Alternative Care Models

Alternative care models are innovative healthcare delivery approaches that move beyond traditional single-provider visits to integrate coordinated teams, community resources, and flexible service methods designed to improve patient outcomes, reduce costs, and enhance accessibility across diverse care settings.
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Personify Health

Personify Health

4.0 (106)
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Founded

2004-08-02

Employees

3,200

Funding Summary

1 Series B

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About Personify Health

Personify Health is the first personalized health platform to bring together holistic wellbeing, health navigation, and flexible health plan administration solutions into a single connected and engaging healthcare experience. We simplify healthcare, resulting in healthier outcomes and more ways to save on healthcare costs. Personify Health offers a comprehensive suite of products. Our wellbeing solution empowers members to actively engage in their health that is designed to create meaningful and measurable results. By combining tools like daily content, habit tracking, and a comprehensive challenge library with social wellbeing features and personalized coaching, we equip individuals with the motivation and resources... Show More
Carrum Health

Carrum Health

Reviews pending
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Founded

2014

Employees

175

Funding Summary

96M Series B

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About Carrum Health

Carrum Health was founded in 2014 with a mission to “bring common sense to healthcare” through a value-based healthcare model that benefits families, employers, and providers. Headquartered in the San Francisco Bay Area, Carrum’s award-winning surgery and cancer care benefits platform connects self-insured employers with top providers under standardized bundled payment arrangements to better manage healthcare costs. By aligning provider incentives with quality performance, Carrum drives improvements in patient experience and health outcomes. Customers include Fortune 500 companies and public sector organizations.
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Mayo Clinic Complex Care Program

Mayo Clinic Complex Care Program

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Founded

1864

Employees

77,500

Funding Summary

Not Provided

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About Mayo Clinic Complex Care Program

The Mayo Clinic Complex Care Program offers managed access (expedited scheduling and condensed appointment itineraries) to Mayo Clinic’s high-quality, cost-effective care for individuals with complex, rare or undiagnosed medical conditions. In other words, Mayo Clinic helps minimize costs while getting patients exactly the care they need.

If employers have members in their medical plan that are experiencing fragmented care, ineffective treatments, potential misdiagnoses or difficulty accessing specialized care for complex conditions, Mayo Clinic can help. At our campuses in Arizona, Florida and Minnesota, teams of the world’s leading experts from every medical specialty and subspecialty work... Show More
Amazon One Medical

Amazon One Medical

Reviews pending
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Founded

2007

Employees

3,300

Funding Summary

Not Provided

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About Amazon One Medical

One Medical challenges the notion that delivering high-quality, accessible health care is unachievable and prohibitively expensive. In fact, we’re working to prove that just the opposite is possible — a system where quality care is affordable and available to everyone. To bring this vision to life, we rely on people-centered design, smart application of technology, and a team of talented primary care providers who have the time and tools to make the right decisions. The integration of these elements allows us to offer a seamless experience that not only saves our patients time and money but also leads to better... Show More
Galileo

Galileo

4.8 (1)
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Founded

2018

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0

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Not Provided

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About Galileo

Galileo is an advanced primary care system helping clients transform care. Our longitudinal and complexivist model offers clients the opportunity to reduce gaps in access to care (honing in on the hard-to-reach), increase the quality of care delivery, and enhance outcomes. Our physician expert team covers 22+ specialties, with many of our physicians obtaining degrees of 10+ years from top accredited institutions. Care is delivered on a 24/7 basis so your client's employees can get the care they need even after average working hours. By leveraging our clinical expertise, we bring advanced, high-quality care to your employees, helping drive improved... Show More
SUMMUS

SUMMUS

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Founded

2015

Employees

78

Funding Summary

70M Series B

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About SUMMUS

Summus is an end-to-end, doctor-led clinical navigation and specialty care platform that was uniquely developed to answer 100% of health questions, including over 120 different specialties. We empower employees to make better health decisions by simplifying how they navigate healthcare and quickly connecting families with the right medical expertise for any health question, big or small—to drive better, more cost-efficient health outcomes. Show More
Teladoc Health, Inc.

Teladoc Health, Inc.

4.7 (10)
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Founded

2002

Employees

5,600

Funding Summary

Not Provided

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About Teladoc Health, Inc.

Teladoc Health is the #1 most recognized and trusted virtual care brand. We have the first-mover advantage in telehealth with a platform built over 20+ years. Our platform is proven to deliver outcomes at an unmatched scale, including 20K+ visits per day. We are executing on a strategy that continues to raise the bar for virtual care for our members and 12K+ clients.

