Faris Ghawi and Amer Alnajar, Co-Founders of Vytalize Health, on building a VBC enabler

👋 Hey all! You may have seen a few weeks ago that value-based care enabler Vytalize Health made a few announcements — it raised $55 million, it is now profitable, and it is seeing 8% cost savings in its patient population.

Given Vytalize’s momentum in an otherwise challenging value-based care macro environment, I thought it’d be worth learning more about Vytalize and what they’re up to. Vytalize’s CEO Faris Ghawi and CMO Amer Alnajar gracious enough to answer some of my questions, which you’ll see below. I enjoyed learning from them about Vytalize’s model and how they sees the provider enablement market evolving over time. I hope you enjoy the interview!

- Kevin

Background:

I’ve long been a fan of the thesis that supporting independent primary care providers is a key component of a better performing healthcare ecosystem. Conceptually its one of those things that just makes sense to me — supporting local providers in caring for their communities seems like a good thing to me. Given that, one of the spaces in healthcare innovation that I’ve been most intrigued by over the last decade is VBC provider enablement.

The last decade has seen rapid growth in these types of value-based care enablers supporting providers in taking risk, alongside growth in risk-bearing care delivery companies. The market map below from Health Management Associates and Leavitt Partners I think highlights both the level of activity in, and the complexity of, this market:

As VBC enabler businesses have grown over the last decade plus, led by names like agilon, Aledade, Privia, VillageMD, Vytalize, and others, more questions have cropped up related to how well these models are working. Despite goals from the CMS Innovation Center (CMMI) of having 100% of traditional Medicare members in ACO programs by 2030, growth in programs like MSSP has stalled recently, as evidenced by the recent NEJM Catalyst post Crossing the Chasm: Marketing and Selling Value-Based Care to the Mainstream. agilon and Privia have both seen significant declines in their stock price as Wall Street has increasingly questioned the VBC enablement play. agilon’s stock is down 94% from its IPO in 2021, and Privia down 46% since its IPO, also in 2021. It underscores a tough macro environment for VBC at the moment.

Given those broader market challenges, it caught my attention seeing Vytalize’s recent announcement that it is now a profitable business and is seeing 8% cost savings on its members by year 3. When you combine that with the recent $55 million in funding it raised to pursue growth acquisitions, it certainly seems like Vytalize is seeing positive momentum even despite the challenging macro circumstances. Given that, I thought it would be fun to learn more about the Vytalize model and their views on the state of the provider enablement market.

Vytalize’s CEO Faris Ghawi and CMO Amer Alnajar were gracious enough to answer my series of questions below — enjoy!

Questions:

Grounding

1. Imagine I’m a primary care provider learning about Vytalize for the first time. How would you explain what you do to me? How is it different from other similar platforms talking to providers?

2. As I understand it Vytalize’s patients are pretty evenly spread across ACO REACH and MSSP. Could you provide an overview of your business in each model and key differences between the two from where you sit?

3. Recent reporting on Vytalize suggested that roughly 45% of your revenue is outside of Medicare, 30% coming from commercial and 15% coming from Medicaid. Coming into this, I would have expected substantially more than 55% of your revenue coming from Medicare programs – can you provide some details on the businesses in Commercial and Medicaid?

4. Every physician enabler seems to have a slightly different group of providers they choose to work with. I saw you have 1,000 practices, 3,000 PCPs, and 7,000 specialists today. What characteristics do you look for in partnering with providers? Are there provider types that you do not work with? How do you think about the interplay between PCPs and specialists in your model?

5. Milliman shared a white paper earlier this year analyzing how three contractual levers in MSSP (beneficiary assignment methodology, whether to early renew an agreement, track selection) could ultimately drive $10+ million swings in performance for a hypothetical ACO with ~30,000 members. That seems like a huge swing in financial outcomes that has nothing to do with improved clinical care, while it seems like the intent of VBC should be to tie better financial performance to better clinical care. I would imagine providers struggle with this complexity, and if anything the complexity distracts providers from clinical care. I struggle to understand why this state of affairs exists, it just seems so complicated and counter to the point of VBC. As an enabler, how do you process the importance of these financial levers versus clinical levers, and how do you help providers understand the decisions they’re making around things like assignment methodology?

Vytalize’s Model

1. You recently released a report sharing that you’re generating savings of 8% per patient per year. I’m sure you’ve seen the reports from other provider enablers as well – everyone cites stats around the savings their platforms generate. As an outsider to these companies, it makes it confusing to understand and evaluate – if every enabler generates these sorts of results, what is really unique? How would you encourage an industry observer to compare and understand what is really going on?

