caused by PA mandates.
In oncology, the stakes are higher. 70% of cancer patients experience delays in care because of prior authorization requirements. In 33% of those cases, the delay is one month—a time window that can increase the risk of death by 13% in certain cancer types. The current system isn’t just inefficient – it’s dangerous.
We’re now at a tipping point. The PA market is $30B, growing at 20% annually. Oncology, at 42% of the specialty pharmacy market, is significantly affected, as 72% of oral cancer medications require PA.
A key issue behind this market is unnecessary denials. 60-75% of denied PAs are eventually approved after appeal. Innovative oncology treatments like proton therapy (which delivers highly precise doses of radiation to tumors while minimizing damage to surrounding healthy tissues) have a 43% denial rate. Again, these inefficiencies increase costs and drive avoidable delays in care.
Oncology care has inherent complexities with multiple lists of formulary drugs, distinct care pathways, availability of biosimilars and step therapy protocols, which all lead to increased overall touchpoints and unnecessary denials. It doesn’t help that health plans each have their own set of PA requirements, which differ by state and line of business.
Lastly, regulatory tailwinds are creating an environment ripe for disruption. CMS’s Interoperability and Prior Authorization Final Rule is set to begin implementation in January 2026 with complete rollout by January 2027.
The ruling mandates the use of HL7 FHIR APIs to enhance the electronic exchange of healthcare data and streamline the PA process. This list of acronyms strung together is a huge deal. It’s going to force the entire industry to modernize and ensure quicker PA turnarounds by automating the submission and verification process. However, this large scale technology integration and consistent, quicker turnarounds will be difficult, expensive and may lead to increased incorrect denials.
Enter RISA.
RISA’s AI-powered solution streamlines PA from start to finish. By integrating directly into the existing electronic health record (“EHR”) systems used by providers, the multi-agent system effectively automates patient registration and eligibility checks through to digitally submitting PAs and providing real-time status updates.
RISA eliminates the need for manual intervention, endless phone calls and outdated technologies like fax machines. This automation can reduce approval times from days to minutes, freeing up physicians’ time, lowering costs, and—most importantly—ensuring patients receive the care they need when they need it.
RISA doesn’t just automate; it optimizes. It pulls critical information from clinical notes and treatment plans, includes the right details in each submission, and uses historical data to prevent denials before they happen. When denials do occur, RISA automates appeals by identifying and correcting discrepancies in real time. RISA is primed to transform oncology PA—and, by extension, healthcare as a whole.
Oncology Ventures is excited to support Kshitij Jaggi and the RISA team as they address the most complicated and high-touch disease area, oncology, and improve the entire Prior Authorization landscape.
If you and your team want to learn more about how you can implement RISA into your workflow, please reach out to us.
Oncology Ventures Hosted an Event on “What goes wrong during healthcare start-up implementations”
We heard from leaders at Dana Farber Cancer Institute, NYC Health + Hospitals, St. Mary’s General Hospital and more.
5 key takeaways from the event on why healthcare implementation projects go south:
Oversold expectations on impact or technical expertise needed to manage the partnership
Not aligning on the right KPIs pre-launch, which makes it difficult to track success and renew / expand your contract
Focus too much on gaining alignment with internal business champions while forgetting to collaborate with the actual end users
Lack of understanding of the system’s financial structure and incentives
Aren’t able to attribute any success or ROI directly to the start-up’s product
After this event, we heard from attendees: “This event was the best oncology-focused event I have been to” and “You could feel the energy in the room around true healthcare innovation.”
If you would like to get on our invite list for upcoming events, let me know.
Comedy!
Rental car companies are getting out of control. You reserve a beautiful, new 4-door Jeep on their website. Then, you get to the rental car shop and they're like - “oh sorry we're out of those, but we have an equivalent vehicle that you will love.” Equivalent is code for they never had it in stock. They’ll pull around a 2011 Kia with the check engine light on and a semi-flat tire.
If you’re lucky, they send you off with a full tank of gas. But, normally you’ll get 1/3 of a tank - they act like they’re doing you a favor, “oh, no worries, you can bring it back the same level”. What a stressful addition to your road trip. How am I supposed to calculate that? The rest of the drive your whole car is doing arbitrary math to nail the 1/3 tank.
You don’t want to come up short with the refill. Because, apparently rental car companies think they are buying gas during the 1973 oil crisis. I’m not paying $24 a gallon. If they are going to do that, they should reimburse you at the same rate - if I leave with an empty tank and I bring it back full, I want that refund handed to me on an oversized Billy Madison check.
The only good deal they give you is insurance. You can pay $18 to fully cover yourself?! That’s wild. It's cheaper to total your car than it is to be one gallon off with your tank of gas. Why even bring the car back?
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If you ever see “cancer” and “data” together in a start-up deck, article or event, please continue to send our way.
And they stick you with an EV (as a perk) where you can have re-fill anxiety for your entire trip