From the Founder | Why Is Getting an MRI Harder Than Booking an Airbnb?

Why Work Here is a series in which Amit Matani, CEO of Wellfound, has honest, behind-the-scenes conversations with founders, executives, and employees about why their companies are worth joining.

When his father’s cancer diagnosis was delayed by weeks of imaging backlogs, Elan Adler, CEO and Founder of OneImaging, saw just how broken the system was. Patients were being treated like bystanders in their own care. He quit his job, used his own savings, and started building a platform that would make medical imaging transparent, affordable, and fast. In the latest Why Work Here episode, he sits down with Wellfound CEO Amit Matani to talk about what it takes to rebuild one of healthcare’s most overlooked industries from the inside out.

🎥 Watch the full interview on YouTube | Listen on Spotify

When Elan Adler’s father found a lump under his arm, getting it checked should have been straightforward. It wasn’t.

“It took forever to get the imaging,” Adler said. “It spread to his breast tissue and it ended up being, stage three cancer … If he had access to imaging a lot sooner, maybe it’s before it spreads.”

His father survived. But the experience left Adler with a question he couldn’t shake:

“Why is getting an MRI harder than booking an Airbnb?”

That question eventually turned into OneImaging, a company trying to make diagnostic imaging feel less like bureaucracy and more like something built for the person actually getting scanned.

The Second-Most Used Service No One Thinks About

Radiology quietly touches almost everyone with employer-based insurance.

“Radiology is the second most used service in all of healthcare,” Adler told Wellfound CEO Amit Matani. “Forty-five percent of people age 18 to 64, that get their insurance from their employer or private insurance plan, are going to use one of our imaging services at least once during the next 12 months.”

OneImaging sits in the middle of that flow. Adler describes it as:

“A radiology platform and insurance plugin that lowers the cost of diagnostic imaging exams by 68 percent on average … for any MRIs, X-rays, ultrasounds, mammograms, or CT exams, making it super easy and streamlined where you know the full cost that you owe.”

The mechanics are simple on the surface. When a doctor orders an exam, OneImaging automates the prior authorization, routes the order to a high-quality imaging center, and texts the patient a link to book.

“Just like you receive a text message from CVS when your prescription is ordered, the same thing happens with OneImaging…When a radiology exam is ordered, you get a text message from us, ‘Hey, [name], we provide the radiology coverage and network for your insurance plan… click here to book your appointment.’”

Before a patient even walks in, they know what they’ll owe. If they can’t afford it, the company offers zero-percent, buy-now-pay-later financing.

“So this is for everyone.”

“You’re the One Spending the Money.”

Adler is not shy about what he thinks is broken in the current system. He said that some of the current players in this system are

“…hiding behind the guise of a nonprofit status and really price gouging in an insane way,” he said. They use “regulatory capture and other negative things on society to create, to capture patients and give them the perception that they don’t have a choice where they want to go.”

He keeps coming back to that word: choice.

“You’re the one spending the money…Shouldn’t you be able to say, wait, hold on one second. I actually know of five other places that are closer to my home that’s lower in cost, that have the same exact equipment, that have the same radiologists that are reading for the hospital as reading for that place. Why can’t I just go there and I’m not gonna have to wait six weeks or seven weeks to get in for an appointment?”

The math is simple. If every referral points to the same big health system, there will be a seven-week wait. If patients and employers see the full map of available centers, those waits start to look less inevitable.

“You now have perception of choice. You do have choice,” Adler said. “You can go where you want and it all works with your insurance plan. And here’s what you will owe. And here’s where you can go. And here’s how quick you can get an appointment.”

Built in a Post-AI Moment

OneImaging also exists because the timing finally lined up.

“I think I have the benefit and luxury of coming post AI,” Adler said. “We were able to automate a ton of tasks and get this off the ground at a lot lower cost.”

He uses faxes as an example, which says a lot about the baseline they’re working from.

“Everything in healthcare has typically run on fax… how do you do that at scale as a technology company?”

Early on, OneImaging trained models to ingest those documents automatically. What would once have required a whole back office of people now flows into a digital system in the background.

The same is true for billing.

“We created a new financial rail system where we’ve been able to auto adjudicate medical claims off of a transaction…The FinTech stack to do that didn’t exist before 2020.”

