“First principles” is the practice of breaking a complex problem down to its most fundamental truths, solving for those, and building back up until you’ve conquered the bigger objective. Elon Musk made the term popular because it’s how he pushes his teams to innovate. It also happens to be a useful way to think about one of healthcare’s most overused phrases: patient access.

Patient access is one of those words that means different things to different people. Strip it down, though, and it’s about one thing: the set of processes that determine whether and how a patient receives care.

So what’s the most fundamental truth underneath it? It’s how a patient makes an appointment with their provider. Not just the mechanics of booking, but how in tune the clinic is with what its patients actually need, and what it does to reach out proactively based on those needs.

In other words, patient access starts with knowing your patients and regularly checking in to see how they’re doing.

Simple in theory. Much harder in practice. No ambulatory clinic can afford to staff a team dedicated to proactively call thousands of patients, one by one.

This is where conversational AI fits.

Here’s a real world example of how conversational AI made a vast improvement in patient access for one of Clarus’ customers. A primary care practice had roughly 1,800 patients overdue for a wellness visit ranging from six months to two years since they were last seen. Our conversational AI platform, Engage, manages AI agents that call and text those patients to check in and help them schedule. Over a 30-day period, 212 of them booked a visit — nearly 12%. That’s 212 patients with access they didn’t have a month earlier.

There are hundreds of campaigns like this in production across clinics and home health agencies nationwide — procedure follow-up, in-home nurse visits, medication adherence, and a range of chronic care gaps.

None of it is complicated. It’s solving the first principle of access through consistent, needs-based communication: asking patients how they’re doing and whether they need help. That’s how conversational AI is making a difference today.

As one VP of Ambulatory Operations at a 72-clinic health system recently put it: “This way of communicating with patients will be how it’s done in the future. So to the extent we can get going now, why wouldn’t we?”

Acquisition positions Clarus among the leaders in conversational AI across the ambulatory, home health, and MSO segments

NASHVILLE, Tenn. — June 18, 2026 — Clarus, a call management and patient engagement platform for growing healthcare organizations and a subsidiary of Graham Holdings (NYSE: GHC), today announced the acquisition of Flowline Health, a leading provider of conversational AI and patient engagement.

Combined with Clarus’ 10+ years of experience and over 60 million patient interactions, Flowline’s expertise uniquely positions Clarus to help healthcare organizations deliver a higher level of care, make staff and providers more productive, and capture revenue they’re losing today.

Clarus is proud to offer a suite of leading products in this space, backed by a decade of knowing what actually happens when patients call. Clarus handles more than 14 million patient calls a year for medical practices and health systems nationwide, and the addition of Flowline extends that platform with conversational AI across both voice and text.

Most healthcare organizations are adopting conversational AI for the first time, and what sets the combined company apart is the ability to make it produce real results. Flowline’s technology, paired with Clarus’ scale and experience, gives healthcare organizations a path to deploy conversational AI and see real outcomes quickly, not just run another pilot.

The combined platform meets patients on the channels they use, by phone and by text, and works across both inbound and outbound. Clarus answers the inbound calls and messages that keep a practice running, while Flowline strengthens engagement on both sides, reaching patients proactively to confirm appointments, close care gaps, and follow up on the outreach that too often falls to overextended staff. The result is one platform built for the full range of patient communication, rather than a patchwork of point solutions.

The acquisition reinforces Clarus’ commitment to the ambulatory, home health, and MSO segments, where conversational AI can help close persistent gaps in patient communication: missed follow-ups, unanswered calls, and manual outreach that pulls staff away from patient care.

“Gabe and I started Flowline because we believed conversational AI would become foundational to the future of healthcare operations,” said Andrew Bull, co-founder of Flowline Health. “Deploying our solutions in the real world has been tremendously rewarding. Joining Clarus, a leading platform already handling millions of patient interactions a year, lets us put our technology to work for practices at a real scale, and do what we always dreamed of: help patients and providers every day.”

“Clarus and Flowline have always been chasing the same thing: ensuring patients have world-class access to care, and providers can run sustainable businesses,” said Gabe Mamallo, co-founder of Flowline Health. “Coming together lets us serve patients and providers, across voice and text, in a way neither of us could alone. I’m excited about what we’re going to build for the practices and patients who count on us.”

Clarus and Flowline will share more about the combined product roadmap in the coming months.

About Clarus

Clarus is a call management and patient engagement platform for growing healthcare organizations, handling more than 14 million patient calls a year for practices and health systems nationwide, built on 10+ years of experience and over 60 million patient interactions. Clarus is a subsidiary of Graham Holdings (NYSE: GHC). Learn more at claruscare.com.

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The Problem: Managing Urgent Home Infusion Therapy Calls Created Operational Challenges

PromptCare, a home infusion provider specializing in IVIG therapies and biologics needed a reliable way to manage urgent after-hours patient calls. For patients experiencing critical events, rapid response times are essential. However, the organization’s previous on-call process required multiple layers of communication and placed a significant burden on clinical staff.

