Investor deck 2026

PainOS

The operating system for value-based pain care.

CMS is turning pain physicians into accountable-risk operators. PainOS gives practices the workflow, data, and audit trail to survive the shift.

AAPM physician channel1,000+

Global network14 countries

Practice exposure at risk$260K

PainOS

Why now

CMS just turned pain management into a two-sided risk business.

The Ambulatory Specialty Model puts physician groups on the hook for low back pain cost, quality, improvement activities, and interoperability.

2025-2026

PainOS ships ahead of mandate

The platform is live before practices must report.

Jan 2027 — 6 months out

ASM mandatory in ~25% of U.S. metro markets

Groups with 20+ Medicare LBP episodes/year must comply. ±9% hits all Part B revenue.

2028

First performance year reconciled

Physicians learn, retroactively, what they made or lost.

2031

Risk matures to ±12% of Part B revenue

Roughly $260K of CMS exposure, with up to about $220K net savings if implementation stays below $40K.

CMS holds hospitals accountable under TEAM — ASM shifts that burden to the individual physician, with MSK, cancer, and mental health next. Pain is first, not last.

PainOS

The problem

Every pain practice is about to be graded on data it is not collecting.

EHRs schedule and bill. They do not prove conservative care, track outcome windows, model episode cost, or preserve PCP exchange evidence.

What practices have today

x

Encounter records

No episode-level exposure model.

x

Procedure documentation

No conservative-care proof.

x

Billing codes

No outcome achievement tracking.

x

Siloed notes

No audit-ready exchange trail.

What ASM requires

+

Patient risk scoring

Know who is driving the adjustment.

+

PROM window control

Baseline through end-of-period completion.

+

Care pathway logs

PT, education, SDOH, behavioral health, opioids.

+

Interoperability proof

CEHRT and PCP coordination evidence.

PainOS

Market

A $40B beachhead inside a $624B condition.

Chronic low back pain: $40B/year direct spend, $624B total economic burden - trailing only diabetes in per-capita cost.

TAM$624B

Total U.S. chronic low back pain burden

CMS Payment Risk Escalation

% of Part B revenue at risk, by year

1

Physician-level risk

For the first time, CMS holds individual physicians - not hospitals - accountable for episode cost and outcomes.

2

Specialists drive spending

CMS says specialists account for most spending growth - pain is the pilot, MSK and mental health are next.

3

20-episode threshold

Any group managing 20+ Medicare LBP episodes a year in a launch market must comply - it is not optional.

Specialists drive most spending growth - pain is CMS's pilot for MSK, cancer, and mental health next.

PainOS

Product

The PainOS ASM Command Center is live.

A real-time operating layer for the exact workflows CMS will audit: risk, outcomes, improvement activities, claims exposure, and care exchange.

painos.app / command-center

Live demo

$148K

Projected downside

Current modeled exposure

11

High-risk patients

Score 65 or above

18

Open windows

Need PROM capture

7

Interop gaps

PCP evidence missing

PatientRiskFlagOpen actionExposure

PT-001

Lumbar stenosis

82Cost outlierOpioid review$4,240

PT-004

Failed back syndrome

71Care gapPT pathway proof$3,180

PT-007

Lumbar radiculopathy

64Interop gapPCP exchange$2,510

PainOS

Distribution

Distribution is the wedge: specialty-society trust before mandatory compliance.

PainOS is positioned through relationships that practices already trust, rather than a cold SaaS motion into independent physician groups.

AAPM partnership path

1,000+ physicians

Warm specialty-society channel into the practices ASM hits first, with webinar, demo, and website launch path.

Strategic pipeline

Up to 14 states

National Pain and Spine discussion creates a multi-state expansion path.

Global reach

14 countries

Pain Innovation Network creates optionality as value-based specialty care spreads.

The sales motion is not "convince pain physicians risk matters." CMS already did that.

PainOS

Global network

The Pain Innovation Network gives PainOS a 14-country expansion option.

U.S. ASM is the wedge, but the software category is broader: specialty practices need infrastructure for outcomes, risk, and audit-ready care coordination.

Pain Innovation Network footprint shown as a practical expansion surface after U.S. ASM adoption.

