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Freshpaint

YC S19

San Francisco, US · Founded 2019 · 120 employees · Hiring · 8 known investors

Freshpaint provides a platform for healthcare marketers to securely connect and activate customer data across marketing channels while maintaining privacy compliance. The platform helps healthcare organizations measure marketing performance, optimize spending, and scale growth within regulatory constraints.

Also known as Perfalytics · Freshpaint, Inc.

Founders & leadership· Y Combinator alumni (S19)

Freshpaint was founded in 2019 by Steven Fitzsimmons and Michael Malis.

SFSteven Fitzsimmons
Steven FitzsimmonsinFounderCo-founder of Freshpaint, a platform that helps healthcare marketers securely connect and activate customer data across marketing channels while maintaining privacy compliance.
MMMichael Malis
Michael Malisin𝕏Founder2019–2026Michael Malis joined Heap after graduating high school in 2015, where he worked on scaling their Postgres database infrastructure and eventually led the database team. He has experience with large-scale database optimization and cost reduction initiatives.
RMRay Mina
Ray MinainChief Executive Officer
TSTom Spiegelman
Tom SpiegelmaninChief Product & Technology Officer

Investors · 8

Also in the syndicate · 2

ThresholdleadZero Prime

Funding

SEC filings, press & company announcements

$60M disclosed across 2 rounds · 2024

Source: company announcements and press reports — follow each round's link for the claim.

Company profile

researched Aug 2026

Freshpaint provides a privacy-first marketing data platform built specifically for healthcare organizations. The platform collects website and marketing data, applies privacy and governance rules before that data is shared downstream, and connects marketing activity to patient outcomes such as booked and attended appointments and revenue. It is positioned to remove the tradeoff healthcare marketers face between campaign performance and compliance with HIPAA, HHS web-tracking guidance, FTC enforcement, CMS rules, and state privacy laws.

The product set spans data collection and activation (integrations with direct-response ad platforms such as Google Ads, Meta Ads and Microsoft Ads, DSPs including Viant and StackAdapt, and CTV platforms), Audiences for segment activation and suppression of existing patients, a Consent Manager for multi-state privacy requirements, Web Tracker Manager for auditing pixels and trackers on a site, Ad Performance and Insights (including multi-touch attribution) for cross-channel measurement, web analytics with funnels, session replay, heatmaps and surveys, a data warehouse connection, Freshpaint Video and Freshpaint Maps for compliant hosted media and location finding, call-tracking integrations with Invoca, CallRail and CTM, and Freshpaint AI for guided analysis. The company describes its platform as de-identifying and filtering sensitive customer data so healthcare organizations can continue using mainstream ads, analytics and personalization tools without rebuilding their technology stack, and states that implementation typically takes a few weeks and does not require engineering or data-engineering resources.

Freshpaint serves hospitals and health systems, payers, urgent care, dental and DSO groups, orthopedics, dermatology and other specialty providers, and pharma and medical device companies including direct-to-patient programs. Named customers include Baptist Health, LetsGetChecked, Boulder Community Health, Yale, Modern Health, Allergy Partners, OrthoCarolina, St. Elizabeth Healthcare, Heartland Dental, BU Dental, CU Medicine, HealthTrust and the agency Amsive Health.

Founding story

Freshpaint was co-founded by Michael Malis and Steven Fitzsimmons; Fitzsimmons served as CEO and co-founder through the company's 2024 Series B. The company is a Y Combinator alumnus, with Y Combinator participating in later rounds.

Business model

Freshpaint sells a subscription software platform to healthcare organizations, with published plans and pricing and a demo-led sales process. Freshpaint handles implementation work including migrating existing tracking setups, configuring integrations and applying data governance rules, and the product is designed to be operated by marketing teams without dedicated engineering support.

Traction

Freshpaint states it is trusted by more than 250 healthcare organizations. The company reported 10x revenue growth in 2023 and described itself as one of the fastest-growing software companies that year while remaining capital-efficient. Published customer outcomes include an 80% drop in cost per lead for OrthoCarolina, a 30% reduction in cost per acquisition for BU Dental, a 92% improvement in search conversion volume for St. Elizabeth Healthcare, an 8x reduction in customer acquisition cost versus a pixel-less setup for Heartland Dental, a 53% improvement in Meta campaign performance for a national payer, a 96% campaign performance improvement and cost per lead falling from $300 to $12 for Allergy Partners, and a national urgent care provider cutting CAC 24% while adding roughly $1.92M in annual appointment revenue. The company cites an average customer acquisition cost reduction of over 20% and 5-25% lower patient acquisition costs on average.

