Greater Good Health raises a $20.5 million Series B on the conviction that the future is people taking care of people

This morning, Greater Good Health announced a $20.5 million Series B funding round led by Allumia Ventures, along with a $12.5 million venture debt facility from HSBC.

Greater Good Health sits at the intersection of a few different themes that have been top of mind for us at Health Tech Nerds including the expanding role of nurse practitioners in US health care delivery, the challenges states and payers are having with recruiting primary care providers in certain parts of the country, and a Medicare Advantage market where Star Ratings are increasingly make or break for plans.

Below you’ll find a short video interview I did with the Greater Good Health team, along with a longer-form, written Q&A with Founder and CEO Sylvia Hastanan about the business, the care model, and the policy landscape.

- Martin

Q1: Nurse practitioners are not a new concept; the University of Colorado established a training program in 1965. But it seems like there’s been a shift recently in how nurse practitioners are shaping care delivery. You’ve seen some of this trajectory firsthand at HealthCare Partners, Davita, Optum, and now leading Greater Good Health. Can you walk us through how the role has changed from your perspective over your time in healthcare? 

Q2: I think a lot about this article from KFF, where a small town in Florida is looking for a doctor: “The town’s recruitment campaign has drawn a lot of interest from nurse practitioners, but few primary care physicians have applied for the position. Town leaders say they’re holding out hope of finding a family physician who can practice and prescribe medications independently.” Do you see any of this from patients or leaders in the places you’re working? Have attitudes towards NPs shifted or changed from your perspective?

Q3: One of the primary concerns that seems to be cited by providers when arguing that NPs shouldn’t be able to practice on their own is that patient safety may be impacted. Given the general critique of NP-centric models, I’d be curious to better understand how you think about your care model as an organization. How do you think about the tension between standardizing care pathways and allowing NPs the freedom to practice? What are the core tenets of your care model that you seek to standardize?

Q4: Can you talk about the Greater Good Health business model? On your website, you list out three customer groups: patients, health plans, providers, and insurance brokers. From what I understand, the second category seems like it is likely to be your primary revenue stream. How does Greater Good work with health plans and providers? Are you primarily partnering with organizations that take on risk and have the Greater Good Health NPs providing population health support on a PMPM basis, or are you doing direct clinic operations in provider-shortage areas? In the direct clinic segment, are you managing risk? 

Q5: The current market dynamics in Medicare Advantage are challenging with v28, higher Star Rating quality thresholds, and a forecast for a modest drop in MA enrollment next year. I could see these dynamics as a headwind or a tailwind for your business. What are you seeing as an operator? We’ve heard that risk-bearing providers are feeling the brunt of the market correction as the percentage of premium contracts have gotten squeezed by the revenue hit to the industry. How are risk-bearing providers and payers thinking about their strategy for going forward, and where Greater Good Health fits in? Given the challenges risk-bearing providers face in particular, are you seeing more success selling into payers recently?

Q6: The physician shortage, especially in primary care, is one of the defining challenges of healthcare right now. Despite an increased focus on the supply side and “abundance” solutions from the think tank world, the US still ranks last in terms of GPs per capita among similarly situated countries. What are the root causes behind this extreme supply/demand mismatch? Greater Good Health operates clinics in Montana and Idaho. What about these states has made it hard to keep physicians, but conducive to Greater Good Health building out clinics? 

Q7: The BLS expects nurse practitioners to be in the top three fastest-growing professions over the next decade. On the one hand, it seems like NPs are an obvious solution to physician shortages. But the AMA does very intense advocacy work on what they term “scope creep” of NPs and PAs. From my cursory scan of the literature, the question of relative quality, safety, and efficacy seems to be an unresolved question, with the AMA and AANP both citing research that seems to conflict. Obviously, you’re not a strictly neutral party here, but the question that always comes to mind for me is that in places like Montana and Idaho, which both have more expansive scope of practice laws, the choice isn’t between an NP and a physician, but between an NP and no care at all. Is that accurate? How does Greater Good Health, as an organization, navigate what seems to be a fraught relationship between the two professional associations?

