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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Galileo, Inc.

Galileo, Inc.

4.8 (1)
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Founded

2018

Employees

0

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About Galileo, Inc.

Galileo is an Advanced Primary Care system transforming care. Our longitudinal model and complexivist approach is built to close gaps in care—especially for hard-to-reach populations—while raising the quality of care and improving outcomes for clients across 50 states.

At Galileo, our clinical team spans 22+ specialties, with many physicians bringing 10+ years of education and training from top accredited institutions. And because health needs don’t stop at 5 p.m., we deliver care 24/7, giving employees access when and where they need it.

The result: more care delivered in-house, fewer barriers, and better outcomes. We... 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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Firefly Health

Firefly Health

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Founded

2017

Employees

150

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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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Personify Health

Personify Health

4.0 (106)
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Founded

2004

Employees

3,900

Funding Summary

None

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About Personify Health

Personify Health is a health and wellbeing company that supports the full health journey – differently and more completely than anyone else.

World-class engagement accelerates every other outcome we deliver. Dynamic points and incentives, expanded challenges, employer-sponsored campaigns, and deeper personalization are at the core of our wellbeing experience. Our engagement engine is getting smarter and more configurable so employers can drive consistent actions across their whole population.

We're connecting our engagement foundation to clinical action and measurable cost impact at scale. That means personalized wellness plans that adapt to each member,... 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
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
SUMMUS

SUMMUS

Reviews pending
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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

None

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About Teladoc Health, Inc.

Teladoc Health, a global leader, is the #1 most recognized and trusted virtual care brand. Over 20 years ago, we were founded on a simple, yet revolutionary idea, that everyone should have access to the best healthcare, anywhere in the world on their terms. Our mission is to empower all people everywhere to live their healthiest lives by transforming the healthcare experience. Today, we are transforming virtual care into a catalyst for how better health happens. We connect patients, care providers, healthcare platforms, and partners to provide more complete and personalized care. Through our unique technology, breadth of services, and... Show More
Lantern - The Specialty Care Platform

Lantern - The Specialty Care Platform

Reviews pending
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Founded

2011

Employees

1,000

Funding Summary

30M Private Equity Round

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About Lantern - The Specialty Care Platform

Lantern Specialty Care delivers high-quality, cost-effective care for complex and high-cost conditions through two integrated solutions: Network of Excellence and Specialty Care Management. Network of Excellence connects members to rigorously vetted providers and facilities for surgery 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. Show More
Nomi Health

Nomi Health

Reviews pending
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Founded

May 2019

Employees

0

Funding Summary

110M Series A

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About Nomi Health

From patient care to provider payments, we're rebuilding no-nonsense healthcare that is truly direct and affordable by changing how healthcare is delivered, purchased, and paid for. 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, please... Show More
Anthem

Anthem

4.8 (1)
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Founded

November 30, 2004

Employees

10,700

Funding Summary

35.2M Series B

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About Anthem

At Anthem Blue Cross and Blue Shield we understand our health connects us to each other. What we all do impacts those around us. So Anthem is dedicated to delivering better care to our members, providing greater value to our customers and helping improve the health of our communities.

Anthem Blue Cross and Blue Shield is the trade name of: In Colorado: Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc. In Connecticut: Anthem Health Plans, Inc. In Indiana: Anthem Insurance Companies, Inc. In Georgia: Blue Cross Blue Shield Healthcare Plan of... 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
Centivo

Centivo

4.8 (1)
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Founded

2017

Employees

260

Funding Summary

51M Angel Round

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About Centivo

Centivo is a new type of health plan anchored around leading providers of value-based care. Centivo saves self-funded employers 15 percent or more compared to traditional insurance carriers and is easy to use for employers and employees. Our mission is to bring more affordable, high-quality healthcare to the millions of working Americans who struggle to pay their healthcare bills. With Centivo, employers can offer their employees affordable and predictable costs, a high-tech member experience, exceptional service, and a range of benefit options including both proprietary primary care-centered ACO models as well as traditional networks. Show More
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
Included Health

Included Health

Reviews pending
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Founded

2011

Employees

2,100

Funding Summary

570M Venture Round

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About Included Health

Included Health is a new kind of healthcare company that delivers personalized all-in-one healthcare to millions of people nationwide. We provide healthcare access, answers, and advocacy through a modern experience designed to treat people better—mind, body, and wallet. It’s all included: comprehensive virtual and in-person care, system-wide navigation and care coordination, and 24/7 support for every clinical and admin need. Our members see better doctors, experience better outcomes, and have more healthy days, all at lower cost. Show More
INTERLINK COE Networks & Programs

INTERLINK COE Networks & Programs

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Founded

1995

Employees

72

Funding Summary

Not Provided

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About INTERLINK COE Networks & Programs

INTERLINK is a privately held managed care corporation based in Hillsboro, Oregon. INTERLINK builds Centers of Excellence networks for high-cost, low frequency medical procedures which are used by health plans all across the nation. INTERLINK is known for its Predictive Modeling TransplantCARE Program, which enables health plans to build their own customized COE network based on predicted outcomes or utilize our narrowed performance based TransplantELITE network for greater cost containment. CancerCARE is our comprehensive cancer management program; using three custom built COE networks and fully integrated case management. Both TransplantELITE and CancerCARE include INTERLINK's ACA adjusted benefit plan language.
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ZERO Health

ZERO Health

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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
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

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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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