Keith Pinter, Co-Founder And CEO, Rise Health

Value-based care—a term often tossed around in the world of healthcare. Yet its true essence remains elusive to many. Amidst the buzzwords and surface-level discussions, only a select few visionaries have delved deep into value-based care with a genuine commitment to making a meaningful difference in the world.These trailblazers are redefining the very paradigm of healthcare by placing patient outcomes, cost-effectiveness, and the patient experience at the forefront. With their transformative influence, they are breaking new ground, transcending traditional conventions and spearheading the path to a healthier future while leaving an indelible legacy of positive impact for generations to come. An embodiment of such exemplary leadership is Keith Pinter, the CEO and co-founder of Rise Health, a leading value-based primary care company that leverages technology to operate and support value-based primary care clinics.

Before his journey with Rise Health, Keith had already left his mark on the business world with a series of successful endeavours. After successfully building, buying, and selling his technology businesses, Keith felt a profound calling stirred within him to make a meaningful difference in the world of healthcare. Given the inefficiencies in the healthcare system, which consumed a significant percentage of GDP with subpar outcomes, this was not the legacy he wanted to leave for his daughters.

In 2010, a promising opportunity arose as he joined the new leadership team at HMA, the third-largest publicly traded hospital operator at the time. During his tenure, Keith served on the senior team re-engineering the company, which enabled multi-billion dollar growth, and ultimately a sale to CHS. One of his most notable achievements was the digitalization of physician services, modernizing the service delivery ecosystem, and transforming the company from an industry laggard to a true leader in innovation and technology.

The Genesis of Rise Health

Despite the numerous advancements in healthcare, Keith realized that the traditional “heads in beds”was at odds with delivering value-based care. His fascination with the role of clinicians and the inefficiencies of EMRs in a clinical setting further led him to join Sheridan Healthcare around the time of the Amsurg merger. As a member of the senior team charged with rapidly growing the company, Keith played a pivotal role in expanding the business from $800 million to an impressive $2.2 billion before merging with Envision, where he served as the Chief of Staff/COO of the $6.5B physician services business. However, he observed that simply being big did not necessarily equate to success, especially in the context of value-based care. Moreover, the healthcare system appeared to be highly reactive, with patients often only seen in a hospital setting. But it was a personal tragedy that deeply affected Keith, prompting him to delve into the chronic disease ecosystem, which accounted for a staggering 82% of the total healthcare cost.

He immersed himself in studying chronic disease management and collaborated with early change agents, serving on multiple boards in the process. This is when he realized, the industry did not need standalone providers and the primary care ecosystem was highly under-resourced, therefore making the adoption a challenge. Recognizing the potential to make a significant change, Keith, along with two co-founders, embarked on a mission to empower primary care clinicians with the necessary tools, data, resources, technology, and capital to act as care quarterbacks for patients along the entire continuum. This vision led to the birth of Rise Health, a transformative venture with a mission to maximize healthy patient days by acquiring primary care practices and converting to global risk – effectively becoming a ‘payvider’ (hybrid of a payor and provider) organization.Today, Rise Health operates exclusively in the southwest region, serving approximately 150,000 patients via current practices/those under contract with expectations of doubling that number by mid-2024.

Turning Personal Tragedy into a Catalyst for Change

Keith’s journey as a change agent was deeply influenced by a personal tragedy – the loss of his father to chronic disease conditions. Despite knowing that most chronic disease conditions couldn’t have been prevented, Keith couldn’t shake off the feeling that earlier diagnosis and proactive care might have slowed the progression, granting his parents a better quality of life. This profound experience sparked a determination within him to make a difference in the healthcare system.

Keith recognized that healthcare primarily operates on a local level, with primary care clinicians deeply rooted in their communities. Thus, he realized that enabling these clinicians with comprehensive data, resources, tools, dedicated teams, and ample time to manage a patient’s overall health would be the perfect starting point for a transformative change. Hence, the concept of REACH ACO began to take shape. The continued success of MA plans and strategic partnerships with Innovaccer and bWell allowed Keith to capitalize on structural changes to economics and advancements in technology, paving the way for an expansion of their footprint in the southwest. “By focusing and aligning incentives on delivering the most healthy patient days, better-equipping clinicians to manage overall health and being at risk to deliver on this, we are removing the excuses inherent in FFS and more importantly creating THE new paradigm for primary care and healthcare in general,” elucidates Keith.

