For me, it really is primarily the interest rates. I wouldn’t even know if there are other providers right now — I’m not looking, because I don’t need to.
Dr. Mathias Krisam, Co-Founder, Mittiq
The idea came over wine. Sometime in the evening, in the company of former colleagues, the conversation turned — as it so often does among people who have spent years close to a broken system — to what would genuinely need to happen for things to change.
Dr. Mathias Krisam had spent the better part of a decade advising Germany’s statutory health insurers, the Krankenkassen: absorbing their institutional frustrations, mapping their procurement rhythms, learning precisely why an apparatus charged with looking after the health of more than 70 million people so consistently falls short. He was a practising consultant. But sitting at that table, he allowed himself to think like a founder.
The conversation did not end with a modest proposal. The group talked about founding an entirely new statutory health insurance fund — from scratch, with modern software, a different culture, and a fundamentally different relationship between insurer, patient, and care provider. Krisam, trained as a physician before pivoting into health consulting, felt the pull of the idea immediately. His father, a teacher, had once delivered what amounted to life-changing career advice: don’t chase the money. Find a goal you can imagine waking up for, every single morning, for the next ten years.
“That advice stayed with me,” Krisam says. “And sitting there that evening, the idea finally had a shape.” The new fund never came to be. The path it set him on, however, led somewhere more durable — and eventually to a co-founder who would prove indispensable to making it real.
The Doctor Who Never Found the Clinic
Krisam’s career has always resisted the obvious trajectory. After completing his medical degree — a years-long process that built deep literacy in clinical realities, patient needs, and the mechanics of treatment — he never practised in a hospital. He moved instead into health consulting, drawn by the possibility of operating at a systemic rather than individual level.
“I understood what patients needed, what conditions they had,” he explains. “But I also understood how physicians work, how hospitals function, how pharmaceutical companies operate. Sitting at the intersection of all of that turned out to be where I could contribute most.”
He also holds a doctorate, having researched the relationship between social determinants and health outcomes — a qualification he pursued deliberately, after years of watching what the research literature makes plain: health outcomes track social gradients with uncomfortable precision. Poorer populations get sick earlier, navigate the system less effectively, and place disproportionate administrative burdens on providers — not through any failure of intent, but because the system was never fully designed with them in mind.
That insight quietly shapes everything Mittiq now builds.
Founding Ninety-Three Companies at Once
The Neugründung idea — building a new Krankenkasse from scratch — ran hard into institutional reality. No statutory health fund had been established in Germany in over twenty years; hundreds had been closed. Krisam investigated regardless, discovered that the regulatory pathway still existed for companies with at least 5,000 employees as a membership base, and drew up a list of roughly a hundred qualifying German firms.
One expressed serious interest — then promptly commissioned a competing consultancy to evaluate the proposal, leaving Krisam sidelined from his own idea. He withdrew. But withdrawal was not abandonment. Someone reframed it for him not long after: you are not trying to found one new fund. You are founding 93, if you can bring every existing one along. That reframing changed everything.
Instead of just venting, I try to translate frustration into something constructive. Something doesn’t exist yet, or doesn’t work well enough — and the question becomes: how do we actually build this?
Dr. Mathias Krisam, Co-Founder, Mittiq
He co-founded Mittiq with Alexander Seidmann, who brings a background in software and process optimisation to the partnership. The two first crossed paths on a freelance project and found, through that initial collaboration, the foundations of a working dynamic. In September 2025, that dynamic became a company — and a genuine partnership.
“Mathias knows the challenges in the GKV sector better than our customers sometimes do,” Seidmann says. “I come from the software side — translating user pain into actual product requirements, building the architecture that makes solutions genuinely usable. We meet in the middle.”
Two Founders, One Language
The balance between Krisam and Seidmann runs deeper than a division of labour. Krisam describes himself as the more emotionally driven of the two — quicker to excitement, quicker to frustration, and by his own admission occasionally too far ahead on the accelerator. Seidmann sets the guardrails.
“Alexander has told me what he values most about working together,” Krisam says. “Which is that I manage to translate that emotional drive into action constructively.”
From Seidmann’s side, the framing is complementary but distinct. “Mathias is the one charging forward — he has a deep sense of urgency about the problems we’re solving. I look after the longer view: making sure we don’t scatter our efforts, don’t overcommit to something that doesn’t fit our bigger picture, keeping a clear software line and making real progress on product-market fit. Mathias pushes the accelerator. I maintain the guardrails. And that balance works remarkably well.”
This philosophy extends directly into how the two approach customers. In the GKV sector — where AI has become a fixation and everyone wants a strategy, a workshop, a model — Mittiq has made a deliberate choice to work in the opposite direction. Understand the problem first. Arrive at the solution only once the problem is genuinely clear.