Q8: In the Rural Health Transformation Program notice of funding opportunity, there’s a Scope of Practice category with CMS awarding no points for states with restricted scopes of practice. Do you see this as a tailwind for Greater Good Health, and what’s your perspective on what other policy changes or interventions would help unlock the supply of NPs and meet the demand for care delivery?

Q9: Right now, Greater Good Health is focused on primary care for seniors, but two other areas where NPs are making big impacts are behavioral health and obstetrics & gynecology for Medicaid patients. Is there any interest from your payer partners in expanding Greater Good Health’s scope and model beyond seniors and primary care?

That’s right, the role of NPs and all advanced care providers, in fact, has certainly evolved over the last decade.

From a supply perspective, nurse practitioners are the fastest-growing healthcare profession, with a 40% year-over-year increase. According to the American Association of Nurse Practitioners (AANP), nearly 90% of NPs are certified in primary care, and more than 70% work in primary care roles.

From a training perspective: NPs are trained in a nursing model with a focus on chronic disease management, prevention, and social determinants of health – all things that support value-based care. With this nursing training myself, I can attest that philosophically the practice is very implementation-focused, patient-education focused, and care coordination focused.

From a need perspective: In my experience, specifically in primary care, nurse practitioners are often an overlooked and untapped workforce. Often, NPs are used to backfill, support, and extend physicians, but here at Greater Good Health, we believe that NPs can, should, and need to step into larger roles and take on more accountability for patients. However, most healthcare spaces have largely lacked the platform, model, and infrastructure for them to do so. And that’s where Greater Good Health’s NP-led care model comes into play.

Back to Questions

Yes! Attitudes have shifted; if not because people understand the scope of practice laws and technical capabilities of NPs, but purely out of necessity.

There is an ongoing shortage year after year of primary care physicians in this country, especially in smaller rural markets. We see it firsthand. In some communities we are in, the physicians who are in the market are sometimes unwilling or unable to care for seniors and patients with Medicare. This is a more pervasive problem than people realize.

Thanks to strong advocacy of this shortage issue, our legislators have taken action, and nearly 30 US states and territories have passed laws allowing nurse practitioners to practice autonomously without physician oversight (Full Practice Authority), including prescribing.

But back to your question about attitudes and perspectives: Prior to opening our Montana and Idaho clinics, Greater Good Health conducted focus groups with seniors and experienced very little pushback about receiving care from NPs. We also learned that seniors value and prioritize access to quality care over provider credentials. During our first few years in operations, we have not experienced much pushback on our clinicians’ credentials. Is there opportunity for clarity and awareness of what NPs can do - sure. But once they walk in and understand how we can help simplify healthcare for them, all those barriers are lowered. Don’t take my word for it - our growth and high patient satisfaction scores are good evidence of that.

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Let’s go back to the data. Greater Good Health’s NP-led clinics are outperforming every other value-based care provider in our markets across key clinical metrics, based on results reported directly from our health plan partners. When compared with physician-led peers, our patients spend less time in the ED, more time engaged with our care teams, achieve higher quality scores, and experience better outcomes.

There is ongoing noise about whether NPs can manage patients independently, without physician oversight. Yet AANP-supported research consistently shows that the quality of care delivered by NPs in primary care settings is equivalent to — and in many cases better than — that of physicians. Claims about compromised safety or quality simply aren’t supported by evidence, which is why more state legislatures continue to advance Full Practice Authority. And as patients receive care from NPs, they overwhelmingly prefer to continue seeing them — a trend we see every day in our clinics.

