Spring Health

Sierra

Spring Health

B2B employer benefit — similar model to Lyra Health but with a sharper focus on precision matching. Companies pay Spring Health a per-employee-per-month fee.

Employees take an initial assessment and Spring Health's algorithm recommends a care pathway: therapy, medication management, coaching, digital self-care, or a combination. The key differentiator is the precision — the algorithm claims to reduce treatment time by 50% by getting the right match first instead of cycling through options.

Spring Health also provides a therapist network, psychiatric services, and crisis support. Revenue scales with employer contracts and employee utilization.

Sierra

Companies pay Sierra to run their customer service with AI agents instead of hiring rooms full of humans. The agent talks to your customers over chat.

It answers questions. It processes returns.

It updates subscriptions. Here is the clever part.

Sierra charges based on outcomes, not seats. Brands pay when the AI actually resolves a problem, not just for having the software installed.

That pricing is unusual. Most software charges a flat monthly fee no matter what.

Sierra only gets paid when the bot does the job.

Spring Health

April Koh was studying computational neuroscience at Yale when she encountered research on precision medicine for depression — the idea that you could use data to predict which patients would respond to therapy versus medication versus a combination. The existing system was essentially trial and error: try an antidepressant for six weeks, and if it doesn't work, try another one.

Meanwhile, patients suffer. Koh co-founded Spring Health in 2016 with Adam Chekroud, a Yale neuroscience PhD, to build a platform that uses machine learning to match employees to the right mental health treatment on the first try.

They started by publishing peer-reviewed research showing their algorithms could predict treatment response better than chance, then turned that research into a product that employers would pay for.

Sierra

Bret Taylor had already done the impossible twice. He co-created Google Maps.

He later became co-CEO of Salesforce, chaired Twitter's board during the messy Elon Musk takeover, and became chairman of OpenAI in late 2023. Clay Bavor spent 18 years at Google, most recently running its Labs group.

The two friends left their big jobs in 2023 to build something together. They picked customer service on purpose.

It is the least glamorous corner of software. Their logic was simple.

Companies hate their support costs. Customers hate waiting on hold.

AI that actually resolves problems could fix both sides at once. They launched Sierra in February 2024 with $110 million from Sequoia and Benchmark.

Spring Health

Enterprise sales to large employers, competing directly with Lyra Health, Headspace Health, and traditional EAP providers. Spring Health leads with outcomes data — publishing research showing faster recovery times and higher clinical improvement rates than industry benchmarks.

Celebrity advisor Apolo Ohno and high-profile board members gave early credibility. Series C at $2.5 billion valuation generated press coverage that opened doors.

International expansion to serve global workforces. Strategic investment from Kinnevik gave European distribution relationships.

Partnership with health plans to offer Spring Health as the behavioral health component within existing benefits.

Sierra

Sierra went straight for big brands, not tiny startups. SoFi, Ramp, ADT, Sonos and Brex signed up early.

By 2026 it said more than 40% of the Fortune 50 were customers. The trick was trust.

Enterprises are terrified of an AI bot going rogue and insulting a customer. So Sierra built guardrails and let each company control exactly how the agent behaves.

Bret Taylor's contacts did the rest. When the chairman of OpenAI calls a Fortune 500 CEO, they pick up.

Sierra hit $100 million in annual recurring revenue in November 2025, seven quarters after launch, and $150 million by February 2026. In April 2026 it launched Ghostwriter, which builds and deploys a new agent from a plain-English description.

Spring Health

Direct competition with Lyra Health, which is larger and better-funded. The employer mental health benefit space is crowded and increasingly commoditized — every startup claims better outcomes and faster ROI.

Therapist supply is the binding constraint across the entire industry. Proving that ML-driven matching actually produces better outcomes than simply having a good therapist network is a difficult clinical claim to substantiate at scale.

Employee engagement is everything — if employees don't take the initial assessment, the precision matching engine can't work. And the macro headwind: employer benefits budgets are under pressure, and mental health benefits are easier to cut than medical benefits when money gets tight.

Sierra

Everyone is building AI customer service agents right now. Decagon has raised at a multi-billion valuation.

Salesforce, ServiceNow and Intercom all shipped their own agents. Sierra is not the cheap option.

It sells premium AI to giant companies that move slowly. The bigger risk sits underneath the product.

Sierra does not make its own AI models. It rents them from providers like OpenAI and Anthropic.

If those model makers decide to compete directly, Sierra's edge gets thin fast, and its co-founder chairing one of them only makes that question louder. A $15.8 billion valuation on roughly $150 million in revenue leaves almost no room for a stumble.

Spring Health

Precision mental health platform — ML-driven assessment that predicts optimal treatment pathway for each individual. Therapist matching engine connecting employees to the right provider by specialty, approach, and predicted fit.

Spring Health Moments — bite-sized digital exercises based on CBT for mild symptoms. Medication management through in-house psychiatric providers.

Manager and HR tools for supporting teams without violating privacy. Work-life coaching for non-clinical needs like stress and work-life balance.

Family support extending benefits to dependents. Crisis support including 24/7 access for emergencies.

Sierra

The core product is the Sierra AI agent. It is a branded customer service bot that companies deploy on their website, app, and phone lines.

It handles the boring stuff. Order tracking.

Refunds. Password resets.

Account changes. Sierra also built its own tools to test and monitor these agents so they do not make things up.

In 2024 the company added a voice version that talks to customers on the phone. In April 2026 it added Ghostwriter, a tool that builds and deploys a new agent from a plain-English description.

The whole pitch is one AI agent that carries your brand's name and never sleeps.

Spring Health

Investors include Tiger Global Management, Kinnevik, Northzone, William K. Warren Foundation, and Able Partners.

Series C in 2022 valued the company at $2.5 billion.

Sierra

Sequoia Capital and Benchmark wrote the first checks at launch in February 2024, $110 million between them. Greenoaks Capital then led both the $175 million round in 2024 and the $350 million round in September 2025.

In May 2026 Tiger Global and Google's GV led a $950 million round at a $15.8 billion valuation, with Benchmark, Sequoia and Greenoaks back in. That takes total funding to about $1.6 billion.

That is partly the product and partly Bret Taylor. Investors bet on founders who have already built billion-dollar things.