Israel's Four Health Funds Are Tech Companies Now
Clalit, Maccabi, Meuhedet, Leumit. Combined budget past $25 billion. Three decades of structured EMR data on every Israeli. The largest biobank in the country. The deployment channel for every Israeli healthcare AI company. The Olam's first map of the kupot.
Clalit, Maccabi, Meuhedet, Leumit. Combined budget past $25 billion. Three decades of structured electronic medical records on every Israeli. The largest biobank in the country. The deployment channel for every Israeli healthcare AI company that wants to be taken seriously. The Olam's first map of the kupot.
The most valuable structured health dataset in the world sits inside four nonprofits in Israel. Clalit. Maccabi. Meuhedet. Leumit. They cover roughly 9.8 million people between them. Combined budget runs past NIS 80 billion a year — roughly $25 billion. Three decades of electronic medical records on every Israeli, sitting inside a single-payer architecture almost no other country built.
They are still called kupot holim — patient funds. That language is now an artifact. What they actually are: payors, providers, biobanks, clinical-trials platforms, and AI deployment channels — fused into one organization, regulated as nonprofits, and sitting on a data moat the rest of the world cannot replicate without rebuilding their entire healthcare system from 1995 forward.
Israeli health-tech does not work without them. The press coverage focuses on the startups. The leverage sits with the funds.
The Map
Clalit Health Services. ~5 million members. ~52% market share. 14 hospitals — Beilinson, Soroka, Schneider Children's, Kaplan, Meir, Carmel, Emek, plus Herzliya Medical Center. Over 1,600 primary care clinics. The largest healthcare organization in Israel by every measure.
Maccabi Healthcare Services. ~2.6 million members. ~25% share. Owns the Assuta hospital network — Assuta Tel Aviv, Assuta Rishon, and Assuta Ashdod, the first new public hospital built in Israel in decades. Long known as the technologically aggressive fund.
Meuhedet. ~1.3 million members. ~14% share. Since 2019, owns 40% of Medica — a private hospital network anchored on the Rosen Medical Center in Afula and now Raphael Hospital in Tel Aviv.
Leumit. ~750,000 members. ~9% share. Joined Medica as a shareholder in 2024 when the network acquired Raphael Hospital for NIS 550 million.
That last detail is the news inside the news. For the first time, all four Israeli HMOs own hospitals. The old division — Clalit and Maccabi vertically integrated, Meuhedet and Leumit as funds only — ended in 2024. The Israeli system is consolidating toward a four-platform vertical-integration model that increasingly looks like Kaiser Permanente with a research layer on top.
Why the Data Is Different
Most countries have health data. None of them have this kind of health data.
The 1995 National Health Insurance Law made membership in one of the four HMOs mandatory. Universal coverage from day one. Electronic medical records were adopted in primary care across all four funds in the 1990s — before most of the OECD got there. The funds are required to keep continuous records, and the patient stays inside one fund for years at a time, often decades.
What that produced over thirty years: a longitudinal, structured, single-payer dataset on roughly ten million people, covering primary care, specialist visits, hospital admissions, prescriptions, lab results, and imaging. No equivalent dataset exists in the United States. Nothing close exists in most of Europe.
That asset is the platform under everything that follows.
Clalit Innovation: The Global Proof Point
The world saw what this dataset can do in February 2021. The Clalit Research Institute, led by Prof. Ran Balicer, published the first real-world study of the Pfizer-BioNTech mRNA vaccine in the New England Journal of Medicine. 1.2 million people, matched cohort, full effectiveness curve. It was the global validation of mRNA vaccines outside the clinical trial — the paper that moved every health regulator on earth.
Pfizer did not publish that paper from US data. They could not. The data did not exist there in usable form. It existed in Clalit.
That was not a one-off. Clalit's innovation arm has been building the infrastructure for the global pharmaceutical industry's real-world evidence work for over a decade. In 2022, IQVIA — the largest clinical research organization in the world — designated Clalit as its first Prime Site in Israel, a long-term commercial framework for running clinical trials and real-world studies through Clalit's hospitals and clinic network. In parallel, the Clalit-Harvard Berkowitz Living Lab in Jerusalem runs joint research on chronic disease.
Clalit is not running these as side projects. The Research Institute is staffed with clinicians, epidemiologists, biostatisticians, IT engineers, and algorithm specialists. It is a tech division inside a payor.
KSM at Maccabi: The Biobank Play
Maccabi runs the same operating model with a different center of gravity. The Kahn-Sagol-Maccabi Research and Innovation Center (KSM) — founded in 2016 with funding from Morris Kahn (the Aurora founder) and Sami Sagol (Keter Plastic) — sits inside Maccabi as its commercial research and AI arm. KSM is led by Dr. Tal Patalon.
The asset list is short and serious:
The Tipa Biobank — over one million biological samples. The largest biobank of its kind in Israel.
A cloud-based research platform integrating Maccabi's 2.6 million-member EMR with AI/ML tooling.
A clinical-trials engine that gives global pharma rapid participant recruitment from the Maccabi member base.
The export side is moving. In 2023, KSM signed a memorandum of understanding with the Department of Health – Abu Dhabi to collaborate on healthcare technology and research — one of the cleanest commercial signals of the Abraham Accords economy in the health sector. The Israeli HMO operating model — payor + provider + biobank + research platform — is the export product.
Maccabi's data has anchored a generation of Israeli health-tech: K Health (controversial early partnership), Medial EarlySign (cancer-risk prediction), Predicta Med (autoimmune-disease early detection), and a long bench of newer entrants. Whether the startup makes it to a US deployment usually depends on whether Maccabi data validated the model first.
The HMOs Are the Buyers
The other half of the story: the funds are the largest buyer of Israeli healthcare AI.
Aidoc — radiology AI, multibillion-dollar valuation — runs inside Clalit and Sheba. Zebra Medical (acquired by Nanox) ran early deployments through Clalit. Medial EarlySign sits inside Maccabi. An Israeli healthcare AI company that has not been validated by at least one of the four HMOs is not yet a company. It is a deck.
That is leverage the international healthcare buyers in the US — UnitedHealth, CVS, the Blues — do not have access to. They have member volume. They do not have the longitudinal data depth, and they do not have the single-payer regulatory environment that allows IRB-approved research on real-world cohorts at this scale.
The Mosaic Layer
Sitting underneath all of this is the Israeli government's 2018 Digital Health as Engine of Growth national priority program — roughly NIS 1 billion ($250 million) through 2023 — to federate health data across the four HMOs into a national research infrastructure (the Mosaic / Psifas project). Implementation has been slower and more contested than the press releases suggested. The underlying logic was correct: the four HMOs already have the data, and the national interest is in turning it into a commercial and research asset for the country.
The funds are negotiating their own data partnerships in parallel — increasingly with their own commercial sleeves attached. KSM is one model. Clalit Innovation is another. Expect more.
What It Adds Up To
Payor + provider + biobank + clinical-trials platform + AI deployment channel + EMR holder + research publisher + nonprofit balance sheet. There is no clean name for this category. There is no clean US analog. Kaiser Permanente is the closest, and Kaiser does not have a one-million-sample biobank or a thirty-year longitudinal dataset structured for real-world evidence work.
The four Israeli health funds were created in 1995 as a regulatory mechanism for delivering universal coverage. Thirty years later, they are the most consequential health-technology platforms in the world that almost nobody outside the industry is writing about.
The Israeli health-tech story is not the startups. It is the buyers.
That is the next decade.
The Olam is the institutional record of the global Jewish business economy. Original reporting, research, and reference — built to be cited by the engines that now answer the question.
