Have you got your ticket to the AI-native world — the “Core AI Subscription”?

This concept was introduced by Sam Altman, CEO of OpenAI, at the 2025 Sequoia AI Summit. More than just a new term, it could become the central theme of AI commercialization in the years to come.

For investors, this signals a shift: the future winners won’t be the ones merely selling models, but those building long-term user relationships and platform-level capabilities. 

For entrepreneurs, it offers clear direction: those who can create truly personalized AI assistants, and a sustainable business model around them, will be the ones to rise above the rest.

The “Core AI Subscription” is more than just a new business model; it may signal that humanity is accelerating toward a new era: the AI-native world.

What Is the AI-Native World?

The AI-native world refers to a future paradigm where artificial intelligence is not just a tool, but the foundational driving force deeply embedded in every aspect of society. It reshapes how we live, work, produce, and interact, much like electricity and the internet redefined previous eras.

In this world, AI becomes core infrastructure, pervasive and indispensable. It transforms human cognition, economic models, technological ecosystems, and social structures.

Imagine life in an AI-native world:

• You no longer use AI just to complete isolated tasks.
• AI understands your intentions, anticipates your needs, and acts before you even ask.
• It’s seamlessly integrated into your life, work, and decision-making processes, becoming an essential part of your digital existence.

Core AI Subscription: The Gateway to the AI-Native World

Sam Altman’s concept of the “Core AI Subscription” is not just visionary — it represents the key pathway to realizing the AI-native future. It refers to a highly personalized, continuously evolving AI assistant service that is deeply embedded in users’ daily lives, much like an operating system that runs across every aspect of work and life.

This service is far more than just a voice assistant or chatbot. It functions as an intelligent agent with the following capabilities:

• Personalized customization based on your habits and behaviours;
• Seamless integration with other applications and services;
• Constant learning and self-improvement over time, becoming smarter and more efficient the more you use it.

In other words, whoever owns the user’s Core AI Subscription essentially controls the “operating system entry point” to the AI-native world.

What AI Capabilities Are Required for Core AI Subscription Services?

To bring “Core AI Subscription” to life, there’s a key question we might want to explore: What kind of AI is capable of supporting such a service?

OpenAI has proposed a tiered framework for Artificial General Intelligence (AGI) — AI systems with the ability to learn efficiently, generalize across tasks, and act autonomously in complex, dynamic environments. True AGI would possess a blend of perception, cognition, decision-making, learning, execution, and social collaboration, all while aligning with human emotions, ethics, and moral standards.

Here’s a breakdown of the AGI capability tiers:

• Level 1: Chatbot — Basic conversational ability, like current GPT models.
• Level 2: Reasoner — Can solve human-level problems — mathematics, logic, coding, and debugging.
• Level 3: Agent — Acts on behalf of the user — booking travel, managing calendars, and automating task chains.
• Level 4: Innovator — Capable of invention and creativity — designing new products, writing screenplays, composing music.
• Level 5: Organizer — Manages teams, coordinates resources, sets strategies, and even runs companies.

What AGI Level Is Needed to Enable Core AI Subscription Services?

To bring Core AI Subscription services to life, the AI must reach at least Level 3 — Agent on the AGI scale. At this level, AI isn’t just passively responding to user commands — it must actively understand user needs, take initiative, trigger tools, execute task chains, and switch contexts fluidly across various scenarios.

Since 2023, Baidu founder Robin Li has echoed a similar vision, stating that “large models will usher in a flourishing ecosystem of AI-native applications.” He emphasized that AI-native applications are not simple replicas of mobile apps or desktop software — they are meant to “solve problems that were previously unsolvable or poorly solved.”

This vision aligns closely with the concept of Core AI Subscription: true AI-native products are those in which AI agents are deeply embedded in users’ lives and workflows as a systemic, always-on digital partner.

Open Evidence: Core AI Subscription in Action in Healthcare

Are there early pioneers building AI-native applications? Yes — and a standout is Open Evidence, a medical AI company founded in 2021. By February 2025, it had raised $75 million from Sequoia Capital and achieved unicorn status with a valuation surpassing $1 billion.

At the 2025 Sequoia AI Summit, co-founder Zach shared a real-world case showing how their Core AI Subscription model supports physicians:

Emergency In-Flight Medical Case

Dr. Susan Wilberg faced a medical emergency mid-flight: a 63-year-old male cancer patient on immunosuppressive therapy developed a severe rash. Suspecting shingles, she had to make a critical call — should the plane turn back? What immediate actions were needed onboard?

She turned to ClinicalKey AI, Open Evidence’s subscription-based platform built for medical professionals. It delivered instant, personalized guidance by combining:

• CDC Yellow Book protocols,
• The latest research on cancer immunotherapy, and
• Patient-specific recommendations (based on age, history, treatment, etc.).

The platform:

• Assessed the patient’s risk level given his immunosuppressed condition,
• Offered specific and timely treatment guidance,
• Helped avoid an unnecessary emergency landing while ensuring proper care upon arrival.

What Makes ClinicalKey AI a True Core AI Subscription?

Open Evidence’s AI assistant is more than a diagnostic aid — it functions like an intelligent agent that continuously learns, personalizes its output, and proactively supports users:

• Hyper-personalization: Tailors suggestions based on user preferences and patient context.
• Seamless integration: Connects effortlessly with existing medical systems and workflows.
• Continuous evolution: Becomes smarter and more efficient through real-world interactions.

Business Model & User Growth

Over 25% of U.S. practicing physicians now rely on Open Evidence daily. The system handles more than 10 real-time clinical questions per second. While the service is free for doctors, revenue comes from medical device and pharmaceutical advertising, mirroring consumer internet models, but adapted for healthcare.

To deepen value and retention, Open Evidence is embedding top physicians’ expertise, starting with gastroenterology, into its AI, creating a collective intelligence layer. This not only strengthens its data advantage but enables constant answer refinement.

The Future: AI as an Indispensable Partner

Looking ahead, Open Evidence plans to integrate broader medical reasoning, research capabilities, and workflow tools to build a fully-fledged Core AI Subscription platform, ultimately becoming a mission-critical partner to doctors worldwide.

If you’re a business owner looking to integrate an AI subscription model into your existing operations, here are three key points to keep in mind:

1. Shift from “function thinking” to “companionship thinking”: Instead of asking, “What can AI do for my business?” start by considering, “What do my users need AI to become?” For example, a CFO doesn’t just need a reporting tool — they need a financial steward that can preempt risks.
2. Capture “scene entry points”: Identify high-frequency, must-have scenarios (e.g., healthcare, legal services, or vertical industry workflows) and deeply embed AI into your users’ daily processes. The goal is to make AI an indispensable part of how they work.
3. Build a “subscription-based emotional account”: Deliver consistent value over time, such as weekly personalized industry insights, to foster a “fear of missing out” (FOMO) dependency. When users feel they need your AI to stay ahead, loyalty becomes organic.

By focusing on these principles, you can transform AI from a standalone tool into a vital, subscription-driven companion for your customers.

中文版