Pivotal Health

What Pivotal Health does

Pivotal Health is a privately held, tech-enabled healthcare delivery company founded in late 2020 in Middleton, Wisconsin, that operates a clinician house call and telehealth platform serving Wisconsin metro areas (Madison, Green Bay/Appleton, and Oshkosh/Fond du Lac). The company delivers in-home urgent care, primary care, chronic disease management, lab services, mental health assessment and referrals, and — per its public website — advanced cancer screening, with scheduling and billing handled through a custom iOS/Android mobile app, a phone line (888-688-4746), and website booking. The underlying technology is primarily an operational platform that schedules and routes licensed clinicians to patients' homes, offices, or dorms and supports after-visit summaries and insurance/billing management, with on-site rapid diagnostics (COVID, flu, strep, RSV) and arranged in-home X-rays as notable service-level capabilities.

The business model is predominantly cash-pay and subscription-based: a self-pay single visit is priced at $189, while the Direct Care membership offers unlimited urgent care, primary care, chronic disease management, and most labs for a monthly, semester, or annual fee. As of December 31, 2024, Pivotal Health no longer accepts health insurance except for Network Health Medicare Advantage members, and memberships become HSA/FSA eligible starting January 1, 2026. A parallel B2B channel — Pivotal Health Direct Care for Employers — sells per-employee monthly memberships with $0 to $50 visit copays, anchored by the strategic partnership with Prevea Health in Northeast Wisconsin. The company has raised approximately $2.78M in disclosed funding across a late-2021 seed round (Comeback Capital, SymphonyAlpha Ventures) and a March 2023 round (Tundra Angels) and operates with 11-50 employees.

Name

Pivotal Health

Legal name

Pivotal Health, Inc.

Website

https://pivotalhealth.care

Company type

Private

Founded year

2020

Operating status

Operating

Headcount range

11–50 employees

Short description

Pivotal Health is a Wisconsin-based, tech-enabled clinician house call platform providing in-home urgent care, primary care, chronic disease management, and mental health referrals to individuals, families, college students, and employers via cash-pay visits and subscription memberships.

Ownership category

akta.pro rank

Product category

Home Healthcare Services

NAICS

Offices of Physicians (62111), Ambulatory Health Care Services (621), Home Health Care Services (62161), Offices of Physicians, Mental Health Specialists (621112)

SIC

Services-Offices & Clinics Of Doctors Of Medicine (8011), Services-Home Health Care Services (8082), Services-Health Services (8000)

akta.pro primary industry

Skilled Home Health (Medicare-Certified) Agencies (HLAFAEAA)

akta.pro secondary industries

Care Management & Care Coordination (Home & Community-Based) (HLAFAEAL), Primary Care & General Medicine Virtual Care (HLALAAAA), Primary Care & General Medicine Virtual Care (Employer-Sponsored) (HLALADAA)

Keywords

• House call healthcare
• Mobile urgent care
• Direct primary care
• Telehealth visits
• In-home diagnostics

Headquarters

HQ city

Madison

HQ country

United States

HQ region

North America

Offices4 records

Markets served

GTM type

B2B and B2C

Offering type

Services

Cost components

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

Revenue model

1. Direct Care Membership Fees: Monthly, semester, or annual membership fees providing unlimited urgent care, primary care, chronic disease management, and most diagnostic labs. Family membership limited to two adults and legal dependents.
2. Per-Visit Fees: Single visit cash-pay pricing at $189 for non-members, paid when scheduling through app or phone
3. Employer Direct Care Plans: Monthly per-employee fees providing $0 to $50 visits for employees and family members according to employer preference

Pricing tiers

Go-to-market motion1 record

Distribution channels4 records

Marketing channels5 records

Core offering

Pivotal Health delivers in-home and telehealth urgent care, primary care, and chronic disease management through licensed clinicians who visit patients at their home, office, or dormitory. Services are accessed via a custom iOS/Android mobile app, phone scheduling, or website booking, with membership and per-visit pricing. The company operates across Wisconsin metro areas including Madison, Green Bay/Appleton, and Oshkosh/Fond du Lac, and also offers an employer-based Direct Care program.

Product overview

Pivotal Health is a technology-enabled healthcare delivery company that operates as a single unified platform offering in-home clinician house calls and telehealth services. The core offering consists of urgent care house calls, supported by subscription membership programs (Pivotal Health Direct Care), primary care services, mental health referrals, telehealth consultations, chronic disease management, and employer healthcare solutions. Services are accessible via a mobile app for iOS and Android, phone scheduling, or the website. The Direct Care Membership provides unlimited visits for a monthly fee, while single visits are available at $189 for non-members.