The result is not magic, just a rare alignment: modern tooling, a painful user experience, and a founder who has spent most of his life inside the industry he’s trying to fix.

Reintroducing Competition

OneImaging has raised $38 million so far, including a $31 million Series A. A lot of that capital is going into two areas: employer distribution and local imaging centers.

On the employer side, Adler is trying to get into as many benefit plans as possible.

“The big thing is continuing to expand our reach into more corporations and employers who are now in Fortune 10, Fortune 50, Fortune 500, Fortune 100 … Continuing to saturate that market.”

On the supply side, they partner with existing centers and help them expand under the OneImaging brand.

“We’re actually helping imaging companies expand their footprint in partnership with us, OneImaging branded imaging centers,” he said. “We don’t own them, right? But we’re able to help create our branding and expand that into markets where there is no choice. There is no competitor.”

He is blunt about the goal.

“We’re able to use our model to reinsert capitalism back into healthcare … Competition drives down price.”

The same instinct shows up in how he talks about data. Managing and standardizing imaging data so it is “AI friendly for people” is, in his words, “the biggest thing.”

“Did We Name a Single Healthcare Company?”

For Adler, the product isn’t just cheaper MRIs. It is a shift in which companies people are proud to say they worked for.

“I actually ask people this all the time,” he said. “I say, hey … name me your top five favorite companies that inspired you because of the product that they built.”

The list is familiar: Figma, Spotify, Airbnb, Uber, Microsoft, Amazon, Google, Tesla, XAI, Neuralink.

“Did we name a single healthcare company? No, we didn’t,” he said. “There is no healthcare company that’s inspiring people, that’s really, really pushing the envelope.”

He thinks radiology can change that.

“Radiology is a massive market with a huge long tail of data,” he said. “And this is an opportunity to create the first healthcare company that inspires the next generation of people to say, hey, you know, I want to work at OneImaging.”

In his imagined future, using their product is as ordinary as checking your phone.

“That is a company that completely changed something that I use every year or regularly that I can’t imagine living without,” Adler said. “Like it’s just what I know. What I know is to use OneImaging.”

Culture, Miami, and “Why Can’t I?”

Inside the company, his definition of culture is surprisingly simple.

“I want to work with people that I can go and grab a beer with at the end of a hard day of work … These are people I care about. When employees are having children, I make sure to have them send their baby registry, stuff like that. These are people I care about. That’s the type of company that we’re building.”

The team is mostly remote right now. Next year, they plan to open an office in Miami.

“Next year around this time we’ll have a beautiful office in Miami that I’ve been going over the specs on lately and super excited about,” he said.

He points to the concentration of founders there, the tax environment, and the sense that the city is still in the middle of becoming something.

“This really does feel like the Dubai of the United States right now,” Adler said. “Every day there’s a new skyscraper going up.”

Asked what he’d tell himself three years ago, he doesn’t talk about market timing or pitch decks.

“Adaptability is a must have. Like where you start is not even close to where you end,” he said. “I would say, you know, always ask yourself, why can’t I?”

The same question drives his approach to getting the product into people’s hands.

“You can have the best product in the world, but if you don’t have distribution, it’s just the best product in the world that no one’s using,” he said. “I am incredibly relentless. I look at myself as a part of the sales team.”

And when things get tight:

“Even when your bank account starts to get really, really low, which happens to everybody at some point, you just have to be fearless and say, I’m gonna figure it out … The worst case scenario is never as bad as you think.”

He is talking about startups and about healthcare and about what it takes to keep pushing on a system most people would rather accept than fight.

Takeaways

For Founders

Adler’s reminder is simple: “You can have the best product in the world, but if you don’t have distribution, it’s just the best product in the world that no one’s using.” In a space like healthcare, that means founders have to think like operators and salespeople, not just product builders.

For Recruiters

If you are hiring into companies like this, look for the “why can’t I?” reflex more than the perfect background. People who ask how to move a constraint instead of how to work around it are the ones who will stay with the problem when it gets uncomfortable.

For Job Seekers

Most people only think about radiology when something has already gone wrong. OneImaging is trying to rebuild that experience from the patient outward — pricing, access, and data included. If you want your next line on LinkedIn to be a company you’d name alongside Figma or Airbnb, this is the kind of problem space to pay attention to.

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