Enlace Health (formally Aver)

Enlace Health operates as a tech-enabled services company, providing an end-to-end infrastructure to facilitate the healthcare industry's shift from fee-for-service to value-based care models. Founded in 2010 as Aver Informatics, the company rebranded to Enlace Health in November 2021 to reflect its expanding focus on connecting payers, providers, and patients. This rebranding coincided with a significant $58 million investment led by Cox Enterprises.

The company is steered by President and CEO Bill Nordmark, whose career has been dedicated to developing healthcare reimbursement systems and scaling early-stage companies. His experience at firms like PaySpan, Washington Publishing Company, and Clearwave Corporation provided him with a deep understanding of the systemic inefficiencies in healthcare, which now guides Enlace Health's strategic direction. The leadership team includes seasoned executives from the healthcare and technology sectors, such as CFO Scott Foster, previously with WellCare Health Plans, and Chief Privacy Officer & General Counsel Robert Ball, who has experience at Akamai Technologies and Ionic Security.

Enlace Health's business model centers on its proprietary platform, which equips clients to design, manage, and scale value-based care programs, with a particular focus on specialty care. The company serves large commercial health plans, Medicare Advantage plans, and health systems, helping them design and administer programs in high-cost areas like cardiology, oncology, and orthopedics. Revenue is generated by providing these tech-enabled services to clients, with the company's annual revenue estimated to be between $10 million and $50 million. Since its inception, Enlace has raised approximately $110 million in funding over several rounds from investors including Cox Enterprises, Hearst Ventures, and Drive Capital.

The platform's core functionalities include the Opportunity Analyzer, which identifies areas for cost and quality improvement, and the Program Builder, which allows for the creation of customized episodes of care and other value-based payment models. The Claims Administrator and Claims Payments modules then handle the operational complexities of managing contracts, reconciling claims, and disbursing funds within these new payment structures. This comprehensive suite of tools enables clients to transition from traditional fee-for-service billing to prospective and retrospective episode-of-care arrangements, aligning financial incentives with patient outcomes. Recently, the company has expanded its platform to support the Centers for Medicare & Medicaid Services (CMS) TEAM program, a mandatory episode-based payment model.

Keywords: value-based care, healthcare reimbursement, bundled payments, episode of care, healthcare payment infrastructure, specialty care management, payer solutions, provider solutions, healthcare analytics, cost containment, healthcare finance, claims administration, risk arrangement, care delivery models, health tech, Medicare Advantage, accountable care organization (ACO), value-based programs, healthcare economic models, quality-driven healthcare