Healthcare has a productivity problem that more money and more people alone cannot fix. Providers are spending and hiring at record levels, yet staff are more burned out, workflows are slower, and patients feel it. The causes are many, including aging populations, a sicker post-pandemic patient mix, chronic workforce shortages, and reimbursement pressure, but a big part of the story, we believe, is architectural. For two decades, health systems have been buying software such as EHRs, billing platforms, scheduling tools, patient portals, and most recently a wave of AI copilots, without ever acquiring a layer that actually coordinates across them. The coordination layer has always been human, with staff manually stitching systems together with phone calls, faxes, and copy-paste. When that human layer gets stretched, the whole operation degrades.
This is why the average physician loses 15.5 hours a week to administrative work, and why a single 20-provider practice absorbs roughly $1.4 million a year to manual coordination no one ever designed on purpose.
We invested in XCaliber Health because we believe this coordination gap is one of the most highest-impact unsolved problems in healthcare software and one that cannot be closed by hiring or onboarding more tools.
What XCaliber is building
XCaliber is an agentic operating system that sits across the systems a provider already uses. It pulls data from every corner of the stack, including EHRs, billing, scheduling, and specialty tools, and normalizes it into a unified, longitudinal data foundation of each organization’s own data. On top of that foundation, agents run workflows end-to-end, including scheduling, refills, referrals, prior authorizations, intake, outreach, billing resolution, and care-gap closure, with clinical and operational teams owning the decisions that matter. Autonomy is calibrated workflow by workflow, the only model that scales inside a regulated environment.
A team built for the hardest problem in the stack
The XCaliber team is built precisely for that work. Founder and CEO Prakash Khot previously served as Executive Vice President and Chief Technology Officer of athenahealth, one of the country’s largest EHR platforms, and went on to found and lead engineering at a data platform for privacy and compliance in regulated industries. The team around him has spent years normalizing data across dozens of EHRs and hundreds of enterprise systems, making agents safe to operate inside clinical environments, and building for the long tail of interfaces. This is technical depth that cannot be shortcut.
Already working at scale
The operating system has processed more than eight million chart updates and generated more than 160,000 EHR updates, while reaching more than 700,000 unique patients daily. On top of that foundation, XCaliber has just launched a unified patient-navigation agent spanning scheduling, refills, outreach, intake, referrals, prior authorization, and billing resolution. We were introduced to the company through Affineon Health — a BGV portfolio company that was already one of XCaliber’s largest customers before we met the team. That kind of endorsement, from a customer that understands the problem intimately, is hard to manufacture.
XCaliber is built around what the customer actually needs: a platform that meets healthcare organizations where they are, plugs into the fragmented tech stack they already depend on, and runs workflows end-to-end with intelligent human-in-the-loop oversight on every decision that matters. That is what makes it a true system of action and a core expression of our Enterprise 5.0 thesis. We are excited to be on the journey with Prakash and the team.
