A nascent healthcare startup introduced an acquisition on Thursday that it believes will advance its challenge of increasing the business’s transformation to value-based care.
Guidehealth — a value-based care enablement startup that officially introduced itself a few month in the past — received Arcadia’s value-based care provider department. The corporations aren’t 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 leader technique and innovation officer. Doddamani serves because the Guidehealth’s CEO, whilst Gleeson serves as leader generation officer.
They based the corporate as a result of they noticed an implausible want for generation that is helping well being programs reach value-based care preparations whilst nonetheless keeping up monetary steadiness, Gleeson stated in an interview.
The startup, which has its headquarters in Dallas, is growing an answer that seeks to lend a hand well being programs “toughen their working margin round value-based care, but additionally accomplish that in some way that helps to keep them on the identical quantity or upper for referrals,” he defined.
The entire thought at the back of value-based care is to stay sufferers out of the health facility, however that’s a tough factor for well being programs, Gleeson identified. If a well being machine is a hit at the value-based care entrance, they might finally end up dropping a large number of health facility earnings that they want with the intention to stay their doorways open, he defined.
That’s why Guidehealth’s platform is designed not to simplest toughen suppliers’ monetary efficiency in value-based possibility contracts via predictive analytics, but additionally enhance their relationships with affiliated networks and allow referral enlargement, Gleeson famous. This design may lend a hand shoppers differentiate Guidehealth from different value-based care enablement startups, similar to Aledade and Pearl Well being.
“With the [managed service organization] we’re obtaining, we will be able to focal point on referral control, usage control, prior authorization and affected person get admission to — we will be able to take a latent capability that exists throughout the community and direct high-value, suitable quantity to health facility programs. This permits us to stay the entire quantity and the health facility the similar or upper,” he declared.
Some key components in Guidehealth’s newly received asset come with equipment for streamlining consult with get admission to and referrals, prior authorization control, community management and paying claims to suppliers.
By means of obtaining a “attempted and true, in-the-market answer” for referral and usage control, Guidehealth is positioning itself smartly to lend a hand well being programs take care of affected person quantity whilst excelling in value-based care contracts, Gleeson stated.
The startup makes its cash via charging charges for its generation, in addition to via bearing possibility in value-based care preparations and accumulating the financial savings which can be generated from the ones techniques, he defined.
Guidehealth’s shoppers come with two Chicago-based suppliers, Undertaking Well being — which used to be referred to as NorthShore – Edward-Elmhurst Well being ahead of it rebranded this month — and Amita Well being Care Community.
Photograph: Natee Meepian, Getty Photographs