Scaling Value-Based Primary Care with Upstream

We are thrilled to announce our partnership with UpStream, a technology-forward primary care enablement company. UpStream started in 2018 and is a proven platform leveraging a comprehensive integrated clinical care model with services and technology to provide best in class patient care. Define Ventures is investing in the Series B alongside Dragoneer, Coatue, Mubadula, and Avidity.

UpStream has a distinct clinical model that enables it to support at-risk PCPs in a unique and novel way to enhance patient care and reduce physician burnout. UpStream not only allows its primary care physicians (PCPs) partners to take risk through ACO REACH and Medicare Advantage partnerships, but also reduces physician burden by providing administrative and clinical support to manage the most complex members. Their embedded clinical model is centered around a Clinical Pharmacist Practitioner (CPP) who builds a relationship with the patient and physician in order to provide both medication management and whole person care with support of a team that includes nurses and social workers. By partnering directly with payors and providers and providing team-based care, UpStream is focused on tackling the triple aim of healthcare by improving outcomes and access while decreasing costs.

The Centers for Medicare and Medicaid Services (CMS), the nation’s largest healthcare payor, is promoting value based initiatives to improve outcomes and reduce costs. Since the launch of Accountable Care Organizations (ACOs) in 2012, billions of dollars have been saved per year after adjusting for shared shavings. Primary Care Providers are at the forefront of the value-based initiatives because they are frequently patients’ closest and most trusted partners, and although they only make up ~5% of total healthcare expenditure, their decisions influence all downstream costs. The warm handoff from PCP to CPP extends the patient’s circle of trust. That is why we decided to partner with UpStream. UpStream builds upon these sacred patient-physician relationships by extending PCP’s practices and coordinating better care to impact outcomes and downstream costs.

When we met the team, we were impressed by the depth of their experience in value-based care, dedication to patient outcomes, and sophistication of what they have created. Led by CEO Dr. Sanjay Doddamani, former Chief Medical Officer of Geisinger at Home, the team brings together deep financial expertise from Tom Tran, former Chief Financial Officer of Molina, as well as operational expertise from Steve Neorr, former SVP Population Health of Cone Health.

“On our quest to redefine healthcare, we were thrilled that Define Ventures invested in UpStream. They have tremendous expertise working with early-stage digital healthcare companies, supporting a diverse group of well differentiated portfolio companies. We feel right at home in this creative environment”

— Sanjay Doddamani, UpStream CEO

We look forward to starting our journey as partners and couldn’t be more excited about the opportunity to work together. UpStream plans to expand its model to multiple geographies across the country in 2023, resulting in the doubling of lives under management to 175,000. We are proud to support the team through this period of rapid growth.