Alignment Health

What Alignment Health does

Alignment Health is a publicly traded Medicare Advantage insurer (NASDAQ: ALHC) founded in 2013 and headquartered in Orange, California, exclusively focused on serving Medicare-eligible seniors across five U.S. states: Arizona, California, Nevada, North Carolina, and Texas. As of Q1 2026, the company provides health plan coverage to approximately 284,800 members through 68 plan options across 45 counties, including 24 Special Needs Plans targeting chronically ill seniors and culturally tailored products such as the el ÚNICO plan for Hispanic seniors. The company generates revenue primarily through CMS capitation premiums for each enrolled member, supplemented by revenue from coordinated healthcare services delivered through its provider networks, and reported FY2025 revenue of $3.95 billion (46.1% year-over-year growth) and Q1 2026 revenue of $1.24 billion (33.3% YoY growth).

The company's core technology platform is AVA, a proprietary AI-powered command center that processes eligibility, claims, encounter, and remote patient monitoring data across the full membership every 30 minutes to drive risk stratification, anomaly detection, predictive clinical insights, and process automation. Layered on top of AVA is the ACCESS On-Demand Concierge service, which provides 24/7 board-certified physician access via phone or video, a dedicated concierge team, a branded concierge card, and supplemental benefits including transportation (via Uber Health and Lyft integrations), grocery allowances, and Part B rebates up to $185. Member-facing delivery is supported by the Care Anywhere physician-led program for in-home and virtual care.

Alignment Health distributes its plans through direct sales during the annual Medicare enrollment window (October 15 to December 7), licensed insurance broker channels, and referrals from a network of major health system partners including Sutter Health, Scripps Health, PIH Health, Intermountain Health, Brown & Toland Physicians, Triangle Senior Care Group, and Suvida Healthcare. The company is led by founder and CEO John Kao (who assumed the additional Chairman role in May 2026) with an executive team drawn from Optum, Cigna, Humana, TriZetto, and Intermountain. The company went public on NASDAQ in March 2021, raised $330 million in convertible senior notes in November 2024, and was added to the S&P SmallCap 600 index in May 2026.

Name

Alignment Health

Legal name

Alignment Healthcare USA, LLC

Website

https://alignmenthealth.com

Company type

Public

Founded year

2013

Operating status

Operating

Headcount range

1,001–5,000 employees

Short description

Alignment Health is a publicly traded Medicare Advantage insurer (NASDAQ: ALHC) exclusively serving approximately 284,800 Medicare-eligible seniors across Arizona, California, Nevada, North Carolina, and Texas. It combines an AI-powered care management platform (AVA), 24/7 concierge services, and partnerships with major regional health systems.

Ownership category

akta.pro rank

Product category

Medicare Advantage Health Insurance

NAICS

Services for the Elderly and Persons with Disabilities (62412)

SIC

Hospital & Medical Service Plans (6324), Insurance Agents, Brokers & Service (6411)

akta.pro primary industry

Medicare Advantage (MA) Plans (FSAIAGAA)

akta.pro secondary industries

Medicare Advantage HMOs (HMO/HMO-POS) (HLAEAMAH), Care Transitions Management (Hospital/SNF-to-Home) (HSABAIAC), Benefits, Insurance & Entitlement Navigation (Medicare/Medicaid/VA/LTC) (HSABAIAG)

Keywords

• Medicare Advantage plans
• Senior healthcare coverage
• Coordinated care services
• Special Needs Plans
• Health plan concierge

Headquarters

HQ city

Orange

HQ country

United States

HQ region

North America

Offices1 record

Markets served

GTM type

B2C

Offering type

Services

Cost components

Operations, Personnel, Marketing or Sales, Technology or R&D, Infrastructure

Revenue model

1. Medicare Advantage Premiums: Alignment Healthcare generates revenue primarily through Medicare Advantage premiums paid by CMS for each enrolled member. The company offers health plan options and receives capitated payments for providing coordinated care to seniors.
2. Healthcare Services Revenue: Revenue from providing coordinated care, clinical services, and care management to Medicare Advantage members through its provider networks and clinical teams.

Pricing tiers

Go-to-market motion1 record

Distribution channels4 records

Marketing channels6 records

Core offering

Alignment Health provides Medicare Advantage health insurance plans to Medicare-eligible seniors across five states (Arizona, California, Nevada, North Carolina, and Texas), offering HMO plans that include coordinated clinical care, the 24/7 ACCESS On-Demand Concierge service, the Care Anywhere physician-led in-home and virtual care program, and supplemental benefits such as dental, vision, transportation, and grocery allowances. The company also offers 24 Special Needs Plans (SNPs) for chronically ill seniors and the culturally tailored el ÚNICO plan for Hispanic seniors.

Differentiator

Problem solved

Functional benefit

Brands

• ACCESS On-Demand Concierge: 24/7 concierge service providing members access to doctors, appointment scheduling, transportation, and healthcare support
• AVA
• Care Anywhere
• el ÚNICO

Products and services

• Medicare Advantage HMO Plans Medicare Advantage HMO health insurance plans for Medicare-eligible seniors across Arizona, California, Nevada, North Carolina, and Texas, providing comprehensive benefits including hospital, medical, dental, vision, hearing, transportation, and supplemental benefits. Plans are rated 4 stars or higher by CMS, with Nevada and North Carolina plans achieving 5-star ratings.
• Special Needs Plans (SNPs) 24 Special Needs Plans targeting chronically ill seniors requiring specialized care management for conditions such as diabetes, hypertension, and high cholesterol, with demonstrated 18.5 percentage point improvement in medication adherence rates.
• ACCESS On-Demand Concierge 24/7 concierge service providing members with round-the-clock access to board-certified doctors by phone or video, a dedicated concierge team, appointment scheduling, transportation arrangement, and a black card for purchasing eligible items. Served 182,000 members in 2025.
• Care Anywhere Physician-led care program providing in-home and virtual care services to Alignment Health Plan members, enabling care delivery across in-person, in-home, and virtual care settings.
• el ÚNICO Plan Culturally tailored Medicare Advantage plan designed specifically for Hispanic seniors, providing bilingual provider access and culturally competent care, particularly in Arizona.

