Carebridge

Market position

CareBridge is described as a leading value-based care provider for home and community-based services, backed by four of the five largest managed Medicaid plan operators, whose owners together serve nearly 60 percent of Americans receiving HCBS. It reached unicorn status in June 2022 and topped the 2023 Inc. 5000 as the fastest-growing private company in America and the first healthcare company in a decade to do so. It was also named to Fierce Healthcare's 2022 list of the Top 50 Digital Health Startups to Watch.

CareBridge's model builds its care team around the caregiver already present in the member's home, treating that caregiver as the frontline of the interdisciplinary team, which the company says makes the clinical model both more integrated with in-home care and lower cost to deliver. Rather than defaulting to additional paid caregiver hours, it deploys occupational and physical therapists and home modifications to increase member independence. It also combines clinical delivery with EVV technology and an aggregated HCBS data set spanning states and health plans, which the company positions as a basis for standardizing care quality. It targets the HCBS population specifically, which management describes as roughly 3 percent of Medicaid members but 20 percent of total Medicaid cost.

Technology

CareBridge deploys a cellular-enabled, two-way tablet into the homes of high-risk members, allowing members, family members and caregivers to reach a clinician at any hour and enabling monitoring of health signals. Supporting the clinical model are electronic visit verification software that confirms home healthcare visits were delivered by qualified providers, a data aggregation layer that pools information across states, health plans and providers into an HCBS analytical database, predictive analytics to flag members at risk, and care coordination tools connecting members, caregivers and plans. The company has said it intends to invest in expanding this cross-state, cross-plan database to drive standardization of HCBS care.

Go-to-market

CareBridge sells to health plans rather than directly to individuals, and its largest investors — Elevance Health (formerly Anthem), UnitedHealthcare, Centene, and Aetna CVS — are also among its largest customers, expanding it into states where they hold Medicaid contracts. It has also formed provider partnerships, including a strategic partnership with BAYADA Home Health Care announced in December 2020, and partners with national associations focused on Medicare and Medicaid service delivery.

Managed Medicaid and Medicare health plans, and through them Medicaid and dual-eligible members receiving home and community-based services — including low-income seniors and individuals with physical, intellectual, or developmental disabilities — plus their families and caregivers. The company has also planned expansion of services to individuals with intellectual and developmental disabilities (IDD), and its platform is used by health plans, long-term care providers, and government agencies.

Geography

Headquartered at 501 Great Circle Rd, Suite 300, Nashville, Tennessee 37228. States served include Arizona, Arkansas, Florida, Hawaii, Indiana, Iowa, Kansas, Massachusetts, Minnesota, New Jersey, New Mexico, North Carolina, Ohio, Tennessee, Texas, Virginia, Wyoming and Washington, D.C., with continued expansion into new markets. In mid-2022 the company operated in 11 states and planned to reach 16 states plus the District of Columbia the following year; its payer partners were moving it into 30 states where they hold Medicaid contracts.

History

CareBridge was created by a group of former Aspire Health executives, with founding dates reported variously as 2019 and 2020. Aspire Health, a home-based palliative care provider, had been sold to Anthem in 2018. Brad Smith, previously director of the Center for Medicare and Medicaid Innovation, joined CareBridge as executive chairman in 2021. In June 2022 the company raised $140 million led by Oak HC/FT at a valuation above $1 billion, bringing total capital raised to $180 million. Membership grew from about 1,100 patients in mid-2021 to roughly 20,000 full-risk patients across 11 states a year later, with plans to reach 16 states and the District of Columbia. In August 2023 CareBridge was ranked No. 1 on the Inc. 5000 list on revenue of nearly $873 million. In October 2024 Elevance Health announced an agreement to acquire the company, with Carelon, its health services division, identified as the intended acquirer.

Risks & controversies

Reporting has noted that CareBridge's founders come from senior government and political backgrounds, raising the question of whether they benefit from the movement of powerful people between government and highly regulated industries, and has observed that state Medicaid agencies have faced criticism for awarding contracts to companies whose executives previously worked for those agencies. The company's largest customers are also among its investors, and following the October 2024 agreement its independence is subject to acquisition by Elevance Health.