14

Countries

Pain Innovation Network footprint

1

Category wedge

Pain as the first specialty risk domain

U.S.CanadaMexicoBrazilU.K.GermanyNetherlandsSwitzerlandSouth AfricaUAESaudi ArabiaSingaporeJapanAustralia

Start where regulation forces adoption. Expand where outcomes infrastructure becomes unavoidable.

PainOS

Pipeline

National Pain and Spine creates a near-term multi-state expansion path.

One strategic relationship can move PainOS from specialty-society channel to multi-state clinic deployment before the first ASM performance year.

Upcoming discussions

Leadership engagement

Active pipeline conversations focused on ASM readiness.

Repeatable model

One relationship, many clinics

A clinic group motion scales faster than one-office sales.

14 / 50

U.S. states in scope of the active pipeline discussion.

PainOS

Traction snapshot

Product shipped. Distribution built. Mandate 6 months out.

1K+

Physicians

AAPM-enabled channel

14

Countries

Pain Innovation Network

14

States

Strategic clinic pipeline

2027

Mandate

ASM begins Jan 2027

4

Domains

Tracked live in product

16

Actions

Readiness checklist shipped

$260K

Exposure

CMS risk per sample practice

1

Priced like infrastructure. Aligned like a partner.

PainOS combines white-glove ASM implementation, recurring software, PMPM patient follow-up, and aligned upside when practices improve under value-based models.

Implementation

$10K-$12K per clinic

White-glove EHR panel review, ASM categorization, severity stratification, group clustering, and deployment.

Follow-up

$8-$15 PMPM

Patient app engagement and between-visit monitoring, with annual software licensing kept broad pending final pricing.

Channel

20% AAPM share

AAPM-enabled channel economics can include 5%-10% member discounts while reducing paid acquisition dependence.

100 clinic conversions imply roughly $1M-$1.2M in gross implementation revenue before recurring software and PMPM upside.

PainOS

Moat

Generic value-based-care platforms do not speak pain.

PainOS embeds the clinical logic, outcome windows, opioid risk, and documentation burden specific to interventional pain and MSK care.

Generic VBC platforms

x

No ASM episode model

Cannot identify low back pain attributions.

x

No pain-specific PROMs

Misses ODI, NDI, KOOS-JR, and site-specific instruments.

x

No opioid risk logic

MME/day is invisible as a cost driver.

PainOS ASM module

+

Episode attribution

Scores every likely ASM episode in the panel.

+

Window lifecycle

Baseline to EOP, with completion and miss tracking.

+

Audit trail by design

Every action links to evidence CMS can review.

PainOS

The ask

Raising to convert distribution into deployed practices before Jan 2027.

Capital accelerates onboarding while pain practices are still choosing their compliance operating system.

Pre-Seed Round

$750K

Round

Pre-Seed

Pre-money

$8.5M

Target close

Aug 1

Minimum check

$50K

Deadline

Jan 2027

Pre-seed round at an $8.5M pre-money valuation to convert AAPM-enabled distribution, product readiness, and early pilots into deployed ASM practices before the Jan 2027 deadline.

Product and compliance

Extend ASM coverage and readiness workflows.

40%

Channel activation

Convert AAPM-enabled launch path and clinic pipeline into deployments.

35%

Regulatory infrastructure

Audit-grade data, CEHRT headroom, and exports.

15%

International expansion

Prepare 14-country licensing path.

10%

PainOS

Team & advisors

Clinical credibility, operator discipline, and specialty-society reach.

PainOS is led by healthcare operators and specialty clinicians, with advisors connected to the institutions shaping pain medicine, policy, and clinical adoption.

Our team

Healthcare operators building the platform and commercial motion.

Kike Oduba, MD, MPH

Founder and CEO

Gene Thomas

Chief Operating Officer

Naeem Vehvaria

Fractional CTO

Our advisors

Specialty medicine, pain policy, and academic-network guidance.

Brian Mayrsohn, MD

American Academy of Pain Medicine

JORDI MOYA RIERA

Sine Dolore European Pain Foundation

Kayode Williams, MD

Johns Hopkins Medicine

PainOS

Close

The mandate is coming

The network is already ours.

PainOS is the only platform purpose-built for CMS's Ambulatory Specialty Model, backed by an AAPM-enabled launch path, a global pain network, and a multi-state clinic pipeline.

Schedule due diligence call painos.app

1K+

Physicians

14

Countries

14

States

$260K

Exposure/practice