Quantifiable outcome

• 34% fewer emergency room visits per 1,000 members compared to pre-pandemic Medicare fee-for-service benchmarks
• +6 more outcomes

Named customers6 records

Segments3 records

Ideal customer profiles3 records

Technology focussed Yes

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Integration3 records

AI capability5 records

Feature3 records

Partnerships

Seven partnerships are on record, tiered core.

• Intermountain HealthcoreStrategic or Co-development Partner · 14 October 2025Alignment Health Plan and Intermountain Health launched a new $0-premium, 5-star Medicare Advantage plan in Clark County, Nevada. The co-branded plan offers comprehensive benefits including transportation, caregiver support, and allowances for health-related expenses.
• Suvida HealthcarecoreStrategic or Co-development Partner · 1 October 2025Partnership to expand bilingual primary care access for Spanish-speaking seniors in Arizona's Pima and Maricopa counties, targeting approximately 2.3 million Hispanic residents and including Alignment's culturally tailored el ÚNICO plan.
• Sutter HealthcoreStrategic or Co-development Partner · 18 March 2025Sutter Health and Alignment Healthcare renewed their long-term strategic collaboration, adding 76 new facilities to their Medicare partnership. The partnership provides Sutter's extensive network of providers to Alignment's Medicare Advantage members in Northern California.
• Scripps HealthcoreStrategic or Co-development PartnerPartnership adding 950+ primary care and specialist physicians from Scripps Clinic and Scripps Coastal Medical Center to Alignment's San Diego network, providing in-network care access to Medicare beneficiaries.
• PIH HealthcoreStrategic or Co-development PartnerProvider network partnership opening access to PIH Health hospitals, doctors, outpatient offices, home health services and hospice care for Medicare-eligible individuals in Los Angeles and Orange counties.
• Triangle Senior Care GroupcoreStrategic or Co-development PartnerClinically integrated network of 20 independent primary care practices in Wake County, North Carolina, providing care management services to Alignment's senior members.
• Brown & Toland PhysicianscoreStrategic or Co-development PartnerPartnership with network of 2,700+ Bay Area doctors providing in-network care for Alignment members in Marin County, California.

Scale indicators11 records

Recent moves9 records

Expansion highlights6 records

Broad incumbents

• Humana: Humana is the largest pure-play Medicare Advantage insurer in the U.S. and is Alignment Health's most direct large-scale competitor. It serves tens of millions of MA members across all 50 states and provides a benchmark for the technology-enabled, senior-focused MA model Alignment is pursuing at smaller scale.
• UnitedHealth Group (UnitedHealthcare): UnitedHealthcare operates the largest MA membership base in the industry as part of UnitedHealth Group's diversified health benefits and Optum services portfolio. Comparable in selling Medicare Advantage plans to seniors and in leveraging data/analytics to manage care costs.
• CVS Health (Aetna): Aetna's Medicare Advantage business sits within CVS Health alongside retail pharmacies, Caremark PBM, and Oak Street primary care. Directly comparable in offering MA plans nationally with integrated care delivery and pharmacy benefits.
• Elevance Health: Elevance Health (formerly Anthem) operates Blue Cross Blue Shield plans across multiple states with a significant Medicare Advantage offering. Directly comparable as a multi-state MA carrier with emphasis on care quality and provider collaboration.
• Centene Corporation: Centene is a large managed care company focused on government-sponsored health programs (Medicaid and Medicare). Comparable in operating MA plans and serving dual-eligible / SNP populations across multiple states, though its core franchise is Medicaid.
• Molina Healthcare: Molina is a government-focused managed care company with a growing Medicare Advantage presence alongside its core Medicaid business. Comparable in serving low-income and senior populations through state-level health plans.
• Cigna Group: Cigna divested much of its Medicare Advantage business but maintains MA offerings and serves seniors via Evernorth services. Comparable as a large national health insurer serving seniors with supplemental products.
• Aetna (standalone MA peer view): Aetna's standalone MA franchise competes head-to-head with Alignment Health in shared geographies (Arizona, California, Nevada, North Carolina). Most directly comparable on plan design, broker distribution, and provider network strategy at the state-market level.

Direct peers

• Clover Health: Clover Health is a technology-forward Medicare Advantage insurer using its Clover Assistant software platform to drive primary care and care management. Closest comparable to Alignment Health in scale, MA-only focus, and proprietary AI/data platform strategy.

Emerging players

• Oscar Health: Oscar Health is a technology-driven health insurer offering individual ACA and Medicare Advantage plans with a member-experience focus. Comparable in using tech-enabled, concierge-style service to differentiate in government health insurance markets.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat6 records

Key risks6 records

Key highlights7 records

Customer concentration

• Xx.com/alignmenthealth
• Facebookfacebook.com/AlignmentHealth

Revenue estimate

Valuation estimate

Number of profiles

Profiles14 records

Subsidiaries1 record

Funding overview

Funding rounds5 records

Investors6 records

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about Alignment Health