Upperline Health Snags $58M for Its Network of Value-Based Specialty Care Clinics

MedCity News

Jun 13, 2023 | Katie Adams

View original article at MedCity News

Upperline Health, a provider network focused on value-based specialty care, recently raised $58 million. The startup identifies patients who are seeing specialists four or more times a year and provides them with an interdisciplinary care team that treats them at a clinic, in their home or via phone.

Specialty care is ready for more value-based care models, and investors are helping that transformation move along. Venture funds and angel investors recently funneled $58 million into Upperline Health, a Nashville-based provider network focused on value-based specialty care.

The funding round, announced Wednesday, was led by Crestline Investors. It brings the startup’s total funding to date to $79 million.

Upperline was founded in 2017 with the mission to improve Americans’ health by “providing a treatment-over-triage approach,” CEO David Thorpe said in an interview. The company identifies patients who are seeing specialists four or more times a year and provides them with an interdisciplinary care team that treats them as a whole person rather than a list of diagnoses, demographics and symptoms, he explained.

About 70% of healthcare providers are specialists, yet they have largely been left out of the value-based care environment so far, Thorpe pointed out.

“The math doesn’t work — there aren’t enough primary care providers to serve every Medicare patient, especially if you want providers to spend more than 15 minutes with a patient. We also know that patients with chronic conditions typically see more specialists, and the more specialists they see, the less they receive primary care. Thus, a large portion of our sickest patients are not getting the care they need and deserve despite seeing a number of providers each year,” he declared.

To address this problem, Upperline has established 122 value-based care clinics across the following seven states: Alabama, California, Florida, Georgia, Indiana, Kentucky and Tennessee. These clinics serve 350,000 patients annually.

The staff members who work at these facilities are trained under the startup’s comprehensive care model. These healthcare workers — including physicians, care navigators, pharmacists, social workers and dieticians — provide complementary services in the clinic, in patient’s homes and via phone.

Upperline’s patient base of individuals with chronic and complex conditions is similar to groups like Landmark Health and other largely home-based care models, Thorpe said. He argued that his company differentiates itself through its specialty approach and by primarily seeing patients in the clinic setting.  

This care model is beneficial for both specialists and primary care physicians, Thorpe declared. Upperline’s approach allows specialists to broaden their view of the patient and “utilize their full training and license,” he explained. As for primary care physicians, he argued that Upperline helps them co-manage their sickest patients — who are oftentimes disengaged — via additional home visits, 24/7 call services and care coordination assistance.

Upperline provides value to patients as well, Thorpe pointed out.

“Patients don’t have to change their behavior. Upperline Health meets them where they are — whether it’s in the doctor’s office, in their home or via phone — to receive the care they need. They get a personalized navigator and interdisciplinary care team that overlays whatever providers they currently have so they don’t need to give up those relationships,” he said.