Healthcare data infrastructure · Open source
Tuva Health
An open source dbt project that turns raw claims and clinical records into an analytics ready data model inside a health system’s own warehouse. Apache 2.0 licensed, 135 releases deep, and selling support on top of code it gives away.
Seven hundred codes for one painkiller
Ask a large health system how many of its patients took Tylenol last week. It cannot tell you.
“You would think that your health system knows how many people took Tylenol last week, right? It's like 2024, almost 2025, there's Gen AI, and they don't because Tylenol is made up of almost 700 different codes from multiple coding systems,” Aaron Neiderhiser told Fierce Healthcare in December 2024, the week his company came out of stealth.
That is the business in one sentence: not data access, not artificial intelligence, but the unglamorous work of collapsing 700 codes into one concept, then doing it again for readmissions and member months.
The name is a detour. “Tuva is named after the country of Tuva in the former Soviet Union and the subject of the book Tuva or Bust and an homage to Richard Feynman,” wrote Nikhil Krishnan of Out-Of-Pocket, who disclosed he is a small investor.
Everybody builds the same thing
Claims arrive as 837 procedure files, 835 remittance files and 834 enrollment files, each shaped by whoever sent them. One health plan hires engineers to clean it. Another does the same work differently. Neither publishes its method.
Tuva’s documentation refuses the usual vendor promise: “There is no such thing as perfect data quality in healthcare. Every healthcare dataset has issues.”
What the variation does to the numbers is the real problem. “We've done some exercises where we calculate things like member months slightly differently and we see variations in the corresponding PMPM that are as high as 30-40%,” Neiderhiser told the Pear Healthcare Playbook in 2023. Per member per month spending is the figure value based contracts settle on.
Federal rules made the pile bigger rather than cleaner. The CMS Interoperability and Prior Authorization final rule, CMS-0057-F, issued January 17, 2024, pushes payers toward new data sharing interfaces due by January 1, 2027. More feeds in more formats is the condition Tuva sells into.
Two data scientists and a squash court
Neiderhiser spent three years at Colorado Medicaid inside a longitudinal dataset covering more than a million people over 20 years, on his way to becoming an actuary. He joined Health Catalyst in 2014 as a data architect.
Jorge Zuloaga, known as Coco, came from theoretical physics with a PhD from Rice University and moved into healthcare expecting to do machine learning. “So healthcare sounded awesome. But then very quickly, I realized it was very difficult to do any of this because the data was such a mess,” he told the same interviewers.
They met around 2015 playing squash in downtown Salt Lake City and played many times before working out that they did the same job. Neiderhiser recruited Zuloaga to Health Catalyst; Zuloaga left for Strive Health; the squash conversations kept circling the same complaint. They started Tuva in 2021 and joined Y Combinator’s Winter 2022 batch. The YC profile records the first commercial fact: “Since January 1st, we signed our first customer (paying $10k per month) and completed the first major release of the Tuva Project.”
From a repository to a platform
The GitHub organization was created on June 7, 2021 and the main repository on November 12, 2021. For three years the project shipped in public with no announcement, through version 0.3 in 2023 and 0.18 in May 2026.
The company came out of stealth on December 12, 2024 with a $5 million seed round led by Virtue, with Box Group and Y Combinator. Two months later MultiCare Capital Partners, the investment arm of a Washington state health system, invested alongside a contract for Tuva to build and run the data platform for MultiCare Connected Care, an accountable care organization covering more than 375,000 patients. In June 2025 the research firm Mathematica agreed to run its algorithms on the Tuva model.
Version 1.0.0 landed on September 8, 2026, splitting the project into a core package plus separately released marts for risk adjustment, quality measures and emergency department classification. Governance is still personal. The repository allows one exception to its rule that released data snapshots are read only: “an explicit break-glass instruction from Aaron that names the exact package and asset version and gives a reason”.