2. It seems like achieving better clinical outcomes requires some combination of clinicians choosing to do different things (i.e. prescribe a different medication) and patients choosing to do different things (i.e. do a virtual visit with you instead of going to the ER). Can you describe some examples of those actions for both providers and patients that are driving these clinical savings?

3. It seems like a number of organizations that have demonstrated strong clinical / financial performance at small scale struggle as they attempt to scale models to larger populations nationally. I imagine there is a tension between what competencies stay local with providers you’re working with and what you standardize at a national level. What’s your mental model for how you balance this tension?

4. For providers who choose to align with Vytalize and participate in an ACO, how does compensation look different for them versus how they’re paid in a FFS world? Do providers see any downside risk based on their performance if they are not performing as well as expected? I recognize the point of an ACO is to drive savings and share those savings with the providers, I’m curious to understand better how that actually happens in practice.

5. As you think about your success as a business, how much do you attribute to a proprietary technology platform you’ve built versus the operating model and operational knowhow? Is Vytalize a technology company that does VBC operations or a managed care organization with a technology stack?

VBC Market

1. There’s a lot of uncertainty around the future of ACO REACH and MSSP and how CMS will support each of these models moving forward. We saw CMMI earlier this year sunset a number of models, but not ACO REACH. When do you expect us to see more clarity on the path forward, and what do you think that will look like conceptually?

2. What do you think success looks like in terms of the adoption of value-based care in this country? What is the biggest challenge standing in the way of broader adoption of value-based care?

3. It seems like a big part of success in VBC is aligning with the right provider groups. Conceptually it seems like that means you need to do two things: 1. Win the trust of high performing groups, and 2. Avoid low performing groups. Would you agree with that framing, and how do you think about both of those things if so? I imagine that competition for the high performing groups is fierce, I’d be curious to learn how you ‘win’ versus other enablers who want to work with them as well.

4. It seems like one of the big trends in VBC is an increasing focus on high cost specialty areas to drive performance, recognizing that primary care only accounts for somewhere around 5% of healthcare spending. Increasingly we’re hearing payors and enablers talk about partnerships in cardiology, oncology, kidney care and other high cost specialty areas. How do you see the role of specialty care in your model evolving over time?

5. The sector has obviously faced significant headwinds with the implementation of v28 and changes to risk adjustment. Can you describe how you’ve navigated those impacts as v28 has phased in, and adjust tactical changes you’ve made as a business to adjust course? I’m specifically interested if there are changes you’ve made with your providers (i.e. more training on VBC) and with your payers (i.e. real-time data exchange, etc)

6. Conceptually it seems like there (at least) are four expansion levers for a business like Vytalize: 1. Geographic expansion within Medicare VBC, 2. Expanding in the Commercial and Medicaid markets, 3. expanding provider types (partnering with health systems), and 4. expanding from VBC into FFS contracts. How do you think about expansion levers for Vytalize and what is your framework for evaluating how / when / if to expand?

Interview

Q: Imagine I’m a primary care provider learning about Vytalize for the first time. How would you explain what you do to me? How is it different from other similar platforms talking to providers?

As a primary care provider, working with Vytalize means you'll have access to better data about your patients, evidence-based clinical recommendations through our Vytal Insights platform, financial incentives rewarding you when your patients are healthy, and dedicated, one-on-one support from physician peers to navigate value-based care. Our medical directors partner closely with you to understand your practice's unique needs, share best practices, and address pain points directly.

Unlike traditional ACOs, we reward your practice on a monthly basis, enabling you to invest the time and resources immediately. Additionally, our clinical teams can augment your existing staff when needed. Our easy-to-use clinical decision support tools surpass traditional population health tools, ensuring you can deliver the highest quality care efficiently.

Back to Questions.

Q: As I understand it Vytalize’s patients are pretty evenly spread across ACO REACH and MSSP. Could you provide an overview of your business in each model and key differences between the two from where you sit?

At Vytalize, we participate broadly in both programs and our value-based care approach in each shares a common foundation—emphasizing consistent, high-quality patient care designed around the quadruple aim of lowering costs, improving outcomes, and improving the patient and provider experience.