Our early success is rooted in a standardized, relationship-driven care model that enables our clinicians to practice at the top of their license. Several key elements of this model include:

Back to Questions

Yes, we partner directly with health plans and risk-bearing provider organizations – these partnerships are our primary drivers of revenue. We partner with groups in two ways:

In any market, Greater Good Health partners with payers and risk-bearing providers to offer our Integrated Clinical Solutions, which address key value-based care objectives such as risk adjustment, quality improvement, care transitions, and high-risk population management. Our private-labeled programs operate as an extension of our partners’ existing PCP network, providing seamless support where existing PCPs and clinical programs may be underperforming or overwhelmed.

In access-starved markets: In discussions with our payer partners, we identified markets, such as Montana and Idaho, with inadequate provider networks and limited access to care. To address this, we partner with health plans to establish new primary care facilities, deploy an NP-led care team, and engage in value-based provider agreements, including capitated payment models and shared total cost of care risk. In these cases, we operate the primary care clinics and are the PCP of record.

Back to Questions

I understand why these market factors may be obstacles for some organizations. Venture capital and public markets seem to view them as such. However, there are a few realities that make the current market particularly favorable for Greater Good Health.

First, with the shift to v28, payers and risk -bearing providers have become acutely aware that success requires much more than a strong risk adjustment program. Greater Good Health’s suite of programs is designed to impact quality and MLR overall by managing all aspects of population health. Many of the legacy service and technology companies in our space are more narrow point solutions that cannot be configured across a broad range of clinical and business objectives.

Second, by positioning our own primary care clinics in markets where access to care has been a barrier for patients, we find that we are inheriting patients who have largely been unmanaged for years. These markets are less impacted by some of the national trends you mentioned, which have afforded us a lot of opportunity to move the needle in terms of both clinical and financial outcomes for our patients and payer partners. 

Back to Questions

Several factors contribute to the nationwide shortage of primary care physicians: the high cost of medical education, which pushes graduates toward higher-paying specialties; the heavy administrative burden on primary care providers; limited residency slots; a generational shift toward “lifestyle” specialties with greater earning potential and work-life balance; and ongoing healthcare consolidation.

States like Montana and Idaho face additional hurdles — rural geography, lower population density, fewer academic training centers, and compensation models that are often less competitive than urban markets. These dynamics make it difficult to recruit and retain physicians in these communities.

All of these realities led me to build Greater Good Health with a focus on investing in nurse practitioners and preparing them to serve as the value-based primary care providers of the future.

Back to Questions

When it comes to addressing the most acute shortages in rural communities, several factors have contributed to our success:

Although there is ongoing resistance from the AMA and other physician-aligned groups, we choose to focus our energy on developing and supporting our NPs rather than engaging in political disputes. The AANP has been clear and steadfast in its advocacy for NP autonomy, and we stand behind its efforts. Meanwhile, our outcomes speak for themselves. Two years into our primary care work, I’m proud to say we’re proving the effectiveness and value of NP-led care. 

Back to Questions

We’re encouraged that 30 US states and territories now grant Full Practice Authority to nurse practitioners and other advanced practice providers. Still, there is work ahead to ensure NPs are fully recognized and leveraged as primary care providers. The AANP continues to lead important advocacy efforts in this space, and we’re proud to support their work.

The Rural Health Transformation Program is another meaningful step forward. Every state has rural communities struggling with provider shortages, and programs like this help accelerate solutions. Our hope is that it fuels greater momentum and support for NPs and other essential care team members — because expanding access is truly a team effort. If the goal is to close care gaps, we need everyone to contribute.

Ultimately, the strongest way to sustain this momentum is to consistently demonstrate and share high-quality clinical outcomes that reinforce CMS and CMMI’s direction.

Back to Questions

Yes, that’s correct. Many of our peers are doing incredible work serving those populations, and we’re supportive of that impact. While we’ve begun to engage in adjacent lines of business that touch Medicaid and ACA members, as a growing organization, I want to ensure we demonstrate strong, defensible outcomes before expanding too broadly. For now, staying focused on seniors is the most disciplined strategy. That said, I’m confident there will be future opportunities for Greater Good Health to serve these populations — and potentially more specialized segments —  when the timing is right. 

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