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 (104)
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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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Galileo

Galileo

4.8 (1)
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Founded

2018

Employees

0

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Not Provided

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About Galileo

Digitize the system. Mobilize the care. Serve the employer. Reduce employer's most pressing healthcare costs. These are the areas where Galileo is focused. Today's Galileo is reimagining primary care to offer advanced primary care solutions backed by experts to help employers deliver better health outcomes, efficiently and affordably. Our connected, platform provides employees with 24/7 virtual access to a multidisciplinary care team of primary, specialty, and behavioral care experts. By leveraging our clinical expertise, we bring high-quality care to your team, helping drive improved employee engagement, retention, and productivity. We partner with health plans, employers, and benefit leaders to deliver... 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
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
Cerner Corporation

Cerner Corporation

4.2 (10)
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Founded

1979

Employees

0

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None

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About Cerner Corporation

Together, let’s empower a healthy workforce.

Our goal is to help your organization reduce expenses, improve the health, well-being and productivity of your workforce, and attract and retain talent by offering unique benefits.

As one of the world’s largest health care companies, Cerner is focused on Population Health, helping you to know your population, engage each person, and manage their outcomes.

At Cerner, we work with 200+ employers of different sizes and industries. We live what we do as a company, providing services to more than 28,000 of... 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
Teladoc Health, Inc.

Teladoc Health, Inc.

4.5 (4)
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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
Transcarent

Transcarent

2.0 (1)
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Founded

2020

Employees

2,500

Funding Summary

126M Series D

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About Transcarent

Founded in 2020, Transcarent is a private health and care experience company aimed at simplifying access to high-quality, affordable care. Our integrated mobile and web platform offers a range of services, including everyday care such as instant provider consultations, behavioral health support, pharmacy services, home care, and comprehensive care for complex needs like surgery or cancer treatment.

What sets Transcarent apart is our commitment to accountability and transparency. We offer at-risk pricing models in which we assume financial responsibility for outcomes, with transparent impact reports that demonstrate measurable improvements in experience, health outcomes, and cost reduction. This... Show More
AccessHope, LLC

AccessHope, LLC

Reviews pending
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Founded

2019

Employees

130

Funding Summary

33M Series B

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About AccessHope, LLC

AccessHope believes in putting the ever-growing body of cancer knowledge to work for the greater good. We deliver a revolutionary cancer benefit that connects employees with cancer to the latest cancer expertise of NCI-Designated Comprehensive Cancer Centers.

Accountable Precision Oncology (APO) is a unique and highly differentiated offering that proactively identifies (no member opt-in required) and initiates complex case reviews likely to have the highest outcome variability - allowing us to intervene early and improve health outcomes.

Cancer Support Team (CST) + Expert Advisory Review (EAR) is a service that provides 12-hour-per-day telephonic access... 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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First Choice Health

First Choice Health

Reviews pending
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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
HealthEZ

HealthEZ

5.0 (1)
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Founded

1982

Employees

150

Funding Summary

Not Provided

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About HealthEZ

HealthEZ was founded as Family Health Plan in 1982, establishing the first PPO in the Nation. Our company established medical management services integrated with the network in 1983 and provided an integrated service to many insurance companies, TPAs and large employers, including Northwest Airlines and the Fairview Nurses union plan.

Today we operate as HealthEZ and America’s PPO, under the umbrella of The Araz Group. We have over 150 employees on staff, primarily located in our Bloomington, MN headquarters. Our 40 years of experience operating as an independent network, managed care services company and third-party administrator... Show More
Lantern

Lantern

Reviews pending
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Founded

2011

Employees

500

Funding Summary

92M Private Equity Round

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About Lantern

Lantern is transforming access to excellent care for specialty care categories: All Plannable Surgeries, Cancer and Infusions.

Through Lantern Surgery, we guide members to local, excellent care that creates lower cost for both the plan sponsor and the member. We are unique from our peers in that our model is built on a framework that delivers a highly curated surgeon-first network, combined with access to world-class, nationally recognized facilities – using bundles priced at roughly half of typical carrier rates with our Surgery Care solution.

Lantern Cancer Care is designed to support... Show More
Access2day Health

Access2day Health

4.8 (1)
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Founded

2012

Employees

25

Funding Summary

Not Provided

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About Access2day Health

Access2day Health delivers a simple, affordable way for employers to provide their teams with fast, convenient healthcare. Through a flat-rate membership model, employees and their covered dependents enjoy unlimited access to preventive, primary, and urgent care services—without the hassle of claims, copays, coinsurance, or deductibles.
Serving more than 200,000 members across 100+ clinics in Alabama, Louisiana, Mississippi, and Texas, Access2day Health partners with trusted, local providers to ensure high-quality care close to where people live and work. The program is scalable nationwide, making it easy for employers to extend this benefit wherever their workforce is located.
Unlike traditional... Show More
Best In Class MD

Best In Class MD

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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
Contigo Health

Contigo Health

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Founded

1988

Employees

228

Funding Summary

Not Provided

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About Contigo Health

At Contigo Heath, LLC, we are re-envisioning healthcare to be simpler and more transparent, with access to care that creates value and supports health plan members throughout their health journey. We do that while also committing to be a trusted ally in healthcare financial sustainability, helping to address the need to better control and predict costs for all.

Contigo Health, a consolidated subsidiary of Premier, Inc., is leading the way to financially sustainable healthcare. Contigo Health is a health benefits platform that leads direct-to-employer and direct-to-provider relationships. It is relentlessly focused on revolutionizing healthcare through appropriate, cost-effective,... Show More
Imagine360

Imagine360

5.0 (1)
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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
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

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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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