Both MSSP and ACO REACH are similar in that they are VBC programs for Public Medicare patients (vs. MA) and reward reductions in the total cost of care, with quality components. Important differences in the benchmark calculations and timing of payments exist however. For example, ACO REACH provides upfront capitation which offers ACOs advanced payments on savings, provides a Global Risk option offering ACOs 100% of shared savings, but also involves a “discount” to benchmark which effectively means Medicare retains the first few savings %. Other key nuances exist. For example on quality in MSSP, the focus is primarily on closing defined quality gaps, whereas in ACO REACH, the emphasis is shifted more towards utilization management, including timely follow-ups, reducing readmissions, and managing admissions. Additionally, in ACO REACH, the claims process flows directly through Vytalize, giving ACOs additional tools to partner with non-primary care providers, which is not the case in MSSP.

Overall, there are pros and cons to each program and we expect some convergence to take place over time. Despite the differences, the core is consistent: good clinical care drives lower costs and better outcomes in both models.

Back to Questions.

Q: Recent reporting on Vytalize suggested that roughly 45% of your revenue is outside of Medicare, 30% coming from commercial and 15% coming from Medicaid. Coming into this, I would have expected substantially more than 55% of your revenue coming from Medicare programs – can you provide some details on the businesses in Commercial and Medicaid?

You are correct in that while just under half of our attributed lives are outside of Medicare, Medicare does represent a significantly larger share of our revenue. We typically enter markets and partnerships through Public Medicare and then expand into other lines of business including MA, Commercial, and Medicaid. Our Commercial and Medicaid contracts include two-sided risk, upside-only, as well as other types of arrangements that are centered around PMPM payments and bonus payments tied to achieving specific quality metrics.

Back to Questions.

Q: Every physician enabler seems to have a slightly different group of providers they choose to work with. I saw you have 1,000 practices, 3,000 PCPs, and 7,000 specialists today. What characteristics do you look for in partnering with providers? Are there provider types that you do not work with? How do you think about the interplay between PCPs and specialists in your model?

Having started as an independent practice ourselves, we initially partnered primarily with independent PCP practices. Today, our network spans a variety of providers—including FQHCs, health systems, large multispecialty groups, and many independent practices of various sizes. We don't choose partners based solely on provider type or label; instead, we look for alignment in core values, specifically a commitment to improving care quality and succeeding in value-based care. Although health systems have historically been seen as challenging to engage in value-based models, we've found great success partnering with those genuinely invested in VBC principles. Equally crucial is working with specialists who share these values, embrace open dialogue and win-win partnerships, and actively collaborate with PCPs rather than operate independently. We cast a wide net when it comes to the EMRs the practices use and the size of the practice, which allows us to be selective in working with committed, high-performing practices while maintaining a large TAM.

Back to Questions.

Q: Milliman shared a white paper earlier this year analyzing how three contractual levers in MSSP (beneficiary assignment methodology, whether to early renew an agreement, track selection) could ultimately drive $10+ million swings in performance for a hypothetical ACO with ~30,000 members. That seems like a huge swing in financial outcomes that has nothing to do with improved clinical care, while it seems like the intent of VBC should be to tie better financial performance to better clinical care. I would imagine providers struggle with this complexity, and if anything the complexity distracts providers from clinical care. I struggle to understand why this state of affairs exists, it just seems so complicated and counter to the point of VBC. As an enabler, how do you process the importance of these financial levers versus clinical levers, and how do you help providers understand the decisions they’re making around things like assignment methodology?

This is the elephant in the room and one we hope the industry pays particular attention to. Far too much energy is wasted on financial levers aimed at “getting the math right,” taking important resources away from true value creation.

While we believe public Medicare programs like MSSP and ACO REACH are substantially closer to measuring “true value,” levers you mentioned like beneficiary assignment methodology, track selection, and renewal timing—or others like which program to participate and place practices in, ACO construction, and even risk adjustment, are all variables that have a big impact on performance and yet don’t have a corresponding impact in true value creation.

The ability to isolate the noise (i.e. financial levers) is key. That's why our actuaries and medical economics teams strip out program mechanics and risk adjustment factors when analyzing our results, allowing us to clearly measure how much of our savings come from medical cost reduction on an apples-to-apples basis.

We firmly believe sustainable success in value-based care comes from clinical excellence and lower medical expenses rather than mastery of program nuances. Ultimately, program nuances can and should be changed with a stroke of a pen, while true cost savings and quality improvement will always be of value.

Back to Questions.

Q: You recently released a report sharing that you’re generating savings of 8% per patient per year. I’m sure you’ve seen the reports from other provider enablers as well – everyone cites stats around the savings their platforms generate. As an outsider to these companies, it makes it confusing to understand and evaluate – if every enabler generates these sorts of results, what is really unique? How would you encourage an industry observer to compare and understand what is really going on?