Latest developments

In June 2026 Freshpaint announced new features including Freshpaint AI, conversion rate optimization tooling and personas, and described partnerships with CTM for privacy-safe phone call attribution and with Vibe for measuring connected TV campaigns. Recent publications address the FTC and state complaint against Hims & Hers Health, health data privacy in direct-to-patient and direct-to-consumer pharma marketing, and preparation for 2027 Medicaid changes. Leadership is now headed by CEO Ray Mina, with Tom Spiegelman as Chief Product & Technology Officer; co-founder Steven Fitzsimmons was CEO at the time of the 2024 Series B.

Full profile — market position, technology, go-to-market, geography, history, risks & controversies

Market position

Freshpaint describes itself, and is described by its investors, as the creator and leader of a new software category, the Healthcare Privacy Platform, addressing the compliance gap created by 2022 HHS guidance on web tracking technologies and subsequent FTC enforcement actions against healthcare and digital health companies. Investor commentary frames the opportunity as a burning unmet need in a historically tech-laggard industry, driven by regulatory complexity and the reputational and financial risk of patient data leakage.

Freshpaint states it was built specifically for healthcare rather than retrofitted, enforcing privacy at the point of data collection so customers keep granular control over what data flows to each downstream vendor. It contrasts its approach with Google Consent Mode, which governs only Google tag behavior rather than system-wide control of protected health information across all vendors, and emphasizes fast deployment without re-engineering the marketing stack or requiring data engineers.

Technology

The platform sits between a healthcare organization's website and its marketing, analytics and data systems, enforcing privacy at the point of collection: it de-identifies and filters sensitive data, applies allow lists, audit trails and governance rules, and lets customers control which data is sent to which downstream vendor and what is blocked. Audiences are activated in ad platforms using hashed or platform-specific identifiers, healthcare context is removed before activation, and the platform integrates with EHRs, CRMs, ad platforms, DSPs, call-tracking tools and data warehouses to tie marketing activity to appointments and revenue. Additional components include compliant video hosting and maps, consent management, web tracker monitoring, and AI-assisted analysis.

Go-to-market

Go-to-market is demo-led and content-driven: the company publishes case studies, buyer's guides and compliance alerts, runs a blog and the Freshpaint 5 newsletter, produces the Marketing Rounds podcast, hosts in-person and invite-only events (Freshpaint Live, House Call, leaders' circles for urgent care and orthopedics), and operates a private customer community. A free custom Web Tracker report is offered as a lead-generation entry point. The company also partners with agencies and adjacent vendors, including Amsive Health, Vibe (CTV) and CTM (call tracking).

Healthcare marketers and privacy or compliance leaders at hospitals and health systems, health insurance payers, urgent care chains, dental service organizations, orthopedic and other specialty provider groups, pharmacies, retail healthcare, direct-to-consumer digital health companies, and pharma and medical device firms running direct-to-patient acquisition.

Geography

Headquartered in San Francisco, California, with customers across the United States; product capabilities address US federal regulation (HIPAA, HHS guidance, FTC, CMS) and varying state privacy laws.

History

By 2023 Freshpaint had reached 10x year-over-year revenue growth serving hundreds of healthcare organizations, and in July 2024 it announced a $30.7 million Series B led by Threshold and co-led by SignalFire, bringing total funding to $41.8 million. The company has since broadened from a compliance-focused Healthcare Privacy Platform into a wider healthcare marketing performance and measurement platform spanning attribution, analytics, audiences, consent and AI-assisted insights, and expanded its addressable market from providers to payers, pharmacies, retail healthcare, and pharma and medical devices.

Risks & controversies

The business depends on an evolving regulatory environment: federal HHS and FTC positions on web tracking technologies, CMS requirements, and differing state privacy laws all shape demand and product requirements. Its value proposition also depends on continued ability to pass usable signal to third-party ad and analytics platforms whose identifier and consent mechanisms change over time.

Compiled by commissioned research from 8 cited public sources — announcements, filings, and press listed under research sources below.

Key figures

latest reported
Average customer acquisition cost reductionJan 202620%+ average CAC reduction
Average reduction in patient acquisition costsJan 20265-25% lower patient acquisition costs on average for customers
Average time from audience creation to live campaignsJan 202630 minutes
HeadcountAug 2026140
Healthcare organizations using FreshpaintJan 2026250 organizations
Revenue growthJan 202310x revenue growth in 2023
Total funding to dateJul 2024$41.8M

Company-reported or press-reported figures, each dated to when it was claimed — not independently audited.

