Aligned Marketplace picks up additional funding to expand advanced primary care, employer partnerships

Employers are up against escalating healthcare costs driven by mounting prescription drug expenses and worsening chronic conditions, and companies are bracing for healthcare costs to spike yet again this year.

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In August, the Business Group on Health projected that the healthcare cost trend will jump to 8% in 2025, growing from 6% in 2022.

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At the same time, employees struggle to find accessible, affordable and high-quality primary care close to where they live.

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Many employers are exploring alternative options to manage costs while improving outcomes.

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Aligned Marketplace launched in 2023 to offer an advanced primary care marketplace for self-insured employers. The company offers employers, and their workforces through their health plans, access to a national network with more than 3,000 clinic locations and coverage in all 50 states.

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But, Aligned doesn't operate clinics; it contracts with providers like Marathon Health, Amazon One Medical, Carbon Health, CareATC, Aledade and virtual providers like CirrusMD and Galileo for primary care services. The company's growing network includes in-person primary care clinics, virtual advanced primary care options and population-specific providers like pediatric telehealth provider Summer Health and metabolic care startup Knownwell.

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The company also built out tools such as population health analytics and personal health assistants to engage members and manage high-risk populations.

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"We are the only national and value-based advanced primary care network, and we specifically support self-insured employers and help their members connect to great, high-quality advanced primary care all across the country," Patrick Nelli, CEO and founder of Aligned Marketplace, said in an exclusive interview. "We are aligning the incentives from a payment perspective between the self-insured employers and the advanced primary care groups, so that all of these groups get paid based on delivering high-quality, high-experience, lower total cost of care to the self-insured employers."

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Aligned Marketplace secured $3 million in additional seed funding, bringing its total fundraise to date to $11 million. Last April, the company raised $8 million in a seed funding round led by A* Capital and Maverick Ventures, and those same investors backed its additional $3 million raise.

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"We've had a very long-standing thesis in employer health. Employers represent about a trillion dollars of spend in the U.S., and they have been totally underserved by a lot of the legacy solutions over the last few decades. We are super interested in backing disruptors in the space," Ambar Bhattacharyya, managing director at Maverick Ventures, told Fierce Healthcare.

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Aligned Marketplace says it has added numerous Fortune 500 customers, including 7-Eleven. There are more than 100 million Americans who work at self-insured employers, and Nelli sees big opportunities to reach that workforce.

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"When Patrick and team came to us and said they wanted to create a marketplace model for solving both access, affordability and quality for employers in a nationwide manner that's super CapEx efficient, I was intrigued," Bhattacharyya said. "In essence, what they've done is they figured out a way to take a host of the innovation that has happened on the supply side, in terms of primary care innovation, so partnering with coming some of the best-of-breed companies there and they've stitched a nationwide network."

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As more companies continue to allow remote work options, many companies have an employee base that is spread out across the country.

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"The Aligned Marketplace model has solved a huge problem for HR, which is, how do you make sure an employee in Idaho is getting the same benefits as someone who is in Florida?" Bhattacharyya added.

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The company also focuses on high-quality primary care and is "extraordinarily selective" with the providers that join the network, Bhattacharyya said.

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Nelli has spent his career in healthcare, including nine years at Health Catalyst where he led analytics and served as chief financial officer and president.

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"Advanced primary care has been proven to provide high-experience, high-quality, lower-cost care, especially in the Medicare market through Medicare ACO programs, but it has been difficult for large, self-insured employers to purchase it historically because they have plan members all over the country, and these advanced primary care groups are highly localized or regionalized or fragmented," Nelli said.

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Studies have shown that a comprehensive primary care model can increase quality of care, enhance patient experience and help employers save as much as 15% on total medical costs.

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Aligned Marketplace is designed to offer self-insured employers an "easy button" for advanced primary care with a single value-based, shared savings contract, he said.

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"It's a difficult time to be a self-insured employer. From a health benefits cost management perspective, costs are rising anywhere estimates from 6% to 9% this coming year, depending on the estimate, and employers also, in addition to cost containment, they also care a lot about experience. Employers, and I sat in this seat, are looking for 'win-wins.' They're looking for opportunities that have cost containment, but through higher access and the highest experience. Advanced primary care is, in our view, the best untapped opportunity for them that does provide that 'win-win,'" Nelli said.