At Vytalize, we understand why these savings figures can seem confusing from an outsider's perspective, as many companies report similar numbers. However, what's unique about our recent report is that we deliberately removed risk coding and other revenue optimization (financial levers) from the equation. Many reported "savings" in our industry can be inflated by better documentation or risk adjustments rather than true clinical improvements. In contrast, we worked with third-party actuaries to strip out those factors, isolating genuine medical cost reductions driven purely by better care delivery.

Our data is from 600,000 patient-years and covers 7 years of performance history. Additionally, our analysis isolates the impact of changes in practice participation in our ACOs. Other analyses might show overall improvement in cohort performance driven by the removal of underperforming practices, which is one lever available to ACOs but is not the same as actually improving care and lowering costs at the same practices year over year. By demonstrating sustained clinical improvement within consistent cohorts, we clearly highlight what differentiates true clinical transformation from superficial savings that are not sustainable long-term.

Our report also provides a breakdown of savings by cost category (Inpatient, SNF, Outpatient, Home Health and Hospice).

Here’s a chart we shared Vytalize bending the cost of medical expenditures per beneficiary per year (PBPY) compared to its region:

To put this in perspective – if these savings were scaled to all Medicare beneficiaries, it would save CMS $3 Trillion over the next decade.

Back to Questions.

Q: It seems like achieving better clinical outcomes requires some combination of clinicians choosing to do different things (i.e. prescribe a different medication) and patients choosing to do different things (i.e. do a virtual visit with you instead of going to the ER). Can you describe some examples of those actions for both providers and patients that are driving these clinical savings?

Completely agree. Here's a simple, well-known example of how VBC drives clinical savings through coordinated provider and patient actions:

Before Vytalize, if a patient got admitted to the hospital, their PCP might be unaware, leading to critical gaps in care. For instance, upon discharge, the patient could be prescribed medications that interact poorly with their outpatient regimen because the hospital wasn't fully informed, and the patient wasn't able to provide a complete medication history. This often resulted in avoidable readmissions shortly afterward.

With Vytalize, the process looks very different:

• Preparation: Through financial incentives and proper planning, busy practices create space in their schedules for last-minute appointments.

• Provider action: Through real-time ADT alerts, the PCP is immediately informed the moment their patient is admitted and discharged from the hospital. Vytalize’s clinical team proactively supports the practice, helping schedule a timely follow-up—typically within 2-3 business days after discharge.

• Patient action: The patient attends this timely follow-up visit rather than waiting for complications to arise or resorting to emergency care.

• Provider action: At this visit, the PCP conducts thorough medication reconciliation, catching and correcting potential medication issues early. As a result, the patient avoids unnecessary complications or readmissions. Additionally, through Vytal Insights, the provider may also see recommendations for other actions that may be appropriate for that patient while they are there.

This interplay between timely provider action and proactive patient participation is exactly what drives the meaningful clinical and financial outcomes we achieve.

Back to Questions.

Q: It seems like a number of organizations that have demonstrated strong clinical / financial performance at small scale struggle as they attempt to scale models to larger populations nationally. I imagine there is a tension between what competencies stay local with providers you’re working with and what you standardize at a national level. What’s your mental model for how you balance this tension?

Completely agree—scaling introduces new complexities. We started as a primary care practice ourselves, so we've experienced firsthand the nuances of expanding from independent PCPs to health systems, recognizing that each provider type brings unique dynamics. We've also learned that not every practice fits neatly into a standardized mold; each requires adaptation and tailored support to succeed in value-based care.

One of the benefits of Public Medicare vs. MA is the ability to grow in a capital efficient way, acquiring patients by partnering with practices vs. enrolling one patient at a time and paying insurance broker fees, etc.

Our mental model emphasizes balancing thoughtful growth without diluting quality or the support provided to existing partners. This is how we have been able to achieve profitability. We prioritize alignment of core values and ensure practices have sufficient time and resources to master our model. Additionally, we're highly focused on ROI, ensuring medical expense reductions are sustainable—avoiding programs that spend two dollars to save one. In fact, for every successful initiative we have today, there are probably two others that looked promising on paper but didn’t materialize. This disciplined approach is supported by a team whose talent and experience have been dedicated to sustainable medical expense reduction since our launch in 2014. In short, we emphasize controlled, values-aligned growth, maintaining clinical excellence and preserving what makes us effective as we continue to scale.

