Why Altivera Vision: What It Means for the Portfolio

Altivera Vision is an important addition to the RAD Intel holding company. Over the past year, we’ve been focused on identifying practices where strong operators, real market demand, and more disciplined execution can create outsized value over time. Vision care stood out quickly. The clinical foundation is strong. The patient's need is well established. The real opportunity is in improving how growth happens around the practice and then scaling that model with more precision.

The U.S. vision care market is both large and structurally attractive. Cataract surgery remains one of the most commonly performed procedures in the country, with demand continuing to rise alongside an aging population. At the same time, refractive procedures serve a broad and growing segment of patients seeking independence from glasses and contacts. Advances in surgical techniques and technology have expanded what’s possible across both categories, supporting long-term growth in procedure volume and patient demand.

What makes the category particularly compelling is how it operates at the practice level. Many ophthalmology practices already have the clinical leadership, infrastructure, and local reputation required to grow. Surgical capacity often exists within the current footprint, and the patient base is already present in the surrounding market. The constraint is rarely the ability to deliver care. It’s how consistently patient demand translates into consultations, decisions, and completed procedures.

That dynamic creates a clear opportunity. Vision care carries meaningful fixed costs tied to surgical infrastructure, which means additional procedures performed within existing capacity can drive disproportionately higher margins. As a result, relatively small improvements in patient acquisition, consultation quality, and scheduling alignment can have a significant impact on performance. That’s where the next phase of growth in the category is being shaped — execution over access..

That’s what makes Altivera such a strong fit within the portfolio.

As a portfolio company, Altivera applies our AI-driven platform to help scale high-traction surgeons and vision centers. More broadly, it reflects where we’re headed as a company — using intelligence to improve not just marketing, but the operating decisions that shape utilization, patient flow, and long-term performance.

I sat down with Jeremy Barnett and Bradley Silver to talk about why Altivera belongs in the portfolio, what stood out about the category, and what this launch signals about where we’re going next.

Maria: Let’s start with the obvious question. Why vision care?

Jeremy: Because the fundamentals are already there. You have real demand. You have proven procedures. You have strong unit economics. What you don’t always have is consistency in how that demand turns into completed procedures. That’s where we focus. We look for categories where the infrastructure exists but performance can improve. Vision care fits that very clearly.

Maria: Bradley, what stood out to you when evaluating the space?

Bradley: The gap between capacity and utilization. A lot of these practices can do more procedures than they currently are. The surgeons are strong. The facilities are in place. The reputation is there. But the way patients move through the practice isn’t always consistent. That’s where performance starts to drift. When you tighten that, you don’t need to reinvent the model. You improve how it runs.

Maria: So where does Altivera fit into that?

Jeremy: Altivera sits around the procedure.

The surgeon still leads. That doesn’t change. What changes is how patients are brought into the practice, how they’re guided through consultation, and how the experience holds together as the organization grows. That’s where consistency matters. And that’s where we see the opportunity.

There’s a lot of discussion right now around consolidation in healthcare. How is this different?

Bradley Silver: A lot of models focus on cost.

This one focuses on performance. If you improve how patients are evaluated, how consultations are handled, and how scheduling aligns with capacity, you can increase procedure volume inside the same footprint. That has a very different impact on the business.

Maria: Jeremy, how does the platform show up here in practice?

Jeremy: It shows up in how decisions get made before execution.

We’ve spent years building a platform that understands audience behavior at a very detailed level. What people care about, how they talk about it, when they’re ready to act. In vision care, that translates into understanding which patients are actually moving toward a decision and how to reach them earlier. It also helps practices understand how patients are experiencing the process once they come in. That combination improves both sides of the equation.

Maria: Bradley, you’ve spent a lot of time thinking about the consultation as a moment. Why is it so important here?

Bradley Silver: Because that’s where the decision happens. Marketing gets the patient in the door. The consultation determines whether they move forward.If that experience is clear and consistent, conversion improves. If it varies, performance becomes unpredictable. That’s why so much of this model is focused there.

Maria: One thing that keeps coming up is consistency across locations. Why is that so hard to maintain?

Jeremy: Because growth introduces variation. More people. More locations. More ways for things to drift. The clinical work can stay strong, but the experience around it can start to feel different depending on where a patient enters the system. That’s what we’re focused on holding together.

Maria: What does success look like here over time?

Bradley Silver: More predictable growth. Stronger alignment between demand and capacity. And a model that can expand into new markets without losing the standard that made it work in the first place.

Maria: Final question. Why does this matter for the portfolio?

Jeremy Barnett: Because it shows how the platform extends beyond marketing. We’re not just helping companies communicate better. We’re helping them operate with more precision. Altivera is a clear example of that. It takes what we’ve built and applies it to a category where the upside is already there, and the opportunity is to execute better.