Last fall, Atlanta-based Emory Healthcare tapped health tech and services company Guidehealth to scale up its population health management efforts, expanding primary care to hundreds of thousands of patients across Georgia.
That collaboration is bearing fruit.
Guidehealth collaborated closely with Emory’s Population Health Collaborative to improve Medicare quality scores for one of its major Medicare Advantage contracts. In just a few months, the two entities worked together to close care gaps for a patient panel of 27,000 and collectively improved its Centers for Medicare & Medicaid Services (CMS) star ratings from having one measure rated over four stars to six measures rated over four stars.
The work laid the foundation for an accelerated quality performance program that will extend past 2025, executives said.
Emory Healthcare includes more than 490 provider locations with 10 hospitals and comprises the Emory Physician Group and the Emory Healthcare Network, a clinically integrated network with more than 4,000 physicians including more than 500 primary care physicians.
The academic health system is now backing the startup with a $10 million investment as Guidehealth plans to build out its platform.
The company, which launched in 2023, aims to develop additional tech-enabled healthcare services, including artificial-intelligence-powered virtual care navigation, which includes integrating AI that assists with self-reported blood pressure readings as well as screenings for fall risks and depression.
The company is moving beyond identifying at-risk patients to delivering AI-supported care navigation and tailored interventions. Guidehealth plans to build out prescriptive analytics, as opposed to just predictive analytics, to focus more on personalized care for patients based on their individual health needs.
“This investment from Emory Healthcare marks a pivotal moment in our mission to bring scalable, intelligent care to the forefront of the healthcare system,” Guidehealth founder and CEO Sanjay Doddamani told Fierce Healthcare.
“We’re aligning technology, clinical strategy, and human touch to support providers and patients in a more connected, proactive model of care. Emory’s leadership in value-based care makes them an ideal partner as we work to improve outcomes, reduce fragmentation, and close the gap between insight and action at population scale,” he said.
The company banked a $14 million seed round in August, led by nonprofit Memorial Hermann Health System in southeast Texas, entrepreneur Sidd Pagidipati and other healthcare investors and industry leaders.
Guidehealth develop an AI-powered healthcare services platform that helps health system care teams proactively manage high-risk patients and improve their performance in risk-based contracts. The company uses advanced technology to support health systems and clinical networks in scaling value-based care beyond the inpatient setting. Guidehealth facilitates care coordination like prior authorization and referrals and uses AI to better predict the needs of patients.
Guidehealth also assigns virtual clinical team members to work with its partner systems. These “Healthguides” are medical assistants trained in data science and empathy under licensed clinical professionals and extend the reach of the care teams.
The $10 million investment signals that Emory Healthcare is betting on AI to deliver tangible results.
“Healthcare is undergoing a transformation, and the future belongs to those who can harness AI to deliver proactive, personalized and truly accessible care,” said Joon Lee, M.D., CEO of Emory Healthcare, in a statement. “Our relationship with Guidehealth is more than just an investment—it’s a step toward redefining how we manage chronic disease, close care gaps and engage patients before conditions become crises. By integrating AI-driven intelligence with human-centered care, we are creating a system where every patient gets the right care at the right time, driving better outcomes and a healthier future for our patients.”
Through an initiative kicked off last fall, Emory Healthcare and Guidehealth are working together to improve primary care access and population health management for more than 400,000 individuals across Georgia.
Guidehealth’s AI-powered platform proactively identifies and manages chronic conditions like diabetes, hypertension and heart disease to enable earlier interventions and better health outcomes.
Using this technology, Emory primary care and affiliate primary care providers assess patient health needs and determine their outlying risks to prevent problems and get ahead of diseases before they develop and advance.
The academic health system has been involved at a smaller scale in population health management for a number of years as it was developing its clinically integrated network, according to Patrick Hammond, CEO of the Emory Healthcare Network who was also tapped to be the CEO of the Emory Healthcare Population Health Collaborative.
“This collaboration focuses on increasing the frequency and effectiveness of preventive visits, screenings and improving patient engagement, all while reducing the administrative and operational burden on our healthcare providers so they can focus more on what they do best: helping their patients and serving our communities,” Hammond told Fierce Healthcare in November when the collaboration with Guidehealth kicked off.
Emory already is seeing early success with the initiative with higher quality performance as measured by the improvement in CMS star ratings.
Emory evaluated a number of potential value-based care organizations, Hammond noted. Guidehealth checked several boxes that Emory was evaluating in the selection of a strategic relationship, including its ability to integrate its capabilities into the health system’s clinical workflows.
Partnering with the company provides Emory with the ability to rapidly accelerate its performance in value-based agreements while lowering ramp-up scaling costs, he noted. The partnership also lowers the operational execution risk cost to Emory, and Guidehealth provides a solution for all payer classes, such as Medicare and commercial insurance.
Publisher: Source link
