It's estimated that 6.5 million Americans over the age of 20 have heart failure, and the condition is a leading cause of hospitalizations, driving a significant portion of healthcare costs.
Hospital readmission rates among heart failure patients continue to be a persistent challenge. More than 40% of heart failure patients were readmitted within 90 days of hospitalization, according to one study. For providers, it's a familiar but unfortunate pattern with a churn of heart failure patients between hospitals and homes, often without continuity, coordination or support.
New startup Linea is redefining heart failure care by applying artificial intelligence combined with high-touch care teams to provide patients with more proactive care and reduce preventable hospital readmissions.
The company, which launched in January 2024, combines generative-AI-powered hospital admission detection, medication prescribing and dosing optimization, proactive virtual care teams and real-time patient engagement into a single, scalable model. Linea is backed by venture builder Redesign Health and kidney care provider DaVita.
Linea CEO Rishi Madhok, M.D., an emergency medicine physician at UCSF Medical Center, sees big opportunities to use technology to scale care, including leveraging agentic AI to scale high-quality care.
"We started Linea with the focus of helping a very specific population—patients with heart failure. These patients are high cost, high risk, with a high burden of disease. They get admitted to the hospital frequently, and then they get readmitted at a rate of nearly 40% to 60% across the population. In addition to that problem, we also saw solutions. Better patient engagement, but also the use of specific therapies, guideline-directed medical therapies, have been shown that if you can get patients on these medications and titrate them up safely, you can keep them out of the hospital. But that has to be put into place. You need a platform or a service like Linea to do that," Madhok told Fierce Healthcare.
Linea's approach is to use AI to identify patients early when they are admitted to the hospital, engage them early and "be that hand that lifts them up out of the water and onto the boat, and then get them on an upward trajectory," Madhok said.
The model is specifically designed for accountable care organizations and risk-bearing providers.
"We felt that these groups were the ones that were participating in the Medicare Shared Savings Program. They were taking on risk with these patients. We're taking on a known problem. Patients with heart failure get readmitted. These are patients at higher risk with higher costs, and it's going to affect your MSSP payments," Madhok said. "When you engage with Linea, our goal is to drop that readmission rate to 20% or below it."
Linea provides 90 days of coordinated hybrid care and supports patients end-to-end across four key components. The company's model supports transitions of care and guideline-directed medical therapy with pharmacist-led medication review. It also leans on remote monitoring with real-time alerts triggered by biometrics and symptom tracking for early interventions. Linea provides virtual care services with nurses conducting risk assessments, fluid checks and 24/7 SMS-based support. And it integrates into existing clinical workflows to connect primary care, cardiology, nephrology and ACO teams.
Linea's AI-powered model is already showing strong results for ACOs: a 50% reduction in hospital readmissions, sustained patient engagement and meaningful cost savings.
Linea’s 90-day readmission rate is less than 25%, well below the national average of 40%. The company's post-acute heart failure solution results in earlier detection of hospital admissions and discharges, deep patient engagement quickly following a health event and a level of high-touch follow-up, with more than a dozen check-ins in the first 30 days, the company claims.
On average, patients engage in the platform within two days of a health event, with nearly 80% of patients engaged before being discharged from the hospital.
The Linea platform identifies patient admissions and hospital discharges four days earlier than traditional methods, giving care teams a critical head start.
"Most ACOs will not know that their patients are sitting in the hospital bed. Most ACOs and most cardiologists and doctors will not know that a patient has been discharged until weeks later," Madhok said. "The only thing we need to get going is a name, a phone number and a date of birth."
Patients receive more than a dozen supportive calls and messages in the first 30 days post-hospitalization—compared to a national norm where 60% of patients receive no follow-up at all—driving deeper engagement and patient satisfaction.
In most cases, heart failure patients who are discharged from the hospital are left to fend for themselves, Madhok said.
"The plan that gets put on paper for them within the traditional workflow, [the patients] can't follow it, they end up back in my emergency room seven to 10 days later," he said. "The patients are organizing their cardiologist, their nephrologist, their primary care doctor, their endocrinologist. It's a lot to handle, often on their own or with a caregiver who's trying to support that. Linea looked at that opportunity to say, 'How do we step in?' Not thinking, 'How do we AI this?' Or, 'How do we throw bodies at this?' But, how do we solve this for the patients in a way that also adds value back to that nephrologist, that cardiologist, that PCP?'"
Linea aims to set a new standard in post-acute heart failure care. The solution continuously monitors patient risk, flags changes in conditions and automates key clinical tasks such as guideline-directed medical therapy recommendations, appointment scheduling and medication reconciliation, executives said.
Offered at no cost to patients, Linea's solution utilizes a value-based pricing model where ACOs pay only for actively enrolled patients, helping partners control costs and earn shared savings, according to the company.
Linea is expanding its solution by rolling out to more states and onboarding three additional ACO partners in 2025, Madhok said. The company is poised to partner with new ACOs and payers over the next year.
The startup's strategic partnership with DaVita is key to this expansion. The collaboration also marks an innovative approach to whole-person care that spans conditions and specialties. Heart failure and chronic kidney disease (CKD) frequently coexist. Studies indicate that nearly half of patients with heart failure have a degree of renal impairment, and heart failure is prevalent in 17% to 50% of patients with CKD.
The partnership with Linea bridges a "critical gap in care" and provides a new standard in specialty care, said Misha Palecek, chief transformation officer for DaVita.
"We're excited about working with Linea, because value-based care and figuring out how to move a fragmented, fee-for-service system into an organized chronic condition disease management system is really hard. Linea is a nice example of a partnership where you can take a very specific disease and a company like Linea will focus on that specific disease state. They've had really great results, and we're looking forward to scaling up with them," Palecek said in an interview.
Linea's AI-driven patient engagement and patient navigation is "one piece of the puzzle" to care for high-need patients, Palecek noted.
"When you're managing 85,000 chronic disease patients that have multiple comorbid conditions, you're trying to put together all the different pieces, whether it's diabetic care, or it's COPD care, or it's the CHF or behavioral health, and figuring out what is the most important part for that patient. If you take this approach, that it needs to be patient-centric, then you think about, 'What does that patient need most?' And then you help them navigate that over that 90-day period. With that approach, I think we can do a lot better for the patients. We can do better for the system. We can do better for the American taxpayer," he said.
Moving into 2026, Linea plans to work with more ACOs and will continue to "push the needle" to address the needs of complex patients, potentially expanding into kidney and metabolic diseases, Madhok noted.
“Linea exemplifies the type of company we strive to build, one that effectively integrates AI, clinical expertise and patient engagement to deliver scalable value-based care," said Neil Patel, head of ventures at Redesign Health, in a statement. “We’re proud to support Linea as it scales nationally and builds a smarter infrastructure for post-acute care.”