CareBridge Raises $140M to Tackle the $92B Market in Home & Community Based Services

The Driver:

CareBridge is a value-based care company for home and community-based services (HCBS) that recently raised an additional $140 million in financing led by venture capital and private equity firm Oak HC/FT and four of the nation's five largest Managed Medicaid plans also having co-invested in the company. The new funding will go towards providing increased community-based home health services for thousands of the Medicaid population suffering from multiple physical and mental conditions and disabilities. The funds will be used to expand CareBridge’s HCBS model for Medicaid and patients shared with Medicare (so-called duals or dual eligibles), with physical and intellectual disabilities across the country, according to the company.

Key Takeaways:

• Joint federal and state Medicaid HCBS spending totaled $92 billion in FY 2018, according to the Kaiser Family Foundation

• The public share of LTSS spending has grown from just under 65% in 2000 to over 70% in 2020 according to a June 2022 study from the Congressional Research Service.

• 1 in 4 average adults lives with a disability in America, with 2 out of 5 affecting the elderly 65 years of age and older.

• An estimated $475.1 billion was spent on LTSS, representing 14.1% of the $3.4 trillion spent on personal health care.

The Story:

CareBridge was created by the merger of Health Star and Sinq Technologies both of which offered technology in the HCBS space. As noted in the Nashville Business Journal “CareBridge’s services are aimed at assisting low-income seniors, disabled people and others in need of long-term care with daily tasks such as bathing, administering medication and arranging appointments.” These HCBS services are typically covered under what is called Long-Term Services and Supports (LTSS) by Medicaid and include the broad range of paid and unpaid medical and personal care assistance that people may need when they experience difficulty completing self-care tasks as a result of aging, chronic illness, or disability.” CareBridge offers 24/7 clinical support, decision support, data aggregation, and electronic visit verification (EVV). EVV is used to ensure that services are delivered to people needing those services and that providers only bill for services rendered and all state Medicaid agencies were required to implement an EVV solution for Personal Care and Home Health services under the 21st Century Cures Act.

According to the company, CareBridge exclusively serves Medicaid and dual-eligible patients who have a physical or intellectual disability and are receiving HCBS. CareBridge’s goal is to provide 24/7/365 services for their patients, family members, and caregivers so they have easy access to a clinician whenever they need one. These telehealth visits will help keep many elderly and disabled patients remaining healthy by allowing them to have regular check-ins and avoid expensive emergency room visits. CareBridge has had success in the Medicaid market and as noted, a number of the plans serving that market have invested in the company.

The Differentiator:

CareBridge’s focus is to make sure HCBS patients receive optimal care from home. To facilitate this, CareBridge ships a tablet to patients’ homes to allow them to contact their clinicians at any time. In addition, CareBridge deploys a broad team of clinicians for each patient, including physicians, nurse practitioners, social workers, behavioral health specialists as well as pharmacists. In addition to having four of the country’s five largest Medicaid managed care organizations as investors, CareBridge has partnerships with companies like Bayada Home Health Care, one of the largest home health providers with over 325 locations in the U.S.

CareBridge provides all-day service and assistance through several types of modes of communication including a mobile app, tablet, or telephone. According to the company, they have grown rapidly from 1,100 full-risk patients in June of 2021 to over 19,000 such patients in June of this year.

The Big Picture:

An estimated $475.1 billion was spent on LTSS, representing 14.1% of the $3.4 trillion spent on personal health care according to a June 2022 report from the Congressional Research Service (CRS). Moreover, the CRS report notes that “[these] data underestimate the total costs of providing LTSS because they do not capture LTSS provided by family members, friends, and other uncompensated caregivers.”

CareBridge’s mission is to provide help to the elderly and the physically and developmentally disabled. With their digital health technology, CareBbridge wants to provide exceptional at-home care for their dual-eligible patients with the help of their broad-based clinical care team which can help address a myriad of needs and facilitate a helpful, trusting, and sound experience. As budget pressures at both the Federal and State levels continue to constrain both Medicare and Medicaid spending it is increasingly important to find solutions that help optimize LTSS spending. This is especially important as the public share of LTSS spending has grown from just under 65% in 2000 to over 70% in 2020. As noted by the company, “by taking risk for the total cost and quality of care for a patient, CareBridge is able to ensure individuals receive the right level of services at home to help prevent unnecessary hospitalizations and ER visits.”

Value-based care startup CareBridge clinches $140M to fuel expansion into more states; CareBridge Receives $140M in Financing to Expand Value-Based HCBS Model,Who Pays for Long-Term Services and Supports?