Differentiator

Problem solved

Functional benefit

Products and services

• Urgent Care House Calls In-home urgent care visits for non-life-threatening conditions including respiratory infections, UTIs, lacerations, sinus infections, ear infections, and minor injuries. A licensed clinician comes to the patient's home, office, or dorm at a scheduled time. Targeted at individuals and families seeking convenient alternatives to clinic-based urgent care.
• Pivotal Health Direct Care Membership Monthly, semester, or annual subscription membership offering unlimited urgent care, primary care, chronic disease management, and most diagnostic labs for one recurring fee. Family membership covers two adults and legal dependents. Targeted at individuals and families seeking predictable healthcare costs.
• Primary Care Services In-home primary care including adult wellness exams, health risk assessments, DOT physicals, sports/school/camp physicals, sexual and reproductive health, and medication management. Delivered by visiting clinicians to patients' preferred location.
• Mental Health Services Mental health assessment conducted during in-home visits by Pivotal clinicians, with referrals to partner therapy and psychiatry providers for ongoing treatment. Available to patients across multiple Wisconsin counties.
• Telehealth and Virtual Visits Video or phone consultations with Pivotal providers for medical advice, with the option to escalate to a same-day house call if an in-person visit is needed. Available to patients across the service area.
• Direct Care for Employers B2B employer healthcare solution where employers pay a monthly per-employee fee for urgent care, primary care, or occupational health visits at $0 to $50 copay per visit. Includes access for employees and their family members.
• University Students Service Specialized healthcare offering for college students including in-home urgent care visits to dormitories and apartments, mental health support, and physicals for sports or camp. Targeted at UW-Madison and other Wisconsin campus students.
• Self-Pay Single Visit Cash-pay single visit option priced at $189 for non-members, paid at the time of scheduling through the mobile app, phone, or website. Provides on-demand access to a Pivotal clinician house call without a membership commitment.
• Advanced Cancer Screening Advanced cancer screening services delivered as part of Pivotal Health's in-home care model, offering specialized diagnostic assessments that patients can access without visiting a clinic.

Named customers3 records

Segments4 records

Ideal customer profiles3 records

Technology focussed Yes

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Feature3 records

Partnerships

Three partnerships are on record, tiered core.

• Prevea HealthcoreStrategic or Co-development Partner · 18 July 2023Partnership with Green Bay-based Prevea Health provides employees of participating Prevea Corporate Health and Wellness partners in the Green Bay market access to Pivotal's house call services. Prevea360 health insurance plan also accepted. Dr. Ashok Rai, President and CEO of Prevea Health, stated commitment to making healthcare accessible as close to home as possible.
• DotCom TherapycoreStrategic or Co-development Partner · 1 May 2022Madison-based startup partnership offering online mental health resources. Pivotal's doctors assess patients' mental health concerns during in-home visits and refer to DotCom Therapy for therapy needs. Available to patients in Dane, Milwaukee, Ozaukee, Washington, and Waukesha counties.
• LifeStance HealthcoreStrategic or Co-development Partner · 1 May 2022Arizona-based mental health company partnership offering in-person and online mental health services nationwide. Pivotal refers patients requiring medication management to LifeStance Health. Available to patients with varying insurance types including Medicare and Medicaid.

Scale indicators2 records

Recent moves8 records

Expansion highlights6 records

Direct peers

• DispatchHealth: DispatchHealth provides on-demand in-home urgent care delivered by licensed clinicians, the closest direct analog to Pivotal's house call model, though operating at national scale and with more advanced-care capabilities.
• Sollis Health: Sollis Health is a membership-based concierge medicine provider offering 24/7 house calls, in-home urgent care, and on-site diagnostics—directly comparable to Pivotal's subscription house-call model in urban markets.
• Forward Health: Forward is a tech-enabled primary care provider combining in-person visits with biometrics, app-based monitoring, and subscription pricing—overlapping with Pivotal's hybrid in-home/tech primary care model.

Broad incumbents

• One Medical (Amazon): One Medical, now owned by Amazon, operates tech-enabled primary care clinics with a membership component and mobile app, representing a much larger incumbent with overlapping consumer value proposition.
• Included Health: Included Health (formed from Doctor On Demand and Grand Rounds) offers virtual primary care, urgent care, and mental health—an integrated virtual competitor for Pivotal's care navigation and primary care offerings.

Emerging players

• Premise Health: Premise Health operates on-site and near-site primary care for employers, overlapping with Pivotal's Direct Care for Employers B2B motion and competitive for the same employer benefits budgets.
• Crossover Health: Crossover Health delivers tech-enabled primary care to employer populations through on-site/near-site clinics, directly comparable to Pivotal's employer-channel offering and pricing structure.
• K Health: K Health offers AI-augmented virtual primary care with subscription pricing, competing for the same cash-pay/insurance-agnostic primary care consumer that Pivotal targets in Wisconsin.
• Upward Health: Upward Health provides in-home primary and behavioral care for high-need patients via clinician house calls, comparable in operational model to Pivotal though focused on complex/specialty populations.

Others

• LifeStance Health: LifeStance Health is an existing Pivotal referral partner providing therapy and medication management; it represents both a partner and a potential competitor should Pivotal attempt to internalize its mental health offering.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat4 records

Key risks6 records

Key highlights7 records

Customer concentration

• Xx.com/pivotalhc
• YouTubeyoutube.com/channel/UCMDY5jrbyS7vuHEJQCrVe1A
• Facebookfacebook.com/yourpivotalhealth
• LinkedInlinkedin.com/company/pivotal-healthcare
• Instagraminstagram.com/pivotalhealthcare

Revenue estimate

Valuation estimate

Number of profiles

Profiles4 records

Funding overview

Funding rounds2 records

Investors3 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 Pivotal Health