Aledade CEO Dr. Farzad Mostashari

Value-Based Care

Aledade Acquires VBC Analytics Provider Curia

There are dozens of companies fighting for the independent primary care crown, but as of right now it looks like that crown belongs to Aledade. After adding more than 450 new practices in 2023, Aledade is now the nation’s largest network of independent primary care.

How does a value-based care enabler defend that crown? If you’re Aledade, you acquire VBC analytics company Curia to push your advantage.

Curia uses “practical applications of AI” to optimize the targeting of patient care, identify risk gaps, and predict the likelihood of adverse outcomes – three areas core to Aledade’s value-based performance. 

• The acquisition follows a pilot where Aledade leveraged Curia’s predictive algorithm to target patients with the highest risk for two-year mortality with advance care planning services. Safe to say that went well. 

• Aledade now plans on folding Curia’s tech into its existing solutions while exploring new use cases such as preventing hospitalizations and improving engagement programs.

To give you an idea of what it takes to have the largest independent primary care network in the country, Aledade works with over 1.5k practices, 5k PCPs, and 15k clinicians across 45 states.

• Aledade recently closed a $123M Series E that helped it scale to over two million patients covered by 150+ value-based contracts across Medicare, Medicare Advantage, Medicaid, and commercial payors. 

• Playing in all of those different arenas gives Aledade a big leg-up on most of its VBC enablement competition. MA-focused comparable agilon health last reported 356k members live on its platform, and Oak Street had 59k at-risk members when it was scooped up by CVS for $10.6B.

The Takeaway

Aledade’s scale and nearly half a billion in funding both seem to suggest that an IPO would be a logical next move, although it’s CEO Dr. Farzad Mostashari is on the record saying “the most likely scenario for Aledade to be able to continue our mission is to remain an independent company.” Although that could just be a headfake, the fact that Aledade recently changed its legal structure to a Public Benefit Corporation suggests that it intends on walking the talk and remaining independent as it focuses on delivering better outcomes for everyone, not just its shareholders.

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The Wire

• Amazon Closes One Medical: The FTC decided against challenging Amazon’s acquisition of One Medical, and less than a day later the $3.9B transaction was officially a wrap. For the past eight months, the acquisition has been undergoing an in-depth review led by FTC chair and vocal big tech critic Lina Khan, who’s still working diligently to block Amazon’s takeover of iRobot to protect American consumers from an overconsolidated Roomba market. 

• HIPAA Complaints Rise: The HHS reported that HIPAA-related complaints are up 39% between 2017 to 2021, no doubt tied to the fact that health data breaches were also up 58% over the same period. The report emphasized that penalties related to these breaches have remained nearly flat due to the HHS Office for Civil Rights in charge of enforcement lacking the resources to keep pace with the rise in cyberattacks.

• Elation Acquires Lightning MD: Elation Health acquired medical billing company Lightning MD as it sets its sights on creating an all-in-one technology platform for primary care providers. Elation’s current virtual primary care platform integrates over 20 practice management solutions through its EHR, clinician mobile app, and engagement workflows, with Lightning MD’s revenue management and payor connectivity features set to join the solution suite later this year.

• AliveCor Patent Ruling Upheld: The Apple v. AliveCor saga continued this week after a presidential review upheld the International Trade Commission’s ruling that the Apple Watch infringed three AliveCor patents related to ECG tech. That means a potential import ban on the Apple Watch is still on the table, although the US Patent Trial and Appeal Board recently ruled in Apple’s favor on the same three patents. Another round of appeals is now underway, and AliveCor is doubling down on the face-off with an antitrust trial slated to begin next year.

• Hospital Board Rooms: Less than 15% of board members overseeing the nation’s top 20 hospitals have a professional background in healthcare, according to a study published in the Journal of General Internal Medicine. Of the 529 board members included in the analysis, the largest share had a background in finance (44%), with nearly all of those members leading private equity funds, wealth management firms, or multinational banks.

• IncludeHealth Scores $11M: IncludeHealth secured $11M in new funding (total raised now $22.3M) as it looks to expand its MSK-OS platform for remote musculoskeletal and physical therapy treatments. The investment follows IncludeHealth’s recent partnership with Yale New Haven Health System that combines the health system’s in-person orthopedic services with MSK-OS so that patients can undergo personalized hybrid care using their own devices (smartphone cameras) instead of additional wearables or sensor hardware.

• Privia Expands to Connecticut: Privia Health is partnering with Community Medical Group to launch the largest Clinically Integrated Network in Connecticut, with approximately 1,100 multi-specialty providers caring for 180k patients at 450+ practice locations. The expansion follows similar moves into Delaware and North Carolina as Privia works toward building a national network of primary and specialty care providers across all reimbursement models.

• Eagles Malpractice Verdict: Former Philadelphia Eagles safety Chris Maragos was granted $43.5M in a medical malpractice case that largely focused on the diagnosis of his career-ending knee injury. Maragos was injured in October 2017 and underwent surgery for a torn PCL, although a May 2018 MRI revealed further deterioration and a persistent partial tear, and both exams potentially missed a meniscus tear. The team captain was nonetheless cleared to increase his rehab activities (including running), causing further damage to his knee.

• Patient Education Gap: A Wolters Kluwer Health survey found that 94% of patients want more patient education, yet 32% never receive educational materials from their providers. Among 1k healthcare consumers, 66% reported having lingering questions after their provider encounters and 19% frequently have new questions altogether, causing many patients to turn to social media and other unvetted sources for answers.

• Veradigm + HealthVerity: Veradigm signed an agreement to supply data from its Cardiovascular and Metabolic registries to the HealthVerity Marketplace, an ecosystem for exchanging real-world data for use in clinical trials. Researchers using Marketplace will be able to access deidentified patient data from the Veradigm registries (102M Cardiology records, 79M Metabolic records) to help develop novel treatments for cardiac and metabolic conditions.

• CMS Suspends Surprise Billing Disputes: CMS indefinitely suspended the No Surprises Act’s independent dispute resolution process (IDR) after a Texas District Court ruled that parts of the process violate the Administrative Procedure Act (while benefiting payors). CMS barred all certified IDR entities from making new resolutions while federal departments revise the IDR processes, which might mean a new process that’s more favorable to providers is on the way.

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