HealthFund Solutions

What HealthFund Solutions does

HealthFund Solutions (HFS) is a privately held healthcare services company founded in 2016 by Karen Streets, Michael Streets, and Chuck Kramer, headquartered in Orlando, Florida. Operating on a B2B2C model, HFS partners with hospitals and health systems nationwide to provide eligibility screening and premium assistance services for uninsured and underinsured patients — specifically individuals who earn too much to qualify for public programs but cannot afford private insurance.

The company's core offerings include eligibility screening for Medicaid, ACA Marketplace, COBRA, SSI, and SSDI programs, combined with direct premium payment assistance funded by HFS on behalf of qualifying patients. Supporting technology includes real-time screening tools, Electronic Data Integration (EDI) with hospital partners that transmits patient premium status updates, and a proactive premium monitoring service that alerts hospitals when patients fall behind on payments. The platform is HIPAA-compliant and designed to convert uninsured accounts to insured coverage, reducing hospital bad debt while maintaining continuous patient coverage.

HFS operates through a managed services model with hospital partnerships supplemented by direct-to-patient services delivered via telephone, live chat, and website consultation requests. Pricing is not publicly disclosed. The company is bootstrapped with no external institutional funding or acquisition history, currently employs 51–100 people, and is led by its three co-founders.

Name

HealthFund Solutions

Legal name

HealthFund Solutions LLC

Website

https://healthfundsolutions.com

Company type

Private

Founded year

2016

Operating status

Operating

Headcount range

51–100 employees

Short description

HealthFund Solutions partners with hospitals nationwide to provide eligibility screening and premium assistance for uninsured and underinsured patients. Founded in 2016 in Orlando, Florida, it helps patients secure coverage through Medicaid, ACA Marketplace, COBRA, SSI, and SSDI programs.

Ownership category

akta.pro rank

Product category

Healthcare Patient Assistance Services

NAICS

Other Insurance Funds (525190), Social Assistance (624)

SIC

Insurance Agents, Brokers & Service (6411), Services-Misc Health & Allied Services, Nec (8090)

akta.pro primary industry

Healthcare-Linked Social Benefits Administration (e.g., Medicaid/Means-Tested Health Coverage) (BPAIAKAH)

akta.pro secondary industry

Medigap Member Support & Care Navigation (Advocacy/Concierge) (HLAEADAH)

Keywords

• Healthcare funding assistance
• Premium payment programs
• Medicaid eligibility screening
• Uninsured patient advocacy
• Hospital bad debt reduction

Headquarters

HQ city

Alva

HQ country

United States

HQ region

North America

Offices1 record

Markets served

GTM type

B2B

Offering type

Services

Cost components

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

Revenue model

1. Hospital Partnership Services: HealthFund Solutions partners with hospitals and health systems to provide eligibility screening and premium assistance services for uninsured patients, helping reduce hospital bad debt while ensuring patients maintain coverage.
2. Premium Assistance / Self-Pay Sponsorship: The company provides dedicated income to patients to pay insurance premiums, working with health systems to ensure uninsured and underinsured patients have resources to receive care. No credit check or repayment plan required from patients.
3. Patient Advocacy Services: Guiding patients through Marketplace insurance enrollment, securing coverage even outside Open Enrollment periods, and ensuring continuous treatment without lapses in coverage.

Go-to-market motion2 records

Distribution channels3 records

Marketing channels4 records

Core offering

HealthFund Solutions provides funding assistance programs that pay health insurance premiums on behalf of uninsured and underinsured patients, paired with advanced eligibility screening for Medicaid, ACA Marketplace, SSI, SSDI, and COBRA programs. The company partners with hospitals and health systems to identify eligible patients at the point of care, deliver premium assistance so coverage stays active, and proactively monitor premium status to prevent coverage lapses and convert uninsured accounts to insured ones.