Empowering Clinicians to Deliver Proactive and Patient-Centric Care

In the Fee-for-Service (FFS) ecosystem, clinicians face significant challenges that hinder their ability to provide optimal patient care. Limited access to comprehensive patient data, coupled with the constraints of time, reduced reimbursement, and limited technology, creates barriers to proactive and patient-centric care. Moreover, the lack of timely access to specialists adds to the complexity of patient management. To address these critical issues, the dedicated team at Rise Health has developed a proprietary, purpose-built modern technology platform built on the Innovaccer backbone that enables clinicians to access evidence-based, clinically relevant recommendations right at the point of care, empowering them with the information they need to make informed decisions.Additionally, it receives real-time ADT updates from Health Information Exchanges (HIEs) and personal health records via bWell, ensuring up-to-date care coordination by its Social Determinants of Health (SDOH) care teams.Furthermore, Rise Health’s unique care model includes scribes to assist clinicians, ensuring more time is spent on patient care rather than documenting billing data.

Pursuing Excellence with an Extraordinary Team and Partners

At Rise Health, the journey to transform the healthcare industry began with a clear vision and the formation of an exceptional senior team. They carefully selected individuals who were not only skilled but deeply passionate about driving change in the healthcare landscape. In fact, the CEO had collaborated with nearly all of them, directly or indirectly, at the board level over the past 13 years.After forming a core leadership team with esteemed professionals such as theCOO, Dr.Srini Bollimpalli, the CMO, Dr.Mike Phillips, and the CTO, Chris Strahorn, they further continued to expand their roster with world-class expertslike Scott Dalgleish, CFO. Together, this dynamic team, including co-founders Joseph Whitner and Justin Dangelbrought invaluable insights and expertise to the table. As Pinter states, “Having a co-founder in Justin Dangelwho has also co-founded 2 value-based care organizations within the past 5 years now valued at close to $1B is invaluable! Without his vision, brilliance, financial acumen and strategic understanding of the key levers in value-based care, Rise wouldn’t be where it is today!”Their collective focus remained firmly centred on putting patients first, empowering clinicians to deliver exceptional patient experiences, and finding innovative solutions for traditional challenges through rapid cycle testing and iteration. Rise Health’s commitment to excellence was further reinforced by its partnership with Lorient Capital and Martis Capital, with a substantial in the company in December 2022. “When I think of excellence, we are extremely proud to have Lorient Capital and Martis Capital as our partners. Their combination of metrics management/systems, real-world understanding of global risk/VBC and amazing track record of working with/building world-class management teams are invaluable to us as we build our platform encompassing people, processes, and cutting-edge technology,” shares Keith.

Soaring to New Heights

Today, Rise Health stands at the cusp of an incredible growth journey, bolstered by an exceptional world-class team, cutting-edge technology service delivery ecosystem, and remarkable investors/partners. With a strong foothold in the NM and SoCal markets, the company is now set to explore new territories, establish smaller practices, and engage in promising negotiations with ‘beachhead’ practices in NV, San Diego and AZ. Moreover, by the end of 2025, it aspires to provide exceptional care to over 200,000 seniors in an at-risk environment. “Our objectives are to earn the highest Net Promoter Scores from our clinicians and patients – proving that Rise is the home for clinicians wanting to practice Value-Based Care and deliver the most healthy days for their patients.”

Sharing Three Pivotal Lessons for Success

Drawing the key lessons from his incredible journey, Keith advises budding entrepreneurs to embrace three essential factors that can pave the way to success. First and foremost, he emphasizes the importance of thoroughly studying the ecosystem and identifying a pain point they are passionate about solving. Rather than creating mere point solutions, Keith encourages entrepreneurs to collaborate with trusted allies in the healthcare community to validate their ideas and demonstrate tangible results.Finally, Keith urges them to find the right capital partner once the impact of the venture becomes quantifiable. “They can make all of the difference in your journey, as changing healthcare is not a destination, but rather a journey,” concludes Keith.