Presbyterian Healthcare Services

What Presbyterian Healthcare Services does

Presbyterian Healthcare Services is a not-for-profit, integrated payer-provider health system founded in 1908 and headquartered in Albuquerque, New Mexico. It operates nine hospitals across eight communities, over 100 clinics, a medical group of more than 1,100 physicians and advanced practice clinicians across 50+ specialties, and a captive health plan (Presbyterian Health Plan) offering Individual and Family, Medicare Advantage, Turquoise Care Medicaid, and employer group products, including ASO/self-funded administration. Together the system covers roughly 25% of New Mexicans through insurance and approximately 33% through care delivery, with services spanning emergency, primary, specialty, surgical, cancer, heart and vascular, behavioral health, transplant (UNOS/CMS certified, Optum Center of Excellence), and rehabilitation care, supplemented by VirtualPRES telehealth, the eVisit asynchronous service, and Hospital at Home (developed with Johns Hopkins School of Medicine).

The underlying technology stack centers on Epic EHR integrated with the GW RhythmX AI Precision Care Platform — a system-wide deployment across all 200 primary care clinicians that consolidates patient data, payer criteria, social drivers of health, and clinical guidelines to surface hyper-personalized treatment recommendations, with the GW RhythmX partner providing the AI capability. Additional proprietary assets include the myPRES member and patient portal (with Multi-Factor Authentication), virtual care platforms covering urgent care, primary care, dermatology, and behavioral health, ACOG Maternal Levels of Care Verification across six hospitals (the only system in New Mexico with this designation), and partnerships with National Kidney Registry, New Mexico Donor Services, Optum, and Aetna National Network for out-of-state care access.

Revenue is generated across three streams: health insurance premiums (subscription/recurring), direct patient care services (transaction-based at facilities and clinics), and Medicaid managed care capitation through the Turquoise Care contract. Distribution is multi-channel: direct-to-consumer through phs.org and the myPRES portal for health plan enrollment, employer and producer partnerships for group plans, contracted provider network arrangements for in-network care by other payers, and state-government Medicaid managed care. Recent restructuring includes a Medicare Advantage contract pullback scheduled for 2027 to eliminate $59M in annual losses, 150 administrative position eliminations, and continued credit profile pressure evidenced by a February 2026 Fitch downgrade, partially offset by $84M of FY2024 net income recovery.

Name

Presbyterian Healthcare Services

Legal name

Presbyterian Healthcare Services

Website

https://phs.org

Company type

Private

Founded year

1908

Operating status

Operating

Headcount range

5,001–10,000 employees

Short description

Presbyterian Healthcare Services is a not-for-profit integrated payer-provider health system in New Mexico, founded 1908, operating nine hospitals, 100+ clinics, and a state-wide health plan, serving roughly one in three New Mexicans through care and one in four through insurance.

Ownership category

akta.pro rank

Product category

Integrated Healthcare System

NAICS

Ambulatory Health Care Services (621), Home Health Care Services (621610)

SIC

Services-General Medical & Surgical Hospitals, Nec (8062), Hospital & Medical Service Plans (6324), Services-Health Services (8000)

akta.pro primary industry

Faith-Based & Nonprofit Hospital Systems (HLAFAAAE)

akta.pro secondary industries

Hospital-at-Home & Acute Virtual Care Platforms (HLALABAC), Benefits, Insurance & Entitlement Navigation (Medicare/Medicaid/VA/LTC) (HSABAIAG)

Keywords

• Integrated healthcare delivery
• Health insurance plans
• Hospital care services
• Virtual care platform
• Managed care organization

Headquarters

HQ city

Clovis

HQ country

United States

HQ region

North America

Offices13 records

Markets served

GTM type

B2B and B2C

Offering type

Services

Cost components

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

Revenue model

1. Health Insurance Premiums: Presbyterian generates revenue through multiple health insurance products including Medicare Advantage plans, Individual & Family plans, Turquoise Care Medicaid plans, and employer-offered group health plans (HMO and PPO options). The organization recently announced discontinuation of most Medicare Advantage plans starting 2027, citing $59 million in annual losses.
2. Healthcare Services: Revenue from direct patient care services provided through nine hospitals and over 100 clinics throughout New Mexico, including emergency care, primary care, specialty care, surgery, cancer care, heart and vascular care, and behavioral health services.
3. Medicaid Managed Care: Presbyterian serves as a managed care organization for New Mexico's Medicaid program, generating revenue through capitated payments for covered lives.