Key challenges included:

As a result, PromptCare needed a more efficient and streamlined solution to manage urgent patient communications while reducing operational burden.

The Solution: A Centralized, Easy-to-Use Call Management App

PromptCare implemented Clarus to simplify after-hours communication and ensure urgent patient needs were routed quickly to the appropriate clinician.

Key capabilities included:

With Clarus in place, urgent patient calls are quickly routed to the appropriate care team member, helping nurses respond rapidly to time-sensitive situations while improving operational efficiency.

The Problem: Slow Patient Response Times Led to Patient Dissatisfaction and Staff Burnout

Before implementing Clarus, CoreLife did not have a formal call management system in place. Incoming patient calls were routed directly to voicemail whenever front desk staff were busy with in-clinic patients.

This created several operational challenges:

As a result, staff were stretched thin, and clinic efficiency and patient communication suffered.

The Solution: Structured Call Management and Triage with Clarus

CoreLife replaced their voicemail-based system with a structured, centralized call management solution that automatically categorized and routed patient messages to the appropriate team members.

Key capabilities included:

With the usage of Clarus, CoreLife’s front desk team was able to step away from constant phone interruptions and refocus on higher-value responsibilities.

The Problem: Slow Patient Response Times Led to Patient Dissatisfaction and Staff Burnout

Sauk Prairie Healthcare’s leadership recognized significant challenges with their existing medical answering and call management process.

As a result, the organization needed a more efficient, scalable solution to improve patient communication and reduce strain on staff.

The Solution: Faster, More Efficient Daytime Patient Communication with Clarus

Sauk Prairie Healthcare implemented Clarus to modernize patient communication and streamline high-volume call management.

Key capabilities included:

With Clarus in place, Sauk Prairie Healthcare significantly improved patient response times, enhanced patient satisfaction, and reduced staff overload through a more efficient communication system.

The Problem: Inaccurate Messaging and High Costs from Traditional Medical Answering Services

Sylacauga Obstetrics & Gynecology relied on a traditional medical answering service that created both financial and clinical communication challenges.

As a result, the OBGYN practice needed a more reliable, cost-effective, and secure patient communication solution.

The Solution: A Simple, Scalable HIPAA-Compliant Patient Communication System

In 2015, Sylacauga Obstetrics & Gynecology implemented Clarus to modernize its patient communication and reduce reliance on traditional answering services.

Key capabilities included:

With Clarus in place, the OBGYN practice improved message accuracy, enhanced compliance, and reduced operational costs while delivering more reliable patient communication.

The Problem: Limited Call Visibility and Labor-Intensive Documentation

MidState Pulmonary faced operational challenges with its traditional call management and documentation processes.

As a result, the pulmonary practice needed a more efficient and scalable solution to improve visibility, reduce administrative burden, and lower operational costs.

The Solution: A Cost-Effective, Technology-Based Call Management System

MidState Pulmonary implemented Clarus to streamline call handling, improve documentation accuracy, and reduce staffing demands.

Key capabilities included:

With Clarus in place, the practice improved efficiency, enhanced documentation accuracy, and significantly reduced operational costs while maintaining high-quality patient communication.

The Problem: Traditional Medical Answering Service Caused Inaccurate Documentation

Chicago Nasal and Sinus Center relied on a traditional answering service to manage after-hours patient calls, which led to ongoing communication challenges.

As a result, the practice recognized the need for a more accurate and reliable call management solution.

The Solution: AI-Transcription and Documentation Through Clarus Call Management

Chicago Nasal and Sinus Center implemented Clarus to modernize its after-hours call handling and improve communication accuracy.

Key capabilities included:

With Clarus in place, the practice reduced communication errors, improved staff efficiency, and ensured more accurate and reliable patient interactions.

The Problem: Traditional Medical Answering Service Caused Delays in Patient Communication

Women’s Care of Beverly Hills faced ongoing challenges with its traditional medical answering service, particularly in delayed response times and time-consuming workflows.

As a result, the practice needed a more efficient and reliable way to manage patient calls and messages.

The Solution: An Easy-to-Use Technology-Based Call Management Solution

Women’s Care of Beverly Hills implemented Clarus’s innovative call management system to modernize its patient communication and call management process.

Key capabilities included:

With Clarus in place, the women’s health practice significantly improved communication efficiency, reduced administrative burden, and enhanced the overall patient and provider experience.

The Problem: High-Cost Medical Call Center Couldn’t Scale with Practice Growth

Kansas City Bone & Joint, a growing orthopedic practice with 20+ providers, relied on a traditional live operator system to manage daytime and after-hours patient calls. As call volume increased, the system became costly and less efficient for the practice’s needs.

As a result, they began searching for a more cost-effective and scalable approach to patient call management.

The Solution: A More Affordable, Scalable Patient Communication Solution

Kansas City Bone & Joint implemented Clarus’s AI-powered call management solution to replace its medical answering service with a scalable, technology-based platform designed for growing healthcare practices.

Key capabilities included:

According to Executive Director Caressa Lynch, Clarus’s call management solution immediately improved the call experience for both patients and providers, while positioning the practice for continued growth.