MM Curator summary
The article below has been highlighted and summarized by our research team. It is provided here for member convenience as part of our Curator service.
[MM Curator Summary]: CVS makes another huge investment into its tech portfolio.
New Funding Will Support Waymark’s Market Expansion and Technology Investments to Continue Improving Access and Outcomes for Medicaid Recipients
SAN FRANCISCO, October 18, 2023 (Newswire.com) – Waymark, the Medicaid provider enablement company, today announced $42 million in new financing to scale technology-enabled, community-based care for primary care providers and their patients enrolled in Medicaid programs. Existing investor Lux Capital led the oversubscribed round, and CVS Health Ventures, the venture capital arm of CVS Health, joins the company as a new investor. Existing investors Andreessen Horowitz (a16z) and New Enterprise Associates (NEA) also participated in the round. The investment consists of $22 million in equity capital and a $20 million line of credit, bringing Waymark’s total capital raised to date to $87 million.
“CVS Health Ventures’ investment portfolio is comprised of innovative companies that are at the forefront of transforming care delivery. Waymark’s use of proprietary data science technologies to improve access and quality of care is doing exactly that,” said Vijay Patel, Managing Partner and co-founder, CVS Health Ventures. “We expect this investment will provide Medicaid members expanded access to coordinated and holistic health care.”
Waymark will use its new investment to continue improving healthcare access and outcomes for people enrolled in Medicaid programs. Patients receiving Medicaid benefits often experience challenges accessing care, prescriptions, and social support like housing and food. Waymark hires, trains, and deploys local teams of community health workers, pharmacists, therapists and care coordinators to work directly with primary care practices — at no cost to the practice — and address gaps in care for their patients enrolled in Medicaid. The company’s local teams are supported by Waymark Signal™, a proprietary machine learning technology that has shown industry-leading performance in identifying “rising risk” populations, or patients at risk of avoidable emergency room (ER) and hospital utilization, and helps to direct Waymark teams to the best evidence-based intervention to meet patient goals. The technology is integrated into a care management software built by Waymark specifically for community-based teams, and incorporates data from multiple sources (e.g., local ERs, primary care practices, social services databases, and health plan data) to engage patients who are traditionally hard to reach.
“Medicaid programs have historically been overlooked and under-innovated, but Waymark’s groundbreaking partnerships demonstrate the positive impact technology-enabled services can have for communities who need it most,” said Deena Shakir, General Partner at Lux Capital. “By aligning business incentives with patient outcomes, Waymark continues to build a uniquely effective approach to advance population health. There is no better team or technology out there to take this challenge on, and we are thrilled to deepen our partnership with the entire Waymark team.”
Waymark is currently supporting approximately 50,000 people enrolled in Medicaid across both Washington state and Virginia. Since launching in January 2023, the company has secured partnerships with several large health systems, a federally qualified health center (FQHC), and independent practices across both markets. Through its evidence-based care pathways, Waymark has shown promising early improvements in quality scores and clinical outcomes — including reduced non-emergent emergency department (ED) visits and hospitalizations.
Providence, one of the largest health systems in the country, is working with Waymark to improve access to care for patients receiving Medicaid. “At Providence, we’re committed to addressing inequities in the communities we care for,” said Dr. Scott Anders, CMO, Value Based Care, Providence Clinical Network, Providence Health & Services. “Waymark provides a disciplined Medicaid population health management approach that improves access to high-value care. Waymark’s use of data science combined with a local, person-centered process is compelling, and we are eager to see how they proactively help patients access the care they need.”
At community clinics like Country Doctor Community Health Center (CDCHC), a Seattle-based federally qualified health center (FQHC) with roots in the civil rights movement, Waymark is helping to increase provider capacity and deliver whole-person care to patients. “We chose to partner with Waymark because their local, community-based, multidisciplinary care model aligns not only with the evidence of what works in Medicaid, but also our own mission and values,” said Matthew Logalbo, MD and Medical Director, CDCHC. “We have worked hard to develop services tailored to the needs of our patients (e.g., our low-barrier addiction treatment clinic, peer support specialists, re-entry CHWs, and healthcare for the homeless services), but we can’t meet the level of demand that exists alone. Waymark provides us with more capacity outside the clinic setting to engage and support patients, bring them into care, and connect them to our programs and other resources in the community that can address patients’ social determinants of health.”
Waymark enters into risk-based contracts with Medicaid MCOs to deliver community-based care for their rising risk populations and transition primary care practices to value-based arrangements. By building a new community health workforce to support primary care providers (PCPs) — paid for through value-based arrangements with MCOs — Waymark seeks to increase the capacity of its healthcare delivery system and align payment incentives to enable whole-person care.
“We created Waymark because the evidence of what works to improve Medicaid outcomes exists, but the operational capacity, technology and funding is insufficient to scale to the level of need that exists in communities across the country,” said Dr. Rajaie Batniji, co-founder and CEO of Waymark. “This new financing will allow us to continue hiring and training a new community health workforce, expand PCP capacity, and ultimately deliver on our charter to improve access and quality of care for people receiving Medicaid.”