Compare / OpenAI vs Cohere Health
AT A GLANCE
FUNDING HISTORY
OpenAI
Cohere Health
BUSINESS MODEL
OpenAI
OpenAI makes money primarily through API access and subscriptions. The API charges developers per token (roughly per word) for using GPT models in their applications.
ChatGPT Plus costs $20/month for individual users, ChatGPT Team is $25-30/user/month, and ChatGPT Enterprise is custom-priced. Microsoft pays OpenAI licensing fees and also resells OpenAI models through Azure OpenAI Service.
OpenAI reportedly generates over $5 billion in annualized revenue as of 2025, growing at an extraordinary rate.
Cohere Health
B2B SaaS sold to health insurance plans. Cohere Health replaces the legacy prior authorization workflow with an AI-powered platform.
Insurance companies pay for the software on a per-member-per-month basis. When a doctor submits a prior auth request, Cohere's AI reviews clinical guidelines, patient history, and evidence-based criteria to make an approval or denial recommendation — often in minutes instead of days.
The platform handles the full cycle: submission, clinical review, decision, and appeals. Revenue scales with the number of insured lives the health plan manages.
HOW THEY STARTED
OpenAI
OpenAI was founded in December 2015 as a nonprofit AI research lab. The founding donors — including Elon Musk, Sam Altman, Peter Thiel, Reid Hoffman, and Jessica Livingston — pledged $1 billion with a mission to build artificial general intelligence (AGI) that would benefit all of humanity.
The idea was that AI was too important and too dangerous to leave in the hands of Google alone.
Sam Altman became chairman while Greg Brockman (former CTO of Stripe) became president. Ilya Sutskever, one of the most respected AI researchers alive, left Google Brain to become chief scientist.
The early team was stacked with world-class researchers who published their work openly — hence "Open" AI.
But AI research turned out to be staggeringly expensive. Training large models required millions of dollars in compute.
In 2019, OpenAI created a "capped-profit" subsidiary — investors could earn up to 100x their money, but profits beyond that would flow to the nonprofit. Microsoft invested $1 billion.
The mission was still to save humanity. The method now involved making a lot of money first.
Cohere Health
Nikhil Garg spent over a decade in healthcare technology, including time at McKinsey and health plan companies, watching the same broken process destroy patient care from the inside. Prior authorization — where insurers require pre-approval before covering treatments — was designed as a cost control tool but had mutated into a bureaucratic nightmare.
Doctors spent 16 hours per week on prior auth paperwork. Patients waited weeks for approvals while their conditions worsened.
Insurance companies employed armies of nurses just to review faxed forms. Garg co-founded Cohere Health in 2019 with the thesis that AI could replace the fax-and-phone-call process with intelligent, evidence-based instant decisions.
Not removing prior auth entirely — insurers won't give that up — but making it fast enough that it stops hurting patients.
HOW THEY GREW
OpenAI
ChatGPT's launch in November 2022 was the growth strategy — it just wasn't planned that way. The team expected a modest research preview.
Instead, ChatGPT hit 1 million users in 5 days and 100 million monthly active users in 2 months, making it the fastest-growing consumer application in history. The product went viral because it felt like magic — for the first time, anyone could have a natural conversation with a machine that seemed to understand them.
The Microsoft partnership provided distribution at massive scale. Microsoft integrated OpenAI models into Bing, Office 365 (Copilot), GitHub (Copilot), and Azure.
Overnight, hundreds of millions of Microsoft users had access to OpenAI technology. Microsoft's $13 billion investment was the largest AI bet in history and gave OpenAI nearly unlimited compute.
The API created an ecosystem. Thousands of startups built products on top of OpenAI's models — from customer service bots to coding assistants to content generators.
Each API customer locked themselves into OpenAI's ecosystem, creating switching costs and recurring revenue.
Cohere Health
Selling directly to health insurance plans — these are massive enterprise deals with long sales cycles but enormous contract values. Each health plan covers millions of members, so a single client represents huge revenue.
Cohere positioned itself as the solution to CMS regulatory pressure — the Centers for Medicare & Medicaid Services issued rules requiring faster prior auth decisions, and health plans needed technology to comply. Strategic partnerships with existing health IT vendors to integrate into workflows rather than replace them.
Conference presence at AHIP and HIMSS where every health plan executive shops for technology.
THE HARD PART
OpenAI
The board crisis of November 2023 nearly destroyed the company. The nonprofit board fired Sam Altman as CEO on a Friday, citing a loss of confidence.
Within 48 hours, 95% of employees threatened to quit and follow Altman to Microsoft. By Tuesday, Altman was reinstated and the board was restructured.
The incident exposed the fundamental tension between OpenAI's nonprofit governance and its for-profit ambitions — a tension that still hasn't been fully resolved.
The cost of training frontier models is eye-watering. Each new GPT generation costs hundreds of millions to train.
OpenAI is reportedly spending over $7 billion annually on compute. The company is burning through cash faster than almost any startup in history, which is why it keeps raising at higher and higher valuations.
If revenue growth slows before costs stabilize, the math gets ugly.
Safety concerns are not going away. Multiple prominent researchers have left OpenAI over disagreements about the pace of development versus safety research.
Ilya Sutskever, the chief scientist who was central to the board's decision to fire Altman, left in 2024 to start a safety-focused AI lab. The public debate about whether OpenAI is moving too fast — and whether its safety commitments are genuine — grows louder with every capability improvement.
Cohere Health
Enterprise sales cycles in healthcare insurance are brutally long — 12 to 24 months from first meeting to signed contract. Health plans are conservative buyers who need extensive pilot data before committing.
Integration with legacy systems that were built in the 1990s and still run on COBOL is a real technical challenge. The regulatory environment keeps shifting — CMS rules on prior auth keep changing, which is both an opportunity and a compliance headache.
Competition from established players like EviCore and New Century Health who have decades of relationships with health plans. And the fundamental political risk: if prior auth gets legislated away entirely, the core use case shrinks dramatically.
THE PRODUCTS
OpenAI
ChatGPT is the consumer chatbot — the product that made AI mainstream overnight. GPT-4o is the flagship multimodal model that handles text, images, and audio.
The OpenAI API lets developers integrate GPT into any application. DALL-E generates images from text descriptions.
Whisper transcribes and translates audio. Sora generates videos from text prompts.
GPT Store lets users create and share custom GPT agents. ChatGPT Enterprise gives businesses a private, secure version of ChatGPT with admin controls and no data training.
Cohere Health
Cohere Unify — single platform that consolidates prior auth, utilization management, and care navigation into one system. AI-powered clinical review engine that reads medical records and matches them against evidence-based guidelines automatically.
Real-time decision support that gives providers instant feedback on whether a request will likely be approved. Provider portal that eliminates phone calls and faxes — doctors submit digitally and get decisions digitally.
Analytics dashboard showing approval rates, turnaround times, and cost impact for health plan executives. Interoperability layer that connects with existing EHR systems and health plan infrastructure.
WHO BACKED THEM
OpenAI
Microsoft ($13B), Thrive Capital, Khosla Ventures, Sequoia Capital, Founders Fund, Tiger Global, SoftBank, a16z
Cohere Health
Investors include Andreessen Horowitz (a16z), Deerfield Management, Flare Capital Partners, and Longitude Capital. Series B in 2022 brought total funding past $100 million.