Back to Questions.

Q: For providers who choose to align with Vytalize and participate in an ACO, how does compensation look different for them versus how they’re paid in a FFS world? Do providers see any downside risk based on their performance if they are not performing as well as expected? I recognize the point of an ACO is to drive savings and share those savings with the providers, I’m curious to understand better how that actually happens in practice.

At Vytalize, provider compensation is purely additive—we never subtract from what providers already earn. Physicians continue collecting their full fee-for-service (FFS) revenue, exactly as before. On top of that, we introduce new revenue streams, such as per-member-per-month (PMPM) payments for important clinical activities. At year-end, providers also participate in shared savings.

Importantly, we don't require any of our providers to take downside risk—meaning if the ACO doesn't generate savings, they're not penalized. However, we're increasingly seeing more advanced practices actively seeking arrangements with greater upside potential that include taking on downside risk, which we also welcome.

We designed this provider-friendly model intentionally, reflecting our foundational identity as a PCP-led organization co-founded by two primary care physicians. It's a core reason behind our rapid growth and why we believe we offer the strongest primary care product in the market.

Back to Questions.

Q: As you think about your success as a business, how much do you attribute to a proprietary technology platform you’ve built versus the operating model and operational knowhow? Is Vytalize a technology company that does VBC operations or a managed care organization with a technology stack?

Value-based care enablement uniquely combines the complexities and value propositions of technology companies, provider organizations, health plans, and financial services—all within a single business model. Each of these is needed to succeed and by intentionally blending these competencies, we believe Vytalize is uniquely positioned to deliver differentiated value in the market and scale effectively.

We think of Vytalize as a tech-enabled clinical services company—meaning our success stems from interwoven competencies: proprietary technology, operational excellence, and managed-care expertise. Our proprietary platform, Vytal Insights, powers our clinical decision-making with deeper analytics and actionable insights that traditional population-health tools can't match. At the same time, our operational model and extensive managed-care know-how ensure these insights translate directly into better clinical outcomes and financial results.

Back to Questions.

Q: There’s a lot of uncertainty around the future of ACO REACH and MSSP and how CMS will support each of these models moving forward. We saw CMMI earlier this year sunset a number of models, but not ACO REACH. When do you expect us to see more clarity on the path forward, and what do you think that will look like conceptually?

We expect CMS will clarify the future of ACO REACH soon, likely either maintaining the current structure or integrating its core principles into MSSP. We have all scenarios modeled and from Vytalize’s perspective, our clinical approach is fundamentally similar across both programs, so whether ACO REACH continues independently, is replaced by another program, or features of it are incorporated into MSSP, it doesn't materially impact our practices or operations.

Importantly, we've reached a scale where we're cash flow positive and EBITDA positive, meaning we no longer depend on ACO REACH advances. We have intentionally structured ourselves to succeed and drive value-based outcomes regardless of CMS’s decision on ACO REACH. That being said, we believe there are attractive features in each program that the market would benefit from combining rather than needing to choose from.

At the end of the day, we believe the more flexibility there is, and the simpler the programs are, the better. In many ways, less is more with these programs - by setting the goals right, aligning incentives, and removing program kinks such as the financial levers we mentioned above, ACOs will have what they need to succeed in value-based care, and these programs will fix our broken healthcare system.

Back to Questions.

Q: What do you think success looks like in terms of the adoption of value-based care in this country? What is the biggest challenge standing in the way of broader adoption of value-based care?

Success in value-based care would mean widespread adoption—not just among a small subset of primary care providers, but the vast majority. It would involve most health systems deeply embracing VBC, along with meaningful participation from specialists and downstream providers, creating a unified ecosystem focused on outcomes and quality.

The biggest barrier to broader adoption today is complexity—particularly in CMS's approach. To address this, CMS could simplify benchmark methodologies by streamlining financial and risk calculations, reducing overly steep discounts applied to new practices entering VBC. Shifting away from substantial upfront discounts and instead emphasizing shared savings derived from genuinely bending the cost curve would further incentivize provider participation and promote sustainable, long-term success in value-based care.

Back to Questions.

Q: It seems like a big part of success in VBC is aligning with the right provider groups. Conceptually it seems like that means you need to do two things: 1. Win the trust of high performing groups, and 2. Avoid low performing groups. Would you agree with that framing, and how do you think about both of those things if so? I imagine that competition for the high performing groups is fierce, I’d be curious to learn how you ‘win’ versus other enablers who want to work with them as well.