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Advanced primary care focuses on delivering holistic, patient-centered care that emphasizes prevention, early intervention and the management of chronic conditions. Advanced primary care integrates value-based care payment models, aligning provider incentives with improved health outcomes and cost efficiency, according to Nelli.

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"What that feels like for a member is oftentimes increased access, such as same-day or next-day appointments, and longer appointment times. These groups are also very data-enabled, where they're able to identify care gaps, the preventive screenings and individuals with chronic conditions or unmet needs, and then proactively outreach to them," Nelli said. "From a provider perspective, these providers get paid to keep members healthy and out of the hospital and out of the emergency room. They get to operate at the top of their license."

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He added, "This helps to reduce unnecessary emergency department visits, unnecessary hospitalizations, unnecessary readmissions, and when individuals do need specialty care, it is steering members to high-value downstream and specialty care, and all of that is what ultimately results in total cost of care savings."

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Aligned Marketplace plans to use its additional funding to grow its advanced primary care network, add more capabilities to engage members and ink more employer partnerships.

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'We were interested in investing in Aligned Marketplace for three primary reasons: a focused and mission driven CEO that has earned insights into this market,  a unique product offering that aligns incentives between employees, employers, and providers, and the ability to materially improve healthcare quality and costs for 100+ million Americans," Gautam Gupta, co-founder and general partner at investor A*, told Fierce Healthcare. "We have invested in and helped scaled many marketplaces at A* and we see Aligned as having the potential to be one of the next great marketplace businesses improving American healthcare."

How 7-Eleven aims to support employee health and well-being

Aligned Marketplace rolled out its partnership with 7-Eleven nationwide to support all their members on the company's various health plans, although the companies did not specify the exact number of employees.

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"7-Eleven is a very distributed population, so they are innovators in thinking about solutions to better serve their plan members all across the country, invest in those members' health and being proactive to help reduce complications, unnecessary hospital spends and unnecessary specialist spends, and do that through more proactive preventative care," Nelli said. "7-Eleven is certainly an innovator, and in some ways has to be, given how distributed of a workforce and how varied of a workforce they have."

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Scott Conard, M.D. a physician executive, consultant and physician adviser to 7-Eleven, believes that the U.S. needs to shift from reactive symptom treatment to proactive health-risk management. High-value primary care is a key part of this approach.

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7-Eleven wanted to partner with Aligned Marketplace as the company reevaluated its approach to health and wellness benefits and primary care in particular, Conard said.

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"We went about a deep dive in the marketplace to see who could help us. We could find a group in Minnesota, or we could find a group in Texas, or we find a group in Florida, but there was no way as a corporation as spread out as 7-Eleven is that we could do this," he said in an interview. "Then I was introduced to Patrick Nelli and realized what he was doing. In my opinion, Aligned Marketplace is something that every employer in the United States should get behind, should support and should drive lives into and help develop."

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He continued, "Aligned Marketplace aligns the company who wants great care at a fair price with the employee who wants a long, healthy life, with the primary care doctor who wants to help that person live a long and healthy life and gets paid fairly."

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"We now have 3,000-plus allies that are pulling for the same thing that 7-Eleven wants, and that isn't available anywhere else in the marketplace at that kind of scale," Conard said.

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Nelli noted that advanced primary care providers are, in many ways, trying to return to the practice of "hometown" family medicine doctors who connect with patients and focus on proactive, preventive care and behavior change for long-term health.

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'I do think it takes organizations that can help align incentives between all parties to ensure that the best-performing independent primary care groups can receive the appropriate patients and be paid fairly for that," he said. "We do think there's a real opportunity with the current inflationary dynamics, for self-insured employers to look to new, innovative solutions like advanced primary care or other types of solutions, and we think it can help the system, in some ways, go back to the basics of individuals forming a longitudinal relationship with the primary care provider and having that individual in their corner as their quarterback to help them navigate this increasingly complex system."