CareHarmony, a virtual care coordination startup, is on a mission to help hospitals provide more value-based care.

That mission got a $15 million boost on through a Series A funding round. Maverick Ventures led this round with participation from Nashville Capital Network. The company will use its new influx of capital to fuel the development of its platform and accelerate hiring.

Since value-based care incentivizes providers to focus on care quality, shifting to these care models requires them to make care decisions based on rich data. Because of this, investors and providers alike are paying attention to data-driven firms like CareHarmony. For example, value-based care startups CareBridge and Aledade raised $140 million and $123 million in June, respectively.

In its press release, CareHarmony pointed out that federal programs such as the Medicare Shared Savings Program are mandating high-revenue hospitals and health systems adopt downside risk-based contracting on increasingly shorter timelines.

Founded in 2015, Brentwood, Tennessee-based CareHarmony was created to disrupt the incumbent “encounter-based data view of the world,” said Gokul Mohan, the company’s co-founder and CEO. By this, he means that providers often base the care they provide on episodic treatments rather than taking into account other data that can create a more holistic picture of each patient. He said CareHarmony is challenging this paradigm by leveraging machine learning on novel datasets — which include patients’ clinical, claims and social data — to increase the scalability of care teams. 

By applying machine learning algorithms to those datasets, CareHarmony provides recommendations for care teams to assign targeted interventions based on patient profiles. This model was designed to ensure clinicians can deliver the right care to the right patient at the right time at scale. Mohan added that it allows patients to be treated as unique individuals and receive a “truly personalized path” through the healthcare ecosystem.

Many providers try to “hack together” care coordination solutions in their EMR, with the result being a highly manual process with unstructured data and limited population-level visibility, according to Mohan.

“Simply put — it doesn’t scale,” he said. “With our CareBlocks platform, it’s a complete paradigm shift to focus on novel data sets that just didn’t exist before. With this, the completion of an encounter in the EMR isn’t the end of a patient’s journey, it’s just the beginning.”

CareHarmony partners with hospitals and health systems that are using risk-based contracts or other value-based arrangements. More than 40 hospitals and health systems across more than 20 states are customers, according to Mohan. He claimed that over the past four years, CareHarmony customers participating in a Medicare Shared Savings Program achieved shared savings 95% of the time, including 100% success in the most recent performance year. The company charges its customers on a per-patient-per-month basis. 

Pitchbook currently values CareHarmony at roughly $71 million. As the shift to value-based care continues, we’ll just have to watch to see whether that number grows and if CareHarmony can differentiate itself from its competitors, which include MD Revolution and Signallamp Health.

Photo: Liubomyr Vorona, Getty Images