Greensboro-based UpStream Healthcare has done what every startup hopes for: the company has doubled in a few short months, growing not only its employees but also the patients it cares for.
Up until the end of 2021, UpStream had embedded its pharmacists and nurses in several practices and directly managed the care of about 11,000 seniors. Now, it directly manages the care of about 30,000 patients – with employees embedded in over 50 practices working with almost 300 physicians – with plans to continue its rapid expansion. UpStream also oversees the care of about 100,000 seniors in a four-county region in the Triad, ensuring they receive high-quality care.
Founded in 2017, the startup focuses on vulnerable groups in healthcare, including the elderly, frail, poor and people with chronic conditions. Sanjay Doddamani, co-founder and CEO of Upstream Care, said these patients often end up using the healthcare system in an adverse way, through emergency room visits and hospitalizations for conditions that could be managed better through a doctor. The idea is to help patients receive better care by addressing issues in healthcare upstream, rather than trying to fix the problem when it might be too late or too fragmented.
Doddamani said the company doubled last year and expects to more than double this year. UpStream employs just over 200 people, and Doddamani hopes to have more than 1,000 employees in a year’s time. He also hopes to reach 1 million seniors with the company’s care.
The quick growth is in large part due to a partnership with Cone Health that began at the beginning of this year.
UpStream has embedded its pharmacists and nurses in many of the primary care practices in Cone’s Triad HealthCare Network, an accountable care organization composed of Cone and non-Cone doctors. The network includes 2,378 providers across Alamance, Guilford, Forsyth, Randolph and Rockingham counties.
“UpStream has the necessary capital to support a change in our primary care provider incentive methodology and protect Cone Health from excessive financial risk,” a representative for Cone said. “This agreement will allow us the ability to improve value-based care and reward our physicians for their excellent work as they improve the quality of care and lower the cost of care of those we serve.”
As a risk-bearing health management services organization, Upstream Healthcare enables primary care doctors to maximize the value-based care they provide by embedding nurses and pharmacists in doctors’ offices. Value-based care emphasizes better outcomes and incentivizes doctors to provide higher-quality care, rather than a fee-for-service model which emphasizes how much care a patient receives.
With value-based care, there is a big opportunity for savings and financial incentives for the doctors – but there is also a large financial risk if the doctors do not deliver. UpStream assumes that financial risk and helps the doctors create more opportunities to provide better care, with the goal that it leads to the reimbursement of those incentives.
“There’s been a lot of promise; there’s been a lot of band-aids,” Doddamani said. “We believe that you can transform outcomes and reduce costs for seniors if you can get to the point of care.”
UpStream will expand across the state through its recently announced partnership with the Community Care Physician Network, the largest independent primary care network in North Carolina with more than 3,600 providers.
The startup has been on a hiring blitz recently, adding core members to its C-Suite such as a chief technology officer, chief financial officer and chief network officer.
Given how fast UpStream is growing, Doddamani plans to have more capital and funding needs by early summer. He said he expects to keep the company’s headquarters in Greensboro as it expands.
UpStream has also created a technology platform that is built upon data analytics to understand who is living with what condition, how severe it might be, what gaps exist in care and how to close those gaps. These analytics allow UpStream to take action through its medication optimization, disease management and care coordination programs.
As it looks for other ways to expand and embed its pharmacists and nurses in more practices, Doddamani says UpStream will keep one thing in mind.
“Our focus is patients, the seniors, that are struggling in the community with a lot of needs – many are very dependent,” Doddamani said. “Whatever we can do to alleviate the difficulties they encounter, the doctors appreciate the collaboration.”