Differentiator

Problem solved

Functional benefit

Products and services

• Premium Assistance Program Provides dedicated income to uninsured and underinsured patients to pay their health insurance premiums, ensuring they can maintain continuous coverage for ongoing treatment. Available with no credit check or repayment plan required from the patient. Delivered through hospital partnerships with HealthFund Solutions.
• Medicaid Eligibility Screening Real-time screening service that determines whether patients qualify for Medicaid coverage, reducing delays in care for uninsured individuals referred through hospital partners. Conducted by Customer Advocates via telephone or live chat prescreening, with transfer to Insurance Advocates for additional screening and enrollment support.
• ACA Marketplace Enrollment Support Patient advocacy service guiding uninsured individuals through ACA Health Insurance Marketplace enrollment, including securing coverage outside of Open Enrollment periods, to ensure continuous treatment without coverage gaps. Targeted at patients who earn too much for public programs but cannot afford private insurance.
• SSI and SSDI Application Support Eligibility screening and application assistance for Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI) benefits, helping adults with disabilities affecting employment secure government coverage and ongoing premium payment support.
• COBRA Enrollment Assistance Enrollment assistance for COBRA continuation coverage, helping recently terminated employees maintain health insurance through their former employer's plan, including support with premium payment coordination through HFS funding programs.
• Premium Monitoring Service Proactive monitoring service that alerts hospital partners when patients fall behind on insurance premium payments, with real-time alerts and rapid intervention capabilities to prevent coverage lapses and resulting claim denials. Backed by Electronic Data Integration (EDI) feeds to hospital partners.
• Hospital Partnership Services End-to-end managed services offering for hospitals and health systems, combining eligibility screening, premium assistance funding, premium monitoring, and patient advocacy to reduce bad debt, convert uninsured accounts to insured coverage, and improve patient satisfaction scores.

Quantifiable outcome

• Reduced hospital bad debt through conversion of uninsured accounts to insured coverage
• +2 more outcomes

Named customers8 records

Segments3 records

Ideal customer profiles2 records

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Feature4 records

Partnerships

One partnership is on record.

• Hospitals and Health SystemscoreStrategic or Co-development PartnerHealthFund Solutions partners with hospitals and health systems nationwide to provide eligibility screening, premium assistance, and monitoring services for uninsured patient populations. The partnership helps hospitals reduce bad debt, improve patient satisfaction scores, and convert charity and uninsured accounts to insured coverage. HFS works with various health systems across the country to ensure uninsured and underinsured patients have resources to receive necessary care.

Scale indicators1 record

Recent moves5 records

Expansion highlights4 records

Direct peers

• Centauri Health Solutions: Centauri provides hospital-facing Medicaid eligibility, enrollment, and revenue cycle services for uninsured and underinsured populations — the closest direct comparable in patient population, hospital channel, and core service model.

Broad incumbents

• Availity: Availity operates a large-scale healthcare data exchange and eligibility/benefits verification platform used by hospitals and payers nationwide — a broad incumbent whose eligibility workflows overlap with HFS's screening capability.
• Waystar: Waystar provides hospital revenue cycle management, including patient eligibility and coverage detection — comparable as an incumbent whose eligibility modules could compete with HFS's screening layer.
• Experian Health: Experian Health offers patient access, eligibility verification, and coverage discovery products to hospitals — comparable incumbent technology used for the same pre-service screening workflow HFS performs.
• Optum (Change Healthcare): Optum, via Change Healthcare, provides hospital eligibility, claims, and RCM tools at massive scale — a dominant incumbent whose suite overlaps with HFS's eligibility and enrollment capabilities.

Emerging players

• HealthSherpa: HealthSherpa is an ACA Marketplace enrollment platform that helps agents and consumers shop for and enroll in subsidized coverage — comparable as a marketplace enrollment specialist adjacent to HFS's ACA enrollment offering.
• GetInsured: GetInsured operates a SaaS platform for individual ACA Marketplace enrollment used by states and consumers — comparable as a technology-enabled enrollment specialist targeting a similar uninsured population.

Others

• BeneSys: BeneSys administers Taft-Hartley and multi-employer benefit funds including health and welfare plans — comparable as an adjacent benefits-fund administrator operating in the same healthcare benefit funding ecosystem.
• Health Advocate: Health Advocate provides personal health advocacy and benefits-navigation services to employers and consumers — comparable as an adjacent patient advocacy provider that overlaps with HFS's patient-advocacy layer.

Regional players

• Connect for Health Colorado: Connect for Health Colorado is a state-based ACA Marketplace that screens and enrolls uninsured residents — comparable as a regional enrollment entity operating in HFS's same ACA enrollment space but limited to Colorado.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat4 records

Key risks6 records

Key highlights6 records

Customer concentration

• LinkedInlinkedin.com/company/healthfundsolutions

Revenue estimate

Valuation estimate

Number of profiles

Profiles3 records

Funding overview

Funding rounds

Investors

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 HealthFund Solutions