Value-based care startup CareBridge clinches $140M to fuel expansion into more states

Value-based care startup CareBridge pulled in $140 million in fresh capital to expand its home and community-based services to more states.

Existing investor Oak HC/FT led the financing round. The company also has gained the backing of four of the nation’s five largest managed Medicaid plans: Optum Ventures, CVS Ventures, Anthem Inc. and HLM Venture Partners. Together those organizations serve nearly 60% of all Americans receiving home and community-based services. 

CareBridge's latest investment boosts the company's valuation to more than $1 billion, according to executives, vaulting the startup into "unicorn" territory.

The startup has raised $180 million to date.

Launched in 2020 by a group of former Aspire executives, including former U.S. Senate Majority Leader Bill Frist, CareBridge's services are aimed at assisting low-income seniors, disabled people and others in need of long-term care.

Aspire Health, a home-based palliative care provider, was sold to Anthem in 2018.

CareBridge exclusively serves Medicaid and dual-eligible patients who have a physical or intellectual disability and are receiving home and community-based services. The company enables members, caregivers and health plans to share clinical information while providing 24/7 support and daily check-ins inside the patient’s home.

The new investment and 10-figure valuation are proof points that the industry and health plans are looking for solutions that better serve the Medicaid population, CareBridge executive chairman Brad Smith told Fierce Healthcare.

"We have strong early outcomes that we've shown that we're able to decrease hospitalizations and ER visits typically, depending on the plan, in the 10 %to 20% range. We're showing that we have really high patient satisfaction. Our NPS score from patients and families is 84. And we're also seeing material cost savings that can be in the high single digits, low double digits," Smith said. "There's a big opportunity to both improve care for these patients and help them live more independently at home but also lower the cost of care."

He added, "Across the country, there hasn't been a lot of focus on better managing certain sub-populations of the Medicaid population. And HCBS home and community-based services) population in particular, it's about 3% of all the Medicaid members in the country, but it's 20% of total Medicaid cost in the country."

Smith, the former director of the Center for Medicare and Medicaid Innovation (CMMI), moved over to CareBridge last year as he feels the company is filling critical gaps in care delivery.

CareBridge built a full-risk solution for Medicaid members who receive care and community-based services.

"Putting on my old CMMI hat, what I'm most excited about with CareBridge is the company really shows you can deliver value-based care to a Medicaid population. And I think there are not enough examples of that across the country. And my hope is it'll encourage more people to build value-based care companies in the Medicaid space," he said.

The company is growing rapidly, serving patients in 11 states and growing more than 17x in the past year., A year ago, the company served 1,100 patients and today it's serving in the neighborhood of 20,000 full risk patients, Smith said.

CareBridge’s 24/7 clinical support solution includes deploying a tablet to the home of high-risk individuals so that those individuals, their family members and their caregivers can contact a CareBridge clinician around the clock. CareBridge’s clinical team includes physicians, nurse practitioners, social workers, behavioral health specialists and pharmacists.  

The company plans to use the fresh cash to expand into more states and invest in its technology to continue building a large database for home and community-based services.

"What we're really building is kind of a database to be able to aggregate data across states and across health plans. By doing that, we can help drive more standardization across the country, which we think will improve the quality of care that people are getting, but also help reduce cost," he said.

CareBridge plans to serve members in 16 states and the District of Columbia by next year, executives said.

Smith says the company's clinical model is unique as it leverages the caregiver who is already caring and supporting the patient at home.

"We then wrap our care team around that person, which allows us to be more integrated with the care the patients are receiving at home. It also allows us to deliver our clinical model in a lower-cost way. We're using that caregiver as the frontline of the interdisciplinary care team," he said.

CareBridge also employs a team of occupational therapists and physical therapists to help maximize the patient's independence to keep them safely at home and out of a nursing home, Smith said.

"Let's say a patient has a hard time taking a shower. For a lot of HCBS patients, with the health plans, would they typically would do is just give that person more caregiver hours where that person would come over and give them a shower. But what if the patient wants to try to be independent? We can send an OT or PT to the patient's house for two weeks or six weeks to kind of train them on how to take a shower but also let's get a grab bar in the shower and let's get a chair where you can kind of slide in and out of the shower without having a risk of falls," he explained. "That's the approach we're taking to help both improve quality and independence also reduce costs on the caregiver side." 

CareBridge plans to grow its services to patients with intellectual and developmental disabilities (IDD).

“CareBridge is proof that you can build great value-based healthcare companies in the Medicaid space,” said Annie Lamont, managing partner of Oak HC/FT, in a statement.