Prospect Medical Group Inc.

What Prospect Medical Group Inc. does

Prospect Medical Group (now operating as Prospect Health) is a physician-founded healthcare management organization established in 1986 by physicians in northern Orange County, California. The company operates as an Independent Physician Association (IPA) and Management Services Organization (MSO) platform, coordinating value-based care through more than 20 affiliated IPAs and a network of over 20,000 contracted providers. Its footprint spans California, Arizona, Texas, Rhode Island, Connecticut, and New Jersey, serving approximately 1.6 million members. Prospect Health has earned "Elite" status in the California Association of Physician Groups (CAPG) Standards of Excellence Survey for seven consecutive years.

The company's core capabilities center on population health management for chronic conditions (diabetes, hypertension, heart failure), supported by a provider-facing digital portal called Aerial Care that handles referrals, authorizations, and care coordination. Prospect Health generates revenue primarily through capitated per-member-per-month (PMPM) contracts with major health plans including Aetna, Blue Shield, UnitedHealthcare, Molina, and CalOptima, with additional direct-to-employer arrangements such as the Disney partnership via Cigna Value Select. The company has built culturally-targeted programs for Korean-American (Daehan), Persian, and Latino communities, positioning itself in California's diverse insured populations. Following its acquisition by Astrana Health in July 2025, Prospect Health now operates as a subsidiary within a larger value-based care platform.

Name

Prospect Medical Group Inc.

Legal name

Prospect Health

Website

https://prospectmedical.com

Company type

Private

Founded year

1986

Operating status

Operating

Headcount range

501–1,000 employees

Short description

Prospect Health is a physician-founded IPA/MSO network coordinating value-based care through 20+ IPAs and 20,000+ providers across six states, serving 1.6 million members under capitated contracts with major health plans and operating as a subsidiary of Astrana Health.

Ownership category

akta.pro rank

Product category

Managed Healthcare Services

NAICS

Offices of Physicians (6211), Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension Funds (524292)

SIC

Services-Health Services (8000), Services-Offices & Clinics Of Doctors Of Medicine (8011), Hospital & Medical Service Plans (6324)

akta.pro primary industry

Medicare Provider Networks & Delegated Medical Groups (MA-focused) (FSAIAGAK)

akta.pro secondary industries

Value-Based Primary Care Organizations (Risk-Bearing) (HLAFAGAF), Hospital Shared Services, GPOs & System Support Organizations (HLAFAAAO)

Keywords

• Managed care services
• Population health programs
• Independent physician association
• Health plan provider network
• Care coordination services

Headquarters

HQ city

Orange

HQ country

United States

HQ region

North America

Offices1 record

Markets served

GTM type

B2B and B2C

Offering type

Services

Cost components

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

Revenue model

1. Capitated Health Plan Contracts: Prospect Health generates revenue primarily through capitated contracts with health plans (Medicare Advantage, Medi-Cal, Commercial, Exchange). The company receives a per-member-per-month (PMPM) payment to coordinate care for enrolled members across its provider network. The IPA/MSO structure manages utilization and quality metrics to achieve margins on the fixed per-member payments.
2. MSO Services to Affiliated IPAs: Prospect Health provides Management Services Organization (MSO) services to affiliated Independent Physician Associations, including credentialing, contracting, claims processing, and utilization management.

Go-to-market motion1 record

Distribution channels4 records

Marketing channels8 records

Core offering

Prospect Health operates a network of over 20 Independent Physician Associations (IPAs) and medical groups, coordinating quality healthcare delivery through a contracted provider network of 20,000+ physicians serving approximately 1.6 million members. The company contracts with Medicare Advantage, Medi-Cal, Commercial, and Exchange health plans on a capitated basis, while also providing population health programs, care coordination, utilization management, and MSO services to affiliated IPAs.

Product overview

Prospect Health (formerly Prospect Medical) is a healthcare management organization operating as a platform of over 20 Independent Physician Associations (IPAs) that coordinate quality, accessible care through an extensive provider network. The core offering consists of Population Health Programs (Diabetes Care, Heart Care, Protect Your Kidneys, COPD Care, and Asthma Care) which provide chronic condition management, combined with an Outpatient Care Management Program for post-hospital and at-home support. Healthcare Management Services tie these together through PCP support, referrals, utilization management, and member services. The Aerial Care Provider Portal enables electronic eligibility verification and referral management. The organization also provides urgent care, hospital network access, and lab/imaging services through third-party partnerships.

Differentiator

Problem solved

Functional benefit

Brands

• Prospect Health Network: Network of over 20 Independent Physician Associations (IPAs) and networks providing coordinated healthcare services across multiple states
• Aerial Care
• Daehan (대한 프로스펙트 메디컬 그룹)

Products and services

• Population Health Programs

Quantifiable outcome

• Elite Status quality award from America's Physician Groups for 7 consecutive years
• +2 more outcomes

Named customers7 records

Segments5 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

Feature4 records

Partnerships

Ten partnerships are on record, tiered core and flagship.

