XO Health Launches Next Generation Value-Based Care and Benefits Platform for Self-Insured Market

ALPHARETTA, Ga., Jan. 8, 2025 /PRNewswire/ -- XO Health launches operations of its value-based care and benefits platform, serving self-insured employers, level-funded plans and third-party administrators (TPAs). This launch will enable XO Health to bring their value-based provider network and comprehensive benefits administration offerings to customers in Atlanta, Dallas, Houston, and Minneapolis.

XO Health is redefining how healthcare is delivered and paid for by dramatically expanding access to value-based care with new advanced payment models and modern tech platform that completely rewires health plan operations and delivery. XO Health's suite of solutions includes:

• An independently contracted provider network, built on trust and autonomy, powering streamlined prior authorizations and patient billing, and placing care direction and decision-making back into the hands of physicians and their patients.
• First-of-its-kind risk contracting engine, powering the pricing and management of prospective episode-driven "care packages" delivering unprecedented transparency and predictability into medical and pharmacy costs and opportunities to improve outcomes.
• A secure real-time data and analytics platform, powering optimization of cost and quality outcomes and poised to deploy the most innovative developments in generative AI and automation.
• An integrated member and provider experience, powering high-touch, frictionless transactions and interactions for both plan members and providers through AI-enhanced workflows and omnichannel access.

XO Health was founded by industry veteran Swati Mathai, who was previously at UnitedHealthcare and Elevance Health, and has been working with market-leading self-insured employers from across the Fortune 500 for over 25 years. "Everyone's interests are underserved by today's large incumbent health plans – employer costs continue to spiral as they face growing fiduciary exposure, providers are bogged down with unending bureaucracy and plan beneficiaries are stuck in the middle just trying to affordably navigate their own health needs – and fundamentally nobody trusts each other to do the right thing," said XO Health Founder and CEO Swati Mathai. "New solutions like XO Health have the advantage of a blank canvas – we used that opportunity to deploy a novel approach that sustainably aligns everyone's interests in the pursuit of better care, improved health, and lower costs."

The company has assembled a team of leading industry experts in health plan design and value-based care. They have also engaged a broad set of advisors, including former Benefits leaders from companies who have been at the forefront of employer-led innovation in healthcare.

Hassan Azar, who is a former Benefits leader at US Foods and Kraft and has been advising the company since inception, said, "Due to the inflationary dynamics, self-funded employers are being forced to be price takers instead of being market makers. With XO Health, employers finally have a benefits solution built around their business and employee needs with an unconflicted partner committed to improving plan performance."

In addition to working directly with self-insured employers, XO Health has also announced partnerships with level-funded plans and TPAs, including Decent and S&S Healthcare, who will offer the XO Health Network to their employer customers. These contracts highlight XO Health's ability to offer more competitive pricing and better outcomes for employers of all sizes.

"We saw an opportunity with XO Health to support our direct primary care network with a like-minded partner who can offer our members the broad, seamless integration of specialty care when their care needs evolve," said Nick Soman, Decent CEO & Founder. "We are drawn to XO Health's unique value-based care approach and their network will deliver a full array of highly effective specialty care at a lower cost with improved outcomes for our members."

"As healthcare costs continue to soar, it is critical that we are introducing new options for our health plan and employer clients to help them manage their spend and the spend of their members," said Vincent Esposito, S&S Healthcare CEO. "Partnering with XO Health not only provided us with an opportunity to deliver material cost of care savings opportunities, but also enhanced delivery and administrative functions of our network to improve the overall experience for everyone."

Working with TPAs to reach employers and their employees at scale represents a critical leap forward in creating a more transparent, accountable and higher performing healthcare system that can be universally more trusted. To this end, XO Health has been focused on expanding access to care by integrating best-in-class digital and direct-access networks for behavioral and women's health into their network offering. XO Health also strengthens primary care access through partners like Hint Health, which embeds thousands of primary care physicians who are not part of traditional networks within the XO Health Network.

"XO Health shares our commitment to improving care delivery and enhancing the doctor-patient relationship," said Zak Holdsworth, CEO of Hint Health. "This collaboration allows us to expand the reach of Hint's Direct Primary Care network, Hint Connect, through XO Health's innovative approach. Together we can ensure broader access to high quality primary care."

XO Health has secured funding from institutional and private investors, including Thurston Group and Sea Court Capital. Jim DeNaut, XO Health Board Member and Managing Partner at Sea Court Capital said, "It's rare to find a leadership team that has such a deep background in health plan operations and has also been at the forefront of payment reform and value-based care. We recognized XO Health's potential right away and were excited to be the lead investor in the company. It's incredibly rewarding to see the company sign up its first customers and execute its live launch."

Following the initial launch in four markets, XO Health plans to expand its geographic presence bringing its innovative healthcare solution to more customers across the country.  The company will also continue enhancing its AI-driven data and technology infrastructure to maximize the impact of its platform. This includes optimizing plan value, improving episode pricing, and enhancing the experience for both members and providers.

About XO Health
XO Health is a groundbreaking value-based care and benefits platform with a mission to bring trust, transparency, and common sense back to healthcare. Built on a foundation of real-time data and analytics and offering a broad solution set, the XO Health platform powers excellence across the entire healthcare ecosystem. With an unparalleled team of experienced leaders from diverse domains, XO Health is uniquely positioned to disrupt the healthcare landscape and deliver the transformative change the industry deserves. To learn more, please visit www.xohealth.com.

SOURCE XO Health