Competitors · 7

by search overlap
Accountable157 shared keywordsAccountable provides a platform that automates HIPAA compliance tasks including policies, training, risk assessments, vendor management, and incident tracking for small and mid-size healthcare organizations such as dental offices, therapy practices, and health tech startups.
Paubox156 shared keywordsPaubox provides HIPAA compliant email security for healthcare organizations, using generative AI to detect and block phishing, ransomware, and social engineering attacks before they reach the inbox. Its products protect both inbound and outbound email while maintaining compliance for protected health information.
Keragon118 shared keywordsKeragon is a HIPAA-compliant, no-code AI automation platform for healthcare providers, with 300+ integrations across 30+ EHRs plus scheduling, billing, and communication tools. It automates front-office workflows such as patient intake, appointment reminders, insurance eligibility verification, and no-show recovery for clinics, medical groups, and hospitals.
Secureframe111 shared keywordsSecureframe provides a compliance automation platform that helps enterprises maintain security and compliance posture with common controls mapping across multiple frameworks. The platform uses AI and automation to reduce manual compliance work for organizations managing standards like SOC 2, ISO 27001, and HIPAA.
Peoplekeep90 shared keywordsPeopleKeep, part of Remodel Health, offers HRA (health reimbursement arrangement) software that lets employers design, administer, and reimburse tax-free health benefits for employees. It serves small businesses, large employers, nonprofits, and brokers in the US, supporting QSEHRA, ICHRA, and GCHRA plan types.
Centraleyes77 shared keywordsCentraleyes offers an AI-powered cyber risk register and GRC platform that links risks to controls, compliance frameworks, evidence, remediation, vendor oversight, and executive reporting. It targets security, IT risk, compliance, and audit teams looking to run risk assessments and manage the full GRC lifecycle.
Sprinto76 shared keywordsSprinto is a compliance and governance, risk, and compliance (GRC) platform that automates security compliance across 200+ frameworks such as SOC 2, ISO 27001, HIPAA, GDPR, and PCI DSS. It serves companies from Series A to enterprise, covering compliance, vendor risk, AI governance, and audit preparation through integrations with cloud, identity, HR, and SaaS systems.

Companies competing with Freshpaint for the same Google search keywords, organic and paid, via search-intersection analysis.

Timeline · 4

launches, deals, and filings
Jun 2026
Freshpaint AI, conversion rate optimization and personas released

Freshpaint announced new features for healthcare marketers including Freshpaint AI, conversion rate optimization capabilities and personas, aimed at improving website conversion and faster analysis.

source ↗

Jun 2026
Partnership with CTM for privacy-safe call attribution

Freshpaint and CTM partnered to enable privacy-safe phone call attribution for healthcare marketers.

source ↗

Jun 2026
Partnership with Vibe to measure CTV campaigns

Freshpaint and Vibe announced work to help healthcare marketers measure how connected TV campaigns drive patient actions.

source ↗

Jul 2024
Freshpaint announces $30.7M Series B led by Threshold

Freshpaint announced a $30.7 million Series B financing led by Threshold with SignalFire co-leading and participation from existing investors Intel Capital, Y Combinator and Zero Prime, bringing total funding to $41.8 million. Proceeds were earmarked for expanding the Healthcare Privacy Platform to hospitals, payers, pharmacies and retail healthcare.

$30.7M source ↗

Dated company events from announcements, filings, and press; legal rows summarize public dockets and regulator releases.

In the news

Research sources · 8

primary sources listed

8 public sources were cited for this profile; the first-party ones are listed here.

Frequently asked questions

What does Freshpaint do?
Freshpaint is a privacy-first data platform that lets healthcare marketers measure and optimize campaigns without exposing patient data.
Who founded Freshpaint?
Freshpaint was founded by Steven Fitzsimmons, Michael Malis in 2019.
Who are Freshpaint's investors?
Freshpaint's investors include Abstraction Capital, SignalFire, Threshold Ventures, Vibe Capital, Y Combinator, Zero Prime Ventures.
How much funding has Freshpaint raised?
Freshpaint has disclosed $60M raised across 2 rounds.
Where is Freshpaint headquartered?
Freshpaint is headquartered in San Francisco, US.