Over 102.4M people in the U.S. now have access to one or more of our services, including over a million enrollees in our chronic condition management programs. In the last year, we've enabled... Show More
Firefly Health

Firefly Health

Reviews pending
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Founded

2017

Employees

150

Funding Summary

None

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About Firefly Health

Firefly offers a clinically-driven health plan that integrates healthcare delivery and coverage -- the result is improved access, quality, outcomes, and cost control. Our solution offers self-funded employers a comprehensive healthcare plan, combining hybrid advanced primary care, a nationwide provider network, and a full suite of TPA services with innovative plan designs. We provide an affordable and differentiated health benefit for employees while providing meaningful cost control for employers.

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Imagine360

Imagine360

5.0 (2)
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Founded

1968

Employees

1,400

Funding Summary

Not Provided

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About Imagine360

Imagine360 has 50+ years of combined experience. In 2020, Group and Pension Administrators (GPA) joined forces with ELAP Services, EBMS, and Imagine Health, which became sibling corporations through WaterStreet Healthcare Partners. This integration allows our organization to deliver the most experienced and first completely integrated health plan with reference-based pricing as its core.

Imagine360 delivers a fully integrated health plan with the savings of reference-based pricing built in and consistently generates 15–25% savings for 900+ self-funded employers. Imagine360 is entering its next phase of growth with a fresh infusion of capital to expand its comprehensive suite... Show More
Lantern

Lantern

Reviews pending
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Founded

2011

Employees

900

Funding Summary

410M Private Equity Round

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About Lantern

Lantern Specialty Care delivers high-quality, cost-effective care for complex and high-cost conditions through two integrated solutions: Network of Excellence (NOE) and Specialty Care Management (SCM). Network of Excellence connects members to rigorously vetted providers and facilities for surgery, cancer, and infusions, helping ensure access to high-quality care at the right site of service while working alongside existing carrier networks. Specialty Care Management provides comprehensive cancer support through dedicated oncology nurse navigation, NCI-level clinical oversight through AccessHope, clinical trial matching, financial navigation, and psychosocial support. Together, these solutions improve outcomes, enhance the member experience, and reduce unnecessary healthcare spending without disrupting... Show More
Apaly Health

Apaly Health

Reviews pending
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Founded

2018

Employees

0

Funding Summary

Not Provided

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About Apaly Health

Apaly makes it simple for TPAs, brokers, consulting firms, and health plans to bring Advanced
Primary Care (APC) to their plan members. Our platform ensures nationwide coverage, seamless
claims-based billing, and powerful analytics—while eliminating administrative burdens. Show More
Best In Class MD

Best In Class MD

Reviews pending
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Founded

2020

Employees

0

Funding Summary

3 Angel Round

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About Best In Class MD

BICMD is dedicated to creating an integrated telemedicine platform focused on personalized musculoskeletal care. We partner with employers, payers, and health facilities to provide virtual telehealth clinical visits and medical second opinions from the top orthopedic experts. Show More
Nova Healthcare Administrators

Nova Healthcare Administrators

5.0 (1)
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Founded

January 1982

Employees

200

Funding Summary

Not Provided

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About Nova Healthcare Administrators

Evolving for nearly 40 years, we are an innovative health care solutions company that sees the people that health plans serve and the businesses they support — and we partner with them on their path to better care.

When it comes to health care, we don’t believe one size fits all. That’s why we operate outside of the box to find solutions that others simply won’t consider for a variety of health plan needs — medical, dental, vision, COBRA, reimbursement account administration and private-labeled partnerships. We provide personal and personalized service and solutions for our clients. We... Show More
Premise Health

Premise Health

Reviews pending
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Founded

1964

Employees

6,000

Funding Summary

1 Private Equity Round

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About Premise Health

Premise Health serves large organizations and their people with exceptional healthcare. We partner with commercial and municipal employers, health plans, unions, and tribes, serving millions of members at more than 800 wellness centers in 46 states and Guam.

Premise’s mission is to help people get, stay, and be well. With more than 30 types of care, we provide easy access to amazing member experiences that improve health and lower healthcare costs.

Premise is the leading direct healthcare company and one of the largest digital providers in the country. For more information, visit... Show More
ZERO Health

ZERO Health

Reviews pending
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Founded

2015

Employees

40

Funding Summary

14M Angel Round

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About ZERO Health

ZERO Health is a healthcare cost-reduction platform that helps employers lower medical expenses by connecting employees to high-quality, zero-cost care options. The company partners directly with providers to eliminate unnecessary middlemen and negotiates fair, upfront pricing for a range of services—including imaging, surgery, labs, and prescriptions. Employees access care through a simple, guided experience, ensuring they receive the right care at no out-of-pocket cost, while employers benefit from significantly lower healthcare spend.