Pricing tiers

Go-to-market motion3 records

Distribution channels6 records

Marketing channels9 records

Core offering

Presbyterian Healthcare Services operates as a fully integrated, not-for-profit healthcare system in New Mexico, delivering patient care through nine hospitals and over 100 clinics and offering health insurance products through Presbyterian Health Plan. The system combines direct patient care (primary, specialty, emergency, hospital, and virtual care) with health plan offerings (Medicare Advantage, Individual & Family, Turquoise Care Medicaid, and Employer Group plans). Core offerings also include digital care platforms (VirtualPRES, eVisit), an AI-powered precision care platform (GW RhythmX), the Hospital at Home program, and specialty services spanning cancer, heart and vascular, behavioral health, transplant, and rehabilitation.

Product overview

Presbyterian Healthcare Services operates as a fully integrated healthcare system offering a unified platform combining a health plan (Presbyterian Health Plan) with healthcare delivery (Presbyterian Medical Group, nine hospitals, 100+ clinics). The portfolio includes core offerings: Presbyterian Medical Group (1,100+ providers in 50 specialties) and Presbyterian Health Plan (Individual, Medicare Advantage, Medicaid, Employer plans). Digital health add-ons include VirtualPRES video care platform, eVisit asynchronous care, Hospital at Home program, and the GW RhythmX AI Precision Care Platform integrated with Epic EHR. Specialty services span Cancer Care, Heart and Vascular, Behavioral Health, Transplant Services, and Rehabilitation. Patient access is facilitated through myPRES member portal and MyChart patient portal.

Differentiator

Problem solved

Functional benefit

Brands

• Presbyterian Medical Group (PMG): Physician and advanced practice clinician group with 1,100+ providers in 50 specialties at 100+ clinics throughout New Mexico
• Presbyterian Health Plan
• Presbyterian Delivery System
• VirtualPRES
• eVisit
• Presbyterian Healthcare Foundation
• Health Plan Place
• Northern Roots
• Hospital at Home
• PresRN
• PRESNow 24/7
• Turquoise Care

Products and services

• Presbyterian Medical Group Multi-specialty medical group with 1,100+ physicians and advanced practice clinicians in 50 specialties at 100+ clinics throughout New Mexico, providing primary care, specialty care, and urgent care services for patients.
• Presbyterian Health Plan Health insurance plan offering Individual & Family Plans, Medicare Advantage Plans, Turquoise Care Medicaid Plans, and Employer-Offered Plans including HMO and PPO options, covering access to 24,000+ providers statewide in New Mexico and bordering communities.
• Hospital at Home Program partnered with Johns Hopkins School of Medicine in which doctors, nurses, and technicians travel to patient homes to provide hospital-level care, reducing unnecessary emergency department visits and bringing academic medical center expertise to New Mexico patients.
• VirtualPRES Virtual care platform offering video appointments for urgent care, primary care, dermatology, behavioral health (talk therapy and medication management), and eVisit for established patients, accessible 24/7 from anywhere in New Mexico.
• eVisit Secure asynchronous questionnaire-based service for established primary care patients to receive non-urgent care for common conditions without scheduling an appointment or going to a clinic. Available 24/7 with response in 24 hours for established patients 18+.
• Transplant Services Multidisciplinary transplant program offering kidney and pancreas transplants, living kidney donation options, certified by UNOS and Medicare/CMS, and designated as an Optum Center of Excellence in kidney transplant surgery.
• Cancer Care Comprehensive cancer services including hematology/oncology, radiation oncology, surgical oncology, breast surgical oncology, gynecologic oncology, and cancer rehabilitation across multiple Presbyterian locations.
• Heart and Vascular Care Cardiac services including cardiology, interventional cardiology, electrophysiology, cardiothoracic surgery, vascular medicine and surgery, congenital cardiology, and cardiac rehabilitation across the Presbyterian system.
• Behavioral Health Full range of psychiatric and substance abuse services for children, adolescents, and adults including outpatient, inpatient, substance use disorder treatment, and virtual behavioral health options.
• Urgent Care (PRESNow 24/7) Walk-in and scheduled urgent care services for minor illnesses and injuries including PRESNow 24/7 urgent care locations across Albuquerque (Paseo Del Norte, Coors, Menaul, Isleta) and pediatric urgent care clinics.
• Rehabilitation Services Comprehensive rehabilitation including aquatic therapy, cancer rehabilitation, fitness, occupational therapy, physical therapy, pulmonary rehabilitation, cardiac rehabilitation, and speech and language therapy.
• GW RhythmX AI Precision Care Platform AI-powered precision care platform integrated with Epic EHR that consolidates patient data, payer criteria, social drivers of health, and clinical guidelines into a single workflow, generating hyper-personalized treatment recommendations for primary care clinicians.

Quantifiable outcome

• 200+ patient conditions identified across more than 10,000 patient encounters using GW RhythmX AI platform
• +4 more outcomes

Named customers4 records

Segments6 records

Ideal customer profiles5 records

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Integration4 records

AI capability4 records

Feature5 records

Partnerships

Six partnerships are on record, tiered core and minor.

