Midstream Health today announced a $20 million Series A as it expands across a customer network representing more than $100 billion in annual operating expenses and over 250 hospitals nationwide. Midstream helps these institutions find and recover margin across both revenue and cost, strengthening the financial capacity required to continue investing in care and serving their communities.

The financing round was led by Valtruis with continued participation from Andreessen Horowitz (a16z), Foundry and CommonSpirit Ventures, bringing Midstream's total funding to $29.2 million. Fairview Health Services and Keck Medicine of USC are among the newest health systems to join the platform, alongside CommonSpirit Health, Mount Sinai Health System and Houston Methodist.

Midstream is building the AI-native financial operating system for health systems. Its platform connects fragmented contracts, claims, purchasing, pharmacy, and payment data, then uses domain-trained AI agents to identify, pursue, and prevent margin leakage across supply chain, managed care, and pharmacy. Unlike traditional analytics tools that stop at surfacing insights, Midstream closes the loop from opportunity identification through financial recovery, with every action traceable to source data.