A nascent healthcare startup introduced an acquisition on Thursday that it believes will advance its mission of accelerating the business’s transformation to value-based care.
Guidehealth — a value-based care enablement startup that formally launched itself a few month in the past — acquired Arcadia’s value-based care service division. The businesses usually are not disclosing the phrases of the deal.
Two healthcare veterans based Guidehealth. One co-founder is Sanjay Doddamani, the previous CEO of value-based care startup Upstream, and the opposite is Michael Gleeson, Arcadia’s former chief technique and innovation officer. Doddamani serves because the Guidehealth’s CEO, whereas Gleeson serves as chief expertise officer.
They based the corporate as a result of they noticed an unimaginable want for expertise that helps well being programs reach value-based care preparations whereas nonetheless sustaining monetary stability, Gleeson stated in an interview.
The startup, which has its headquarters in Dallas, is creating an answer that seeks to assist well being programs “enhance their working margin round value-based care, but additionally achieve this in a manner that retains them on the identical quantity or increased for referrals,” he defined.
The entire thought behind value-based care is to maintain sufferers out of the hospital, however that’s a difficult factor for well being programs, Gleeson identified. If a well being system is profitable on the value-based care entrance, they might find yourself shedding a variety of hospital income that they want with a purpose to preserve their doorways open, he defined.
That’s why Guidehealth’s platform is designed to not solely enhance suppliers’ monetary efficiency in value-based threat contracts by way of predictive analytics, but additionally strengthen their relationships with affiliated networks and allow referral development, Gleeson famous. This design might assist prospects differentiate Guidehealth from different value-based care enablement startups, comparable to Aledade and Pearl Well being.
“With the [managed service organization] we’re buying, we are able to give attention to referral administration, utilization administration, prior authorization and affected person entry — we are able to take a latent capability that exists inside the community and direct high-value, acceptable quantity to hospital programs. This permits us to maintain the general quantity and the hospital the identical or increased,” he declared.
Some key components in Guidehealth’s newly acquired asset embrace instruments for streamlining go to entry and referrals, prior authorization administration, community administration and paying claims to suppliers.
By buying a “tried and true, in-the-market resolution” for referral and utilization administration, Guidehealth is positioning itself properly to assist well being programs keep affected person quantity whereas excelling in value-based care contracts, Gleeson stated.
The startup makes its cash by charging charges for its expertise, in addition to by bearing threat in value-based care preparations and gathering the financial savings which can be generated from these packages, he defined.
Guidehealth’s prospects embrace two Chicago-based suppliers, Endeavor Well being — which was referred to as NorthShore – Edward-Elmhurst Well being earlier than it rebranded this month — and Amita Well being Care Community.
Photograph: Natee Meepian, Getty Pictures