VBC programs reward providers who have historically been high performers. This is positive and consistent with a well aligned capitalistic system that rewards better healthcare outcomes. However, real value creation involves improving practice performance, regardless of the starting point. This comes into play when competing for provider groups - high performing practices also need to know that by partnering with an enabler like Vytalize, that they will be able to perform even better.

We differentiate ourselves by offering a compelling value proposition that includes a proven ability to improve performance through data, robust clinical resources, and extensive hands-on support. This proven track record of driving measurable practice improvement and delivering consistent clinical and financial outcomes is what sets us apart and fuels our sustainable growth and success in value-based care.

Back to Questions.

Q: It seems like one of the big trends in VBC is an increasing focus on high cost specialty areas to drive performance, recognizing that primary care only accounts for somewhere around 5% of healthcare spending. Increasingly we’re hearing payors and enablers talk about partnerships in cardiology, oncology, kidney care and other high cost specialty areas. How do you see the role of specialty care in your model evolving over time?

You're right—specialty care significantly drives healthcare spending, and at Vytalize we've already started evolving our model to address this. Initially, we developed a preferred network of high-quality specialists, clearly communicated to our PCPs through our platform, enabling us to steer away from lower-performing providers and direct patients toward proven specialists.

Beyond that, we're actively developing aligned incentives and "win-win-win" relationships among specialists, PCPs, and patients. For example, we incentivize specialists to perform appropriate procedures in outpatient rather than inpatient settings, benefiting patients, lowering total healthcare spend, and financially rewarding both specialists and PCPs. Similarly, we encourage close coordination between specialists and PCPs, reinforcing the shared goal of better outcomes at lower costs.

Additionally, we've partnered strategically with specific specialists and post-acute providers and now have dozens of these arrangements—each robust enough to be a successful standalone business—covering ophthalmology, oncology, skilled nursing, and more. Over time, these specialty partnerships and enablement collaborations will become increasingly central to our VBC strategy, enhancing care integration, amplifying savings, and strengthening our overall provider network.

Back to Questions.

Q: The sector has obviously faced significant headwinds with the implementation of v28 and changes to risk adjustment. Can you describe how you’ve navigated those impacts as v28 has phased in, and adjust tactical changes you’ve made as a business to adjust course? I’m specifically interested if there are changes you’ve made with your providers (i.e. more training on VBC) and with your payers (i.e. real-time data exchange, etc)

Frankly, we've always focused more heavily on clinical interventions rather than risk coding—likely because our founders come from primary care backgrounds rather than payer or coding-focused organizations. As a result, the shift to v28, while impactful industry-wide, has affected us less significantly than our peers who relied more heavily on coding optimization.

That said, we continue to educate and support our PCPs to ensure accurate coding, mainly because it enhances clinical care by accurately identifying patient risk. We recognize accurate coding is necessary and don't want to under-code, but we fundamentally believe that real, sustainable success in value-based care will come from true clinical improvements and medical cost reductions, rather than short-term gains from risk coding alone.

Back to Questions.

Q: Conceptually it seems like there (at least) are four expansion levers for a business like Vytalize: 1. Geographic expansion within Medicare VBC, 2. Expanding in the Commercial and Medicaid markets, 3. expanding provider types (partnering with health systems), and 4. expanding from VBC into FFS contracts. How do you think about expansion levers for Vytalize and what is your framework for evaluating how / when / if to expand?

I think your framing is spot-on. At Vytalize, our expansion strategy typically follows a clear progression, guided by a structured evaluation framework. We initially enter new geographies through Medicare VBC contracts, creating a foundation and establishing initial density. As our practice cohorts mature and performance stabilizes, we achieve built-in growth from existing attributed lives, as well as organic growth through referrals from current practices recommending us to their peers.

Once we've developed sufficient density in a market, we expand into MA, Commercial and Medicaid contracts, significantly increasing lives per practice through new payer relationships. Historically, we've primarily partnered with independent PCPs, but we're now accelerating our growth through strategic ACO roll-ups and expanding our scope to include health systems, multispecialty groups, and FQHCs from the outset.

Additionally, we strategically pursue vertical acquisitions that provide key capabilities to strengthen our enablement platform. Importantly, our expansion decisions are frequently driven by provider feedback and demand—once practices experience success in Medicare, they actively ask us to support them across their broader payer mix. This provider-led approach ensures alignment, maintains consistent value, and fuels sustainable growth.

Back to Questions.