A recent engagement illustrates the principle. Krankenkassen often manage their Selektivverträge — selective contracts with specific care providers — through unwieldy spreadsheet files. When a consultant needs to advise a member during a phone call, they default to the contract they remember, not the one buried in a spreadsheet row. Mittiq mapped this problem precisely, then designed a software solution that made contract information accessible in the moment. Only at that stage did they recognise where AI could naturally play a role. “We started with the problem — the difficult management of contracts — and only later arrived at a solution that includes AI in parts but is also simply good software design,” Seidmann says. “That sequence matters more than people realise. Especially now, when everyone wants to jump straight to the latest model.”
In the GKV sector and at large organisations, everyone wants to jump straight to solutions — especially right now with AI. It’s a huge trend. But in our work, we leave the hype completely aside and focus on the problem. We only count something as a success once it’s actually been solved — not before.
Alexander Seidmann, Co-Founder, Mittiq
The team now numbers six, distributed across Berlin, Mainz, Hannover, Bavaria, and Leipzig. There is no central office. The company operates through Slack, daily calls between the two co-founders, and a virtual workspace called Gather — a software environment styled like a video game, with individual desks, a kitchen, a meeting room, a chill-out zone, and a gong that anyone can ring when a project ships.
“Gather sits somewhere between a physical office and being fully remote,” Seidmann explains. “You move around as an avatar — everyone has a proximity radius. If someone nearby is talking, you can hear it faintly, decide whether it’s relevant, and join the conversation. It doesn’t replace being in the same room. But it’s closer to it than anything else we’ve found.” The team has used it for nearly two and a half years. No one wants to stop.
Every developer on the team is senior. No one needs managing. Krisam and Seidmann absorb as much stakeholder overhead as they can, so that the people building the products can simply build. Each product is owned by at most two people. Accountability, Krisam believes, is not a management philosophy — it is a design choice.
Three Hundred Billion Reasons
Germany spends somewhere between 300 and 400 billion euros a year on healthcare. Administrative costs — IT, staff, external providers — account for roughly four to five percent of that figure. The remainder is clinical: hospitals, medications, follow-up care, rehabilitation. Krisam has studied these numbers closely. His conclusion is that chasing administrative efficiency, while worthwhile, misses the larger lever.
“If someone with a chronic condition is better supported by their insurer — pointed to the right programme, prescribed the more cost-effective equivalent, kept out of unnecessary hospital admissions — then the savings aren’t marginal. They’re structural,” he says.
Mittiq already has a product in this space: software that helps Krankenkassen actively guide members toward more suitable care options. Early results suggest it works for outcomes and for operational performance alike. Three products are currently in active use; the pipeline extends further. A recent industry webinar attracted over a hundred registered attendees — and, more tellingly, kept most of them engaged to the end, with customers presenting their own results from the field.
The longer vision reaches further still. A future in which the patient’s entire healthcare journey flows through a single integrated interface. Krisam knows it is ambitious. He also knows that Germany, which spends heavily on health and receives roughly average outcomes in return, has sufficient reason to try.
We’re spending an enormous amount of money and getting average results. The gap between what we invest and what we get — that’s the space I want to work in.
Dr. Mathias Krisam, Co-Founder, Mittiq
Seidmann’s read on the system is equally clear-eyed. What still catches him off guard, even now, is not the regulations themselves but the sheer volume of discussion surrounding them — the workshops, alignment meetings, and coordination calls that fill calendars while actual solutions wait. “There are a lot of brakes in the system,” he says. “But there are also customers who genuinely want to move forward. And those are the ones we build for.”
What matters most is feedback that actually concerns the problem — whether what we’re building genuinely improves the daily work of a health insurance employee or not. That’s what keeps you close to the pulse of the problem, and lets you adjust — rather than just collecting polite compliments.
Alexander Seidmann, Co-Founder, Mittiq
Krisam does not claim to be doing it better than others. He is simply, by his own framing, doing it within his radius. Building the thing. With the tools they have. For all 93.
From Interest Rates to Full Transactional Banking
When Krisam founded his holding company CUSA, he ran into a problem familiar to many founders: his Hausbank was paying zero percent interest, and finding an account that offered meaningful returns for a young company proved surprisingly difficult.
It was incredibly difficult to find any provider that offered interest on a business deposit account — especially for younger companies.
Dr. Mathias Krisam, Co-Founder, Mittiq
The answer came via LinkedIn: a company called Pile, which offered exactly what his bank would not. Pile was subsequently acquired by Vivid. Krisam stayed — and the relationship grew. Today, his holding company CUSA runs all its financial transactions through Vivid. “My holding company — CUSA — I actually do all financial transactions through Vivid. And that’s how I ended up there,” he says. Mittiq itself does not yet have its own Vivid account — the cashflows of an early-stage startup are still contained — but the next step is already mapped out: once the volume grows, Mittiq follows.
For me, it really is primarily the interest rates. I wouldn’t even know if there are other providers right now — I’m not looking, because I don’t need to.
Dr. Mathias Krisam, Co-Founder, Mittiq
Krisam has no complaints to speak of. “Honestly, no issues. I’m happy with it.”
