Pathways Health Partners

What Pathways Health Partners does

Pathways Health Partners, legally structured as Pathways Accountable Care, LLC., is a Florida-based Accountable Care Organization founded in 2019 that participates in the Medicare Shared Savings Program under CMS oversight. The ACO recruits primary care and specialty care providers into its Participant and Preferred provider networks and aligns Medicare Fee-for-Service beneficiaries to those providers through voluntary alignment and care coordination services. Its product portfolio includes a value-based care analytics platform with population health management tooling, a patient-facing mobile health application (iOS and Android), the GUIDE dementia care program, an urgent care referral network across central Florida, and provider-network contracting and care management services. The stated mission is the Quintuple Aim: improving population health, enhancing the care experience, reducing costs, improving provider satisfaction, and advancing health equity.

The business model is anchored on shared savings generated through the Medicare Shared Savings Program. Pathways earned $17,405,873.29 in shared savings in Performance Year 2023, $16,595,526.06 in PY2022, and $2,406,273.78 in PY2021, with 70% distributed to ACO participants and 30% retained and reinvested in infrastructure and care process improvements. Supplementary revenue is pursued through CMS/CMMI Advanced Alternative Payment Models, outcomes-based contracts with commercial payors and Medicare Advantage plans, and dementia-specific programs such as GUIDE. Multi-payer partnerships include CarePlus Health Plans, Devoted Health Plans, PHC of Pinellas, Quest Diagnostics, and LabCorp; the company is governed by a board with clinical, administrative, and beneficiary representation including CEO Yesenia Salvadore-Backer, Medical Director William Weaver, DO, and Chief Compliance Officer David P Wagner.

Operations are regionally concentrated in central Florida (Ocala, Belleview, Wildwood, Mount Dora, The Villages, Lady Lake, Leesburg, and Tavares) with a Tampa Bay / Pinellas extension via Professional Health Care of Pinellas. Headcount is reported at 51–100, and the organization is privately held with no disclosed parent company or external funding rounds identified in available sources. Customer concentration is high given structural dependence on CMS, a single-state footprint, and a small anchor provider cohort, while growth has been strong on the back of MSSP performance, new product lines such as the GUIDE Program and mobile app, and entry into Medicare Advantage payer relationships.

Name

Pathways Health Partners

Legal name

Pathways Accountable Care, LLC.

Website

https://pathwayshp.com

Company type

Private

Founded year

2019

Operating status

Operating

Headcount range

51–100 employees

Short description

Pathways Health Partners is a Florida-based Medicare Shared Savings Program ACO that recruits primary and specialty care providers into its network, aligns Medicare FFS beneficiaries for value-based care coordination, and operates a population health analytics platform, mobile app, and the GUIDE dementia care program.

Ownership category

akta.pro rank

Product category

Accountable Care Organization Services

NAICS

Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension Funds (524292), Services for the Elderly and Persons with Disabilities (62412)

SIC

Hospital & Medical Service Plans (6324), Services-Offices & Clinics Of Doctors Of Medicine (8011)

akta.pro primary industry

Care Management & Coordination Platforms (case/disease management workflows) (HLACAHAD)

akta.pro secondary industry

Care Coordination, Referral Management & Transitions-of-Care Pathways (HLACAGAL)

Keywords

• Value-based care
• Accountable care organization
• Population health management
• Care coordination services
• Medicare shared savings

Headquarters

HQ city

Leesburg

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, Infrastructure

Revenue model

1. Medicare Shared Savings Program: Pathways Health Partners participates in the Medicare Shared Savings Program (MSSP) as an ACO. The organization earns shared savings by generating cost savings while meeting quality thresholds. In Performance Year 2023, they achieved $17,405,873.29 in shared savings, with 70% distributed to ACO participants and 30% invested in infrastructure and care process improvements.
2. Value-Based Care Contract Negotiations: The organization engages with CMS, CMMI, Commercial payors, and Medicare Advantage plans to participate in Advanced Alternative Payment Models and outcomes-based payment arrangements, generating revenue through risk-based payment options.

Go-to-market motion3 records

Distribution channels4 records

Marketing channels6 records

Core offering

Pathways Health Partners operates an Accountable Care Organization (ACO) that recruits primary care and specialty care providers into its network to deliver coordinated, value-based care to Medicare Fee-for-Service beneficiaries. The ACO earns shared savings from the Medicare Shared Savings Program and distributes 70% to ACO participants, reinvesting 30% in infrastructure and care improvement. It supports providers with data analytics, proven clinical workflows, payer contract negotiations, and advanced IT infrastructure. Additional offerings include a patient-facing mobile health app, the GUIDE dementia care program, a voluntary alignment program for beneficiaries, and an urgent care referral network across Florida.

Product overview

Pathways Health Partners is an Accountable Care Organization (ACO) offering a unified healthcare coordination platform centered on value-based care delivery. The portfolio includes a mobile health app for patients, the GUIDE dementia care program, ACO care coordination services with data analytics and workflow tools, a network of urgent care referrals across Florida, a provider network of primary and specialty care physicians, and a voluntary alignment program for Medicare beneficiaries. These offerings work together to support the Quintuple Aim for Health Care Improvement: improving population health, enhancing care experience, reducing costs, improving provider satisfaction, and advancing health equity.

Differentiator

Problem solved

Functional benefit

Brands

• GUIDE Program: A program providing respite care and support for family caregivers of patients with dementia, offering custom care plans, nurse assessments, 24/7 access hotline, caregiver education, and medication management.

