August AI, an artificial intelligence-enabled telehealth provider, has launched from stealth with a direct-to-consumer model.
While the company’s AI chatbot is available globally, August is launching telehealth services in the U.S. With August Care, for a $39 monthly membership, members can receive clinical services, discounted labs and quick prescriptions. Globally, August will continue to make its AI chatbot available to users for free. It provides information, not medical advice, based on the company’s knowledge base and guidelines.
“Most of a person’s health journey is what happens between doctor visits,” Nirav Shah, M.D., M.P.H., the company’s fractional chief medical officer, told Fierce Healthcare in an emailed comment. Shah is the former health commissioner for New York State and former chief operating officer for clinical operations at Kaiser Permanente Southern California. “That’s where AI can help close gaps. … August is a health companion, not a replacement for clinical visits.”
The company is on a mission to prevent knowledge and care access gaps. It was founded in 2022 by Anuruddh Mishra, who is also August’s CEO. At 25 years old, Mishra got a misdiagnosis for rheumatoid arthritis, spending four months in pain. He felt lonely and misunderstood. He had to see his doctor every two weeks and make lots of calls.
“That was basically my first interaction with the healthcare system overall,” Mishra told Fierce Healthcare in an exclusive advanced interview. “You’re unhealthy, you’re sick, and in pain, and then you have to do all of the work [to figure out healthcare].”
In a few years, largely through word of mouth, August AI has amassed a following: it’s used by over 9 million people across 160 countries, and is available in over 30 languages. The model does not push users to become August Care members, according to Mishra.
Members of August Care get unlimited AI health chat, one telehealth visit a month—with additional consults available for $19—next-day access to labs and prescriptions sent to the pharmacy within 10 minutes of physician approval. August is also piloting overnight medication delivery. Members also get unlimited follow-up messaging for a year after a consult (about a third of August patients stay longer than a year). Meanwhile, August AI can ingest prescriptions and lab reports to explain medical terms in plain language and help people make sense of their results. It remembers a patient’s conditions and history over time. August can also integrate with outside EHRs and help with benefits navigation.
The company claims August Care can save members up to $3,000 a year, or up to $3,500 for chronically ill patients. This is because of its subscription model that brings down the cost of consultations and labs. August also helps patients find coupons for medications.
The company’s AI was built alongside clinicians to ensure guardrails are in place, Mishra said. It can flag risk and escalate to the appropriate care, including in-person or emergency settings. A licensed physician makes every prescription, note and clinical decision inside August Care, while AI supports users between sessions.
August AI’s dataset is trained on 300 million real patient interactions. The company claims its underlying models score 100% on the U.S. Medical Licensing Examination (USMLE), up from 95% two years ago and higher than competing models. It also claims it scores higher (97%) than others on MedQA, a benchmark of USMLE-style clinical vignettes, and on par with or better (94%) than others on the medical subsets of MMLU, benchmarks that test multi-step clinical reasoning.
“You need to build synthetic simulated environments in which you’re able to test how your AI performs in real life,” Mishra noted. August does this before any model update and also to test it on an ongoing basis.
August has raised $3 million to date and is backed by Accel. The company has treated 100,000 patients in the U.S. “We want to make it compelling to do the package,” Mishra said. “If you’re paying us $39 a month, our north star is can we save you a lot more than that for your healthcare costs?”
August is keeping its AI free. The company hopes to give the millions of people turning to ChatGPT for health questions each week a better alternative. “It’s a large part of the mission, … it’s more of a principled stance for us, for keeping the AI free,” Mishra said. Reimbursement for August Care is on the company’s roadmap, though it is focused on people who are under- or uninsured first.
At the same time, August recognizes some patients will already have existing insurance and established care. “The best approach is to sort of factor that in,” Mishra said. That means sometimes, August is more of a navigation tool than the physician of record. It can support patients in navigating scheduling with an external physician. It’s looking to also roll out AI capabilities to help address prior auths and follow-up reminders in the future.
“August’s job is to make interactions easy,” Mishra said. “It’s our job to stay on hold on the patient’s behalf.”