• LabCorpcoreTechnology or IntegrationLaboratory services partnership providing members access to LabCorp's network of laboratory testing facilities. Members can schedule appointments online or walk-in to LabCorp locations for diagnostic testing ordered by Prospect Health physicians.
• RadNetcoreTechnology or IntegrationDiagnostic radiology and imaging services partnership in California, providing members access to RadNet's premier network of imaging centers for X-rays, MRIs, CT scans, and other radiology services.
• SimonMed ImagingcoreTechnology or IntegrationRadiology and imaging services partnership in Arizona (Maricopa County), providing members access to SimonMed's diagnostic imaging facilities and services.
• Sonora Quest LaboratoriescoreTechnology or IntegrationLaboratory services partnership in Arizona, providing members access to Sonora Quest diagnostic testing facilities.
• Blue Shield of California Promise Health PlancoreChannel Partner/ Reseller/ DistributorHealth plan partnership providing Medicare, Medi-Cal, and D-SNP coverage through Prospect Health's provider network. Includes health education programs, materials, and resources for BSP members.
• Disney (Cigna Value Select)flagshipChannel Partner/ Reseller/ DistributorSpecialized healthcare partnership for Disney employees and Cast Members offering open network access with dedicated Red Carpet Usher healthcare guides, 1,500 specialists, 38 hospitals, and 150 urgent care centers.
• CalOptimacoreChannel Partner/ Reseller/ DistributorOrange County Medi-Cal health plan partnership providing healthcare coverage to Medi-Cal recipients through Prospect Health's provider network.
• Aetna Health of CaliforniacoreChannel Partner/ Reseller/ DistributorCommercial, POS, Medicare Advantage health plan partnership providing member access to Prospect Health's provider network.
• Molina HealthcarecoreChannel Partner/ Reseller/ DistributorMedi-Cal and Medicare health plan partnership providing coverage through Prospect Health's California provider network.
• UnitedHealthcarecoreChannel Partner/ Reseller/ DistributorCommercial, Medicare, and POS health plan partnership providing member access to Prospect Health's provider network.

Scale indicators7 records

Recent moves7 records

Expansion highlights6 records

Regional players

• St. Joseph Heritage Healthcare (Providence): Physician network in Orange County and Southern California affiliated with Providence health system; similar capitated risk arrangements and Orange County/Mission Hospital overlap with Prospect's geography.
• MemorialCare Medical Group: Southern California physician group affiliated with MemorialCare health system; comparable geographic footprint and capitated contract structure, though anchored in a hospital-owned delivery system rather than independent IPA.

Direct peers

• AltaMed Health Services: Large Southern California community-based FQHC/health network serving Medi-Cal, MA, and uninsured populations with capitated arrangements; comparable scale, payer mix, and community-segmented care model.
• Astrana Health (formerly Apollo Medical Holdings): Parent company and direct peer — operates a similar California-anchored IPA/MSO and value-based care platform serving Medicare Advantage, Medi-Cal, and Commercial populations, now combined with Prospect post-July 2025 acquisition.
• agilon health: Value-based care platform partnering with primary-care physicians on full-risk Medicare Advantage contracts; comparable PMPM/capitated revenue model focused on senior populations, though national rather than California-centric.
• Heritage Provider Network: Large California-based independent physician network taking delegated/capitated risk from MA and commercial plans; directly comparable IPA model, geographic overlap in Southern California, and similar capitated PMPM economics.
• Monarch HealthCare (Optum): Orange County-based IPA network serving MA, Commercial, and ACO patients; highly comparable geography, payer mix, and delegated-risk IPA model to Prospect's Southern California footprint.
• Privia Health Group: Multi-state medical group enabling value-based care with capitated and risk-sharing contracts across MA, ACO REACH, and Commercial populations; comparable operating model and payer diversification strategy.

Broad incumbents

• DaVita Medical Group (now Optum): Multi-state medical group with delegated-capitation arrangements for Medicare Advantage and commercial populations; similar VBC operating model though embedded within a much larger dialysis/integrated care parent.
• HealthCare Partners (Optum): Major Southern California IPA group (now part of Optum) with capitated contracts and delegated risk arrangements; competes head-to-head with Prospect in MA and Commercial networks.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat5 records

Key risks6 records

Key highlights6 records

Customer concentration

• YouTubeyoutube.com/@prospectmedicalgroup7965
• Facebookfacebook.com/prospectmedicalgroup
• LinkedInlinkedin.com/company/prospect-medical-systems
• Instagraminstagram.com/prospectmedicalgroup

Revenue estimate

Valuation estimate

Number of profiles

Profiles1 record

Subsidiaries25 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 Prospect Medical Group Inc.