Products and services

• Pathways Health Partners Mobile App A comprehensive health management mobile application available on iOS and Android that enables appointment scheduling, telehealth services, health record access, health device integration, and communication with healthcare providers and support networks for patients and caregivers in the Pathways ACO.
• GUIDE Program A respite care program for family caregivers of Medicare beneficiaries with dementia, Alzheimer's disease, or cognitive impairment. Provides custom care plans, 24/7 access hotline, nurse assessments, caregiver education, medication management, and community-based service referrals, delivered with dedicated Care Navigators.
• ACO Care Coordination Services Value-based healthcare delivery services including clinical care management, managed care services, contract negotiations with CMS, CMMI, Commercial and Medicare Advantage payors, and advanced IT infrastructure supporting ACO Participants' transition from volume to value-based care.
• Urgent Care Referral Network A network of urgent care locations across Florida including Magnolia Family Urgent Care, Express Care of Ocala, CareSpot, Concentra, MedOne, and other facilities serving Ocala, Belleview, Wildwood, Mount Dora, The Villages, Lady Lake, Leesburg, and Tavares areas.
• Provider Network A high-performance network of primary and specialty care providers including ACO Participant Providers and Preferred Providers, offering cutting-edge data analytics, proven workflows, industry expertise, and payer relationships to support value-based care delivery.
• Voluntary Alignment Program A Medicare-aligned voluntary coordination program allowing beneficiaries to designate their main healthcare provider within the Pathways ACO for improved care coordination and preventive services, integrated with Medicare.gov alignment.

Quantifiable outcome

• Shared savings of $17,405,873.29 achieved in Performance Year 2023
• +4 more outcomes

Named customers3 records

Segments4 records

Ideal customer profiles3 records

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Feature3 records

Partnerships

Eight partnerships are on record, tiered core and minor.

• CMS (Centers for Medicare & Medicaid Services)coreStrategic or Co-development PartnerPathways Health Partners operates as a Medicare Shared Savings Program ACO under CMS oversight. The partnership involves participation in quality reporting, shared savings calculations, and alignment of Medicare beneficiaries with participating providers. CMS provides the regulatory framework and financial model for ACO operations.
• AaNeelcoreStrategic or Co-development PartnerAaNeel is listed as a Pathways Health Partners partner, with their logo displayed on the provider and home pages. The partnership involves collaborative efforts in healthcare delivery and patient care coordination within the ACO network.
• CarePlus Health PlanscoreStrategic or Co-development PartnerCarePlus Health Plans partners with Pathways Health Partners, appearing as a partner logo on the website. The relationship involves coordination of care services and payer relationships within the healthcare network.
• PHC of PinellascoreStrategic or Co-development PartnerPHC of Pinellas is listed as a Pathways Health Partners partner organization. The partnership involves collaborative healthcare delivery and network participation in the Florida region.
• Devoted Health PlanscoreStrategic or Co-development PartnerDevoted Health Plans partners with Pathways Health Partners in Florida, coordinating Medicare Advantage plan services with the ACO provider network for integrated care delivery.
• CMMI (CMS Innovation Center)coreStrategic or Co-development PartnerPathways Health Partners engages with CMMI in pursuit of Advanced Alternative Payment Models and outcomes-based payment arrangements, participating in innovation initiatives beyond traditional MSSP.
• Healthcare Providers (GUIDE Program)coreStrategic or Co-development PartnerThe GUIDE program partners with primary care physicians and healthcare providers to deliver dementia care support, respite services, and caregiver education to eligible Medicare beneficiaries with cognitive impairment.
• NSCNminorStrategic or Co-development PartnerNSCN appears as a Pathways Health Partners partner in the website footer, indicating a collaborative relationship in healthcare services delivery.

Scale indicators9 records

Recent moves6 records

Expansion highlights6 records

Direct peers

• Aledade: National ACO enablement platform partnering with independent primary care physicians under MSSP and other value-based contracts. Highly comparable ACO business model and provider recruitment motion.
• Privia Health: Physician enablement and value-based care platform operating ACOs and risk-bearing arrangements with PCPs and specialists across multiple states. Comparable provider-network and MSSP/MA economics.
• Agilon Health: Value-based care organization partnering with primary care physicians to manage Medicare Advantage populations under global capitation. Directly comparable capitated, PCP-anchored care model.
• ChenMed: Senior-focused primary care group operating under full-risk value-based contracts for Medicare Advantage patients. Comparable dual-eligible/Medicare senior population and Florida footprint.
• VillageMD: Value-based primary care platform (with Walmart and Walgreens partnerships) serving Medicare and commercial patients. Comparable ACO-like care management and analytics infrastructure.
• Oak Street Health (CVS Health): Senior-focused value-based primary care provider acquired by CVS Health, operating full-risk Medicare contracts. Directly comparable senior care model and ACO economics.
• Collaborative Health Systems: A Wellcare/Centene subsidiary that operates ACOs and value-based care networks for Medicare beneficiaries. Comparable ACO management and provider enablement offerings.
• Cano Health: Value-based primary care provider for seniors, primarily Medicare Advantage, with strong Florida presence. Comparable Florida footprint, senior population, and risk-bearing model.

Emerging players

• InnovAge Holding Corp. PACE program operator providing coordinated medical and social services to nursing-home-eligible seniors. Comparable dual-eligible senior care management focus, though delivery model differs.

Broad incumbents

• Humana / CenterWell: Large Medicare Advantage insurer and senior-focused primary care operator (CenterWell). Overlaps with Pathways in Florida MA payer relationships and senior care delivery.

Market position

Strengths4 records

Weaknesses4 records

Competitive moat5 records

Key risks5 records

Key highlights6 records

Customer concentration

• Facebookfacebook.com/pathwayshealthpartners

Revenue estimate

Valuation estimate

Number of profiles

Profiles11 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 Pathways Health Partners