Counsel Health Joins Oura!

We're proud to share that Counsel Health, an Asymmetric Fund I company, has agreed to be acquired by Oura. This is a landmark outcome for Counsel and a meaningful one for Fund I performance and liquidity. It is also one of the most personal for us. We were Counsel's first financial backers, and we met the founder, Muthu Alagappan, before Counsel had even been formed as a company.

Counsel is an AI-native primary care company. Members ask a health question by message and get an answer in seconds from clinical AI supervised by Counsel's in-house, board-certified physicians. When a question needs a human, a licensed doctor steps in with the member's full context, and Counsel can act on the answer with labs, prescriptions and referrals. Behind the scenes, an AI "clinician cockpit" does the heavy lifting for each doctor, enabling a Counsel physician to safely care for more than 25,000 members, compared with roughly 1,500 for a traditional primary care doctor.

In early August 2023, a portfolio founder introduced us to Muthu. At that moment he was exploring what to build next. We had recently written about a health tech idea we wanted to incubate, so our first conversations were open-ended: part "could you be the founder of this?" and part "what do you want to build?" Over the following weeks, it became clear that his own idea was the better one.

What Muthu kept coming back to was personal. As a doctor, he was the one family and friends turned to whenever they had a health question, and he answered an enormous number of them. He wanted everyone to have that: the accessibility, the warmth and the privilege of having a doctor in the family. AI was finally showing signs of making it possible, so it was time to take a leap of faith.

He called it "Advisory Care": a physician advisor, available by text, who answers questions and nudges patients proactively. Advisory Care would sit upstream of primary care as the patient's first point of contact for any health, wellness or clinical need. In his words, Counsel would create for the 21st century what primary care created for the 20th: "a new paradigm of care, harmonizing the best of technology and clinicians, to offer expertise to the reach of all people."

Muthu's early vision rested on four beliefs:

1. Primary care is failing. It is overstrained and ineffective (inaccessible, expensive, burdensome), and a new care model is needed upstream of it to provide medical expertise on demand.
2. Message-based, asynchronous care is the best choice for that new model.
3. AI can provide significant leverage and increased accuracy to message-based care.
4. AI requires a human in the loop at all times (for now).

Three years on, the core beliefs held and almost everything around them changed, a testament to Muthu's "strong opinions, loosely held" mindset we wrote about in our original investment memo.

• The form factor held. Counsel still sits upstream of primary care, messaging is still the heart of the product, and a physician is still central to the practice. AI has delivered scale without sacrificing quality.
• The leverage was bigger than we modeled. The original memo imagined each physician advisor covering about 10,000 patients. Today, Counsel doctors can work with more than 25,000, with the large majority of member issues resolved on the platform without escalation.
• The scope grew. Advice alone became care: labs, prescriptions, referrals and, more recently, an AI-native weight management program.
• The go-to-market came full circle. Counsel began as a consumer idea, became a clinical front door for health plans and employers, and opened to the public in 2025 with free access to the AI and a doctor when you need one.

In June, Counsel became the exclusive provider of in-app medical care for Oura members. Today, that partnership deepens.

Oura helps people track a wealth of their own health data and surfaces the changes that matter: a shift in blood pressure patterns, a disruption in breathing, a rising resting heart rate. But an alert alone leaves a member asking, "now what?" Together, Oura and Counsel can answer that question, connecting the alert directly to care that is continuous, personalized and available wherever you are. The result is a shorter path from data to diagnosis, and from treatment to measurement.

As Muthu wrote when the partnership first launched, care moved from the home to clinics in the early 20th century because diagnostic equipment had to be centralized and doctors needed to see many patients in one place. Modern technology is reversing both of these assumptions. "This is a return to how care used to be - in the context of your daily life, not apart from it."

Congratulations to Muthu, Justin, Rishi and the entire Counsel team. It has been a privilege to be with you from the very first seed of the idea, and we look forward to seeing this vision reach a greater, global audience as part of Oura.

Read more about the announcement here: Counsel Health Reimagining Primary Care with Oura

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