Start-up offering coordinated care for over-55s raises $15m
WellbeHealth, a start-up that coordinates care for elderly patients, has closed a $15m series A round, led by F-Prime Capital and 406 Ventures. The company is the only entrepreneurial, venture-backed group in the Program for All-Inclusive Care for the Elderly (PACE), which covers healthcare services for patients at least 55 years old who have been approved for nursing homes by their states' Medicaid office. With the new funds, WellbeHealth will introduce several models to support value-based care and it expects to begin serving PACE participants in Q4 2017.

WelbeHealth, a startup that seeks to coordinate care for frail elderly patients, has closed on a $15 million Series A venture capital round. F-Prime Capital and .406 Ventures led the investment.

F-Prime also led a $1 million-plus seed round for the Menlo Park, California-based company in late 2015.

WelbeHealth is taking advantage of a 2015 rule change by the Centers for Medicare and Medicaid Services to allow private, for-profit companies to support the Program for All-Inclusive Care for the Elderly (PACE). PACE covers healthcare services for patients at least 55 years old who have been deemed by their state’s Medicaid office to be eligible for nursing homes.

“PACE serves the sickest of the sick,” WelbeHealth CEO Dr. Si France said. The average enrollee is 77 years old and has 15 different medical conditions, according to France. Nearly half have some form of dementia.

“PACE becomes like a little [Medicare Advantage] plan,” France, who previously founded and sold GoHealth Urgent Care.

Aside from a group that took part in a CMS demonstration in Pennsylvania, there is just one other for-profit company working with PACE programs, France said. WelbeHealth wants to break new ground. “We’re the only entrepreneurial, venture-backed group in PACE,” he said.

WelbeHealth is developing population health and analytics technology to help stratify risk. “It’s very high-touch and it’s very coordinated,” France said of his company’s approach.

The company has an experienced leadership team in that area. President Matt Patterson served as president of AirStrip for four years, while Executive Vice President Richard Gurley built the analytics engine for Evolent Health.

With the new cash infusion, WelbeHealth is preparing to introduce several models to support value-based care, including one for PACE. For the frail elderly, the startup will be following “known best practices,” according to France.

“Our initial intention isn’t to reinvent the wheel,” he said. “We believe our contribution over time will be to innovate in the model.”

Because it can be difficult to get a PACE license from CMS, WelbeHealth is partnering with Sutter Health to serve eligible patients in Stockton and Modesto, California. (Stockton is the largest city in the state without a PACE program, France said.)

France said he expects to be serving PACE participants in the fourth quarter of 2017, and may later branch out to those outside the program. “There’s still need beyond those who are eligible for PACE,” he said.

Photo: Royalty-Free/Corbis