By focusing on transparency, value-based care, and strategic provider partnerships, ZERO Health helps self-funded employers take control of rising healthcare costs without compromising care quality.... Show More
Acrisure Health Strategy Team

Acrisure Health Strategy Team

5.0 (1)
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Founded

Jan-23

Employees

6

Funding Summary

Not Provided

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About Acrisure Health Strategy Team

The Acrisure Health Strategy team is a dedicated group of experts focused on crafting innovative and cost-effective health solutions. Leveraging deep industry knowledge, cutting-edge analytics, and personalized strategies, we empower organizations to optimize their benefits programs, enhance employee well-being, and achieve long-term financial sustainability. Our services encompass comprehensive benefit analysis, trend identification, risk assessment, and tailored recommendations to drive healthier, more productive workplaces. With a commitment to excellence and a client-centric approach, we're your trusted partner in navigating the complex landscape of healthcare benefits. Show More
Aligned Marketplace

Aligned Marketplace

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Founded

January 2023

Employees

30

Funding Summary

None

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About Aligned Marketplace

Aligned Marketplace is the only national, independent, value-based advanced primary care and specialty care marketplace for self-insured employers. Aligned typically partners with geographically dispersed employers, and specifically engages an employers high and rising risk members to drive the strong outcomes and cost savings for an employer. Show More
ASR Health Benefits

ASR Health Benefits

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Founded

1984

Employees

120

Funding Summary

Not Provided

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About ASR Health Benefits

Our mission is to provide a full range of high-quality administration services for employee health benefit plans. We offer our services to both the smallest and largest employers with equal commitment and with an intense focus on each client’s unique needs. Our highly knowledgeable staff approaches our mission with a commitment to cost-effective plan design, quality service, efficient business practices, and the greatest integrity.

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Collective Health

Collective Health

Reviews pending
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Founded

2013

Employees

0

Funding Summary

Not Provided

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About Collective Health

Collective Health was founded on the belief that the current health benefits administration industry has a serious technology problem that has prevented innovation and contributed to a massive rise in costs. We’ve rebuilt employer health benefits on an entirely new technology infrastructure, allowing us to provide a modern, tech-forward member experience, streamlined benefits administration, and an employer experience that enables our clients to be strategic with the partners and solutions they offer to their members. Our digital platforms play a crucial role in helping employers and members navigate the healthcare system.

Our platforms include:
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First Choice Health

First Choice Health

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Founded

2002

Employees

0

Funding Summary

None

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About First Choice Health

First Choice Health, headquartered in Seattle, WA, is a provider-owned healthcare organization offering employers a forward-thinking alternative to traditional health insurance. We have been serving employers of all sizes and across many industries with exceptional health benefits administration for over 35 years, providing unparalleled access to a growing number of clinically integrated networks (CIN) and a traditional PPO. Alongside our Employee Assistance Program (EAP) addressing mental health and work-life balance, our services collectively support members in every step of their healthcare journeys. Show More

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Frequently Asked Questions

What are Alternative Care Models?

Alternative care models are innovative approaches to delivering healthcare services that differ from traditional, single-provider care settings. These models emphasize coordinated, team-based care that integrates multiple healthcare professionals, community resources, and technology to provide more comprehensive and patient-centered services. Examples include Patient-Centered Medical Homes (PCMH), Accountable Care Organizations (ACOs), integrated behavioral health programs, and community-based care coordination services. Unlike conventional care where patients typically see individual providers separately, alternative care models create collaborative networks focused on whole-person wellness and coordinated treatment plans.

How do Alternative Care Models Improve Patient Outcomes compared to Traditional Healthcare?

These models improve outcomes through better care coordination, preventive focus, and comprehensive services that address medical, behavioral, and social needs together. Key benefits include eliminating communication gaps between providers, engaging patients as active partners, and using shared data to track progress. Studies show 15-25% reductions in hospital readmissions, improved chronic disease management, higher patient satisfaction, and often reduced costs while delivering better health outcomes.

What Challenges do Healthcare Organizations Face when Implementing Alternative Care Models?

Main implementation challenges include financial restructuring from fee-for-service to value-based payments, significant technology investments for interoperable systems, staff retraining for team-based care, navigating complex regulatory requirements, developing new outcome-focused metrics, and educating patients about new care processes. Success typically requires 12-24 months of careful planning, stakeholder buy-in, and phased implementation with ongoing monitoring.

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