What is proven, and what is still claimed
| Evidence | What the record shows | Source type |
|---|---|---|
| License and repository | tuva-core is Apache 2.0, created Nov 12, 2021, last pushed Sep 19, 2026. 326 stars, 140 forks, 135 releases, v1.0.0 on Sep 8, 2026. The organization holds 65 public repositories and 511 stars; 29 carry no license file. | Public record |
| Who writes the code | 49 contributors, 1,142 attributed commits. The six largest accounts hold 866 of them, about 76 percent, and both founders are in that six. Thirteen accounts have 10 commits or more; 19 have exactly one. | Public record |
| Community size, as marketed | 1,000+ and 1,500 practitioners (Dec 2024), “1,700 individual contributors” (Feb 2025), 2,500+ (Sep 2026). These count a Slack room, about 900 people in late 2023, not people who commit code. | Differs from the code record |
| Adoption | 25+ partners (Dec 2024), about 40 organizations using Tuva as their enterprise data model (Feb 2025), more than 50 (Jun 2025), more than 100 (Sep 2026). No customer list is published. | Company-stated |
| Named customers | Oscar Health and CareAbout Health (Dec 2024), Herself Health (MedCity News), MultiCare Connected Care (Feb 2025), Mathematica (Jun 2025). Oscar, MultiCare and Mathematica executives are quoted by name. | Confirmed by partners |
| Cost savings | Implementation costs cut by 90 percent or more, free algorithms saving $500,000 or more a year, MultiCare actuaries reporting Tuva may be two times lower cost. No underlying analysis is published. | Company and partner stated |
| Data quality evidence | Structural checks plus hundreds of logical tests at three severity levels, including a range check on each of 72 temporal fields. No independent benchmark against another data model was found. | Not found |
| Regulatory record | No FDA clearance, registered trial, NIH or NSF award, or PubMed entry tied to the company, as expected for analytics software. | Public record |
| Securities filings | No Form D. EDGAR full text search returns zero documents mentioning Tuva Health and no company of that name appears in company search, while a control query on a comparable startup returns filings. | Public record |
Read plainly: the software is real, maintained and auditable line by line, which is more than most healthcare analytics vendors allow. Thinner is the community. A Slack room of 2,500 is a marketing asset; 49 contributors with three quarters of the commits in six hands is a company product with visible source code.
What to watch
- Whether outside contributors grow after the 1.0 split, or the commit curve stays concentrated in a handful of accounts.
- Any published comparison of Tuva outputs against another data model or a health plan’s own numbers. None exists yet.
- The commercial line. Data Quality Intelligence and enterprise support are paid and closed, and the boundary keeps moving.
- A Form D, or a round large enough to force one. Nothing has been filed through September 23, 2026.
In their words
“We've made a lot of progress on the data access side of things, yeah, but we really have not focused as much on this data transformation piece, and that's what we're really trying to solve.”
Aaron Neiderhiser, CEO and co-founder, Fierce Healthcare, 2024 · Independent
“So all these companies are claiming that they are making data informed decisions and trying to show that their care model works by rigorously analyzing data and things like that. And we can't even trust any of that.”
Coco Zuloaga, CTO and co-founder, Pear Healthcare Playbook, 2023 · Interview
“True tech companies in healthcare find we are solving the same problems over and over again.”
Mario Schlosser, Oscar Health, December 2024 release · Customer, in company release
“A lot of the problems and what I'm trying to solve for in value-based care and population health require pretty sophisticated computing capabilities, and they're not technologies that healthcare have always had access to because they're too expensive.”
Anna Taylor, MultiCare, Fierce Healthcare, 2025 · Independent
“We believe healthcare organizations should stop paying for critical healthcare analytics infrastructure that should really be a commodity.”
Aaron Neiderhiser, Mathematica announcement, June 2025 · Partner release
“Our partnership with Tuva Health enhances the capabilities of both teams to support healthcare analytics that improve health outcomes through our analysis of all-payer claims databases and commercial claims.”
Ngan MacDonald, Mathematica, June 2025 · Partner release
“Becoming the de facto standard everyone trusts is extremely hard.”
Nikhil Krishnan, Out-Of-Pocket, 2023, sponsored post with investor disclosure · Investor
Related companies
Sources
- Public recordGitHub API, tuva-health organization and repositories
- Public recordGitHub API, tuva-core contributors, releases and license
- Public recordEDGAR company and full text search, with control query
- Public recordCMS Interoperability and Prior Authorization final rule, CMS-0057-F
- Public recordRecords pull: no FDA, trial, NIH or PubMed record
- IndependentTuva Health raises $5M in seed funding
- IndependentTuva Health and MultiCare Connected Care partner to power VBC insights
- IndependentTuva Health launches with $5M to clean messy healthcare data
- InterviewLessons from Aaron Neiderhiser and Coco Zuloaga
- InvestorTransforming Healthcare Data with Tuva Health, sponsored post
- CompanyTuva Health Launches Open-Source Platform
- CompanyMultiCare Connected Care Taps Tuva Health
- PartnerMathematica and Tuva Health Partner
- CompanyTuva Health site, platform, partners and documentation
- CompanyTuva Health company profile and founder bio
Profile researched and written by Healthcare Discovery. Last updated September 29, 2026.
