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Brad Smith, Russell Street Ventures launch rural health care startup


Smith Brad
Brad Smith of Russell Street Ventures
Nathan Morgan | Nashville Business Journal

Brad Smith is launching his first startup out of Russell Street Ventures, and he’s recruited some old friends along for the ride.

Main Street Health will focus on providing value-based care in rural America, according to a news release, with its first offering designed for seniors.

The health tech firm is starting with the help of a $26.4 million investment from Smith, Frist-Cressey Ventures, Oak HC/FT and other health care entrepreneurs, according to the release. 

Main Street is a sort of reunion for Smith and Frist-Cressey founder former U.S. Senate Majority Leader Dr. Bill Frist. The pair founded Nashville-based palliative care company Aspire Health in 2013, growing it from 200 employees in 2015 to more than 650 by the time it was sold to health insurance giant Anthem Inc. in 2018.

Frist and Smith will have seats on Main Street’s board of directors, along with former Aspire board member and Oak HC/FT founder and Managing Partner Annie Lamont.

Former Aspire Health Senior Vice President of Operations Bennett Graham will work as Main Street’s president, while former chief medical officer at Community Care of West Virginia Dr. Sarah Chouinard will be Main Street’s CMO. 

Smith, who led the Center for Medicare and Medicaid Innovation during the Trump Administration, will be the company’s CEO. 

“My mom’s family is from rural East Tennessee and my wife’s family is from rural Alabama, and we have both experienced first-hand how much opportunity exists to improve access and the quality of healthcare in rural America,” Smith said in the release.  “We are optimistic that our efforts will create a scalable way to revitalize and reimagine healthcare across rural America.”

Main Street’s launch comes nearly four months after Smith announced the creation of Russell Street Ventures — a part private equity firm, part incubator focused on creating and growing health care startups. At the time, Smith said Russell Street planned to launch or invest in two to three “innovative” companies serving the needs of vulnerable populations over the next six to 12 months, with the first startup to focus on rural health. 

Main Street’s first program, called Extra Access, will provide health care services to seniors, in partnership with rural primary doctors, urgent care clinics and independent pharmacies, according to the release.

Main Street has a proprietary care management platform that integrates with a doctor’s electronic medical record to coordinate care. Senior patients will have a local “health navigator,” as well as 24/7 access to a doctor-led care team that will work with their primary physician. 

The program will initially be offered at more than 30 locations across West Tennessee, in counties with a total Medicare patient population of more than 59,000, according to the release.

“I have always been passionate about rural healthcare,” Frist said in the release. “Main Street Health is one of the first efforts I have seen that is focused exclusively on truly transforming healthcare in rural America.”

This isn’t the first startup former Aspire executives have teamed up on.

In January, Frist, Lamont, former Aspire Chief Legal Officer Cory Brown and former Aspire Director of Strategy Brett Jackson announced that they’d raised $40 million to form a new long-term support company called CareBridge. That round of funding was led by Oak HC/FT.

"Oak HC/FT has always believed that to provide the best care at the lowest cost, the future of healthcare has to be driven by value-based care," Lamont said in the release. "We are proud to continue our longstanding partnership with Brad and collaborate with the entire team at Main Street Health to reinvent healthcare in rural America."


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