• GW RhythmXcoreTechnology or Integration · 3 February 2026Presbyterian Healthcare Services expanded deployment of GW RhythmX's AI Precision Care Platform to all 200 primary care clinicians, marking the first full system-wide implementation of a precision care AI platform in healthcare. The platform integrates with Epic EHR to consolidate patient data, payer criteria, social drivers of health, and clinical guidelines into a single workflow, supporting value-based care arrangements.
• Johns Hopkins School of MedicinecoreStrategic or Co-development PartnerPresbyterian partnered with Johns Hopkins School of Medicine to develop the innovative Hospital at Home program in which doctors, nurses, and technicians travel to patient homes to provide hospital-level care, bringing academic medical center expertise to New Mexico patients.
• Northern Roots ProgramminorStrategic or Co-development PartnerFood program at Presbyterian Santa Fe Medical Center offering fresh fruits, vegetables and pantry items for families with referrals from healthcare providers, addressing food insecurity and nutrition-related health conditions.
• National Kidney RegistrycoreStrategic or Co-development PartnerPresbyterian Transplant Services is affiliated with the National Kidney Registry, offering options for those in need of kidney transplants as well as those interested in living kidney donation.
• New Mexico Donor ServicescoreStrategic or Co-development PartnerPresbyterian Transplant Services partners with New Mexico Donor Services, a leading organ procurement organization, certified by United Network of Organ Sharing (UNOS) and Medicare (CMS).
• OptumcoreTechnology or IntegrationPresbyterian Transplant Services is an Optum Center of Excellence in kidney transplant surgery, meeting quality standards for safe, high-quality care with successful surgical outcomes.

Scale indicators16 records

Recent moves6 records

Expansion highlights6 records

Broad incumbents

• AdventHealth: Large faith-based nonprofit health system operating 50+ hospitals across multiple states with extensive employed medical group; comparable to Presbyterian in faith-based governance and breadth of specialty services, though much larger and multi-state.
• Trinity Health: One of the largest Catholic nonprofit health systems in the U.S. operating 90+ hospitals across multiple states with employed physician networks; comparable faith-based governance and integrated care delivery, but national rather than single-state footprint.
• Baylor Scott & White Health: Largest nonprofit healthcare system in Texas with an integrated delivery network, employed physicians, and health plan offerings; broader geographic footprint and scale than Presbyterian but directly comparable integrated payer-provider model.
• Kaiser Permanente: The archetypal integrated payer-provider nonprofit, combining Kaiser Foundation Health Plan with Permanente Medical Groups and owned hospitals; the canonical reference point for Presbyterian's integrated model, though operating at far greater scale and geographic breadth.
• Bon Secours Mercy Health: Catholic nonprofit health system operating 40+ hospitals and associated medical groups across the eastern U.S.; comparable to Presbyterian in faith-based, nonprofit integrated delivery model with strong community health focus.

Direct peers

• Sentara Healthcare: Integrated nonprofit health system combining a health plan (Optima Health) with 12+ hospitals and a large medical group across Virginia and North Carolina, directly comparable to Presbyterian's payer-provider model and regional dominance.
• Intermountain Health: Utah-based nonprofit integrated delivery network with health plan (SelectHealth), 30+ hospitals, and population-health focus; mirrors Presbyterian's regional concentration, faith-influenced roots, and payer-provider integration.
• UnityPoint Health: Iowa-based nonprofit integrated delivery network operating 20+ hospitals, a large physician group, and a health plan across the Midwest; similar mid-size regional footprint and payer-provider integration strategy as Presbyterian.
• Geisinger Health: Integrated Pennsylvania-based nonprofit operating a health plan, 9+ hospital campuses, and a large employed physician group, with similar geographic concentration and value-based care orientation as Presbyterian.

Regional players

• Lovelace Health System: Albuquerque-based competitor health system operating multiple hospitals and clinics in the same New Mexico market as Presbyterian; directly comparable in scale and geography, providing the clearest head-to-head competitive reference.

Market position

Strengths5 records

Weaknesses4 records

Competitive moat6 records

Key risks6 records

Key highlights7 records

Customer concentration

• Xx.com/preshealth
• YouTubeyoutube.com/user/PresHealth
• Facebookfacebook.com/preshealth
• LinkedInlinkedin.com/company/presbyterian-healthcare-services
• Instagraminstagram.com/presbyterianhealth

Compliance4 records

Revenue estimate

Valuation estimate

Number of profiles

Profiles8 records

Subsidiaries8 records

Funding overview

Funding rounds

Investors

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

M&A

Investments1 record

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

Frequently asked questions about Presbyterian Healthcare Services