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Imagine Health Raises $21M to Expand Benefits Model for Self-Insured Employers

by Jasmine Pennic 02/11/2015 Leave a Comment

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Imagine Health

Imagine Health, a provider of independent provider of high-performance provider teams has raised $21 million in Series A funding led by Trident Capitaland HLM Venture Partners. The capital will be used to expand its transformative approach to healthcare into new markets, including immediate development activities in Phoenix,San Francisco and Atlanta. Imagine Health currently has high-performing hospital and physician teams—known as SmartCare™—in Chicago, Dallas, Houston, San Antonio, Albuquerque and Boise comprising more than 22,000 healthcare providers and 350,000 members.

Overview

Imagine Health creates custom provider teams of hospitals and physicians for large, self-funded employers in a way that transforms healthcare delivery. Unlike traditional “narrow” or “high-performance” networks that focus solely on cost, Imagine Health focuses first on building a team of top-tier quality providers. These teams consistently deliver higher quality care at significantly lower costs than both broad-panel and traditional narrow networks.

The company leverages its sophisticated data analytics and the purchasing power of its large employer clients to negotiate preferred reimbursement rates with the top-performing providers in exchange for incremental volume. As a result, the quality and efficiency improvements from the selected top-tier providers typically exceed 20 percent.

“We have an innovative, proven model that has helped multiple Fortune 100 clients improve the quality of care for their members and control costs by purchasing healthcare from providers the way they approach other major cost centers in their businesses,” said Allison Robbins, chairman and CEO of Imagine Health. “This round of funding helps us prepare to scale Imagine Health nationwide to meet the demand we’re already experiencing, and to prepare us for our projected rapid growth trajectory.”

Imagine Health Benefits

Imagine Health creates mutually beneficial relationships between top-performing healthcare providers, large employers and their health plan members. This model results in:

– Providers obtaining valuable new volume and better patient engagement

– Members receiving higher quality care and provider engagement with lower out-of-pocket costs

– Employers realizing immediate cost savings and higher member/employee satisfaction – SmartCare typically delivers savings of $2,000 to $3,000 per employee per year and engagement above 50 percent

As the healthcare market trends toward value-oriented payment strategies, Imagine Health is focused on reformed payment structures that enable provider teams to maximize the care they provide on behalf of employer-sponsors. Although value-oriented payment, direct contracting and accountable provider team development and operation is relatively new to the market, the Imagine Health team has extensive experience helping large, national employers adopt a variety of payment models.

In addition to the funding, Robbins announced that John Reardon and Arneek Multani of Trident Capital and Peter Grua of HLM Venture Partners are joining the company’s board of directors.

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