This week, HarmonyCares raked in $200 million dollars to scale its in-home primary care delivery model for high-risk senior patients. The funding round was led by General Catalyst, McKesson Ventures and an unnamed large national payer.
The capital will be used to expand HarmonyCares’ market reach, particularly in the Medicare Advantage space — even as hospitals continue to drop their MA contracts.
The company was founded in 1993 under the name U.S. Medical Management. In 2013, Centene acquired a majority stake in the company — and then later sold it off in 2021. About a year after Centene sold its majority stake, the firm rebranded as HarmonyCares.
The $200 million financing round announced this week represents all the capital HarmonyCares has raised since its sale and rebrand, CEO Matthew Chance said in an interview.
The Michigan-based company operates home-based primary care practices in 15 states. Its clinical teams comprise physicians, nurse practitioners, social workers and pharmacists, Chance explained.
He also explained that HarmonyCares’ business model centers on value-based care contracts with MA plans and Medicare accountable care organization (ACO) programs. Some of its MA customers include Centene and Aetna, Chance noted.
In his view, HarmonyCares’ main goal is to increase access to care for seniors and those with complex health issues, pointing out that these patients often struggle to access primary care services.
“We go into the home when providers can’t or don’t. We extend the function of the general healthcare system, and our objective is to allow people to age in their homes. We address social needs and barriers to care, doing our best to keep people out of the hospital and address quality gaps,” he said.
Recent research shows that 33% of MA patients and 32% of traditional Medicare patients have difficulty accessing primary care. This often results in delayed care and unmanaged chronic conditions, which means worse health outcomes, increased preventable hospitalizations and higher costs, Chance remarked.
One major differentiator that helps HarmonyCares stand out from other in-home primary care providers is the fact that it takes on risk for both MA and traditional Medicare patients, he pointed out.
“We’ve been the number two-performing ACO in the country for the last two years and have a pretty strong track record there. I can’t think of any competitor that also works in the Medicare Advantage space that can point back to that history and say, ‘Hey, we’re creating real value here with programs that are independently monitored and validated,’” Chance stated.
HarmonyCares wants to dive even deeper into the MA space, he added.
This push comes during a time in which many health systems are getting increasingly frustrated with MA plans — so much so that some are ditching their MA contracts. Recent research shows that 16% of health systems plan to stop accepting one or more MA plans in the next two years and 45% of health systems are considering doing so.
In Chance’s view, hospitals’ MA gripes primarily have to do with utilization management and the tactics that MA plans use to save money.
“One of the great things about the history of our organization is we’ve created a lot of value that has nothing to do with utilization management. It has everything to do with proactive engagement with patients around their health conditions,” he declared. “When you look at the programs that we’re in on the traditional Medicare side, we’re saving money without those UM levers. So we can go to a Medicare Advantage plan and say, ‘In these populations, there’s opportunity to drive savings and value that benefit the patient and benefit you guys as well.’ That allows us to kind of stay out of the UM war that’s going on right now.”
HarmonyCares’ physician-led primary care teams also help it stand out, Chance added. Positioning a physician as the cornerstone of a patient’s care team leads to care journeys that are more longitudinal, he explained.
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