Strive Health, a value-based kidney care company, banked $300 million in a series D equity round and secured $250 million in debt financing to invest in artificial intelligence tech and deepen its partnerships with payers and providers.
New Enterprise Associates (NEA) led the equity funding and additional investments were received from CVS Health Ventures, CapitalG, Echo Health Ventures, Town Hall Ventures and Redpoint alongside several new institutional investors, including funds and accounts managed by affiliates of BlackRock. Hercules Capital led the debt financing.
Many of those same investors also backed the company's $166 million series C round in 2023.
Strive Health has raised $700 million to date and the latest capital raise boosts the company's valuation to $1.8 billion.
The kidney care company has steadily grown, now caring for over 145,000 people with kidney disease and partners with more than 6,500 providers across all 50 states. The company says it manages nearly $5 billion of annual medical spend.
In 2023, the company served 80,000 chronic kidney disease (CKD) and end-stage renal disease (ESRD) patients across 30 states. Strive now has more than 700 employees.
The company, which was founded in 2018, uses a unique combination of technology-enabled care interventions and seamless integration with local providers, Strive forms an integrated care delivery system that supports the entire patient journey from chronic kidney disease to end-stage kidney disease. The company also has expanded into additional high-cost specialties such as congestive heart failure.
Strive partners with commercial and Medicare Advantage payors, Medicare, health systems and physicians through flexible value-based payment arrangements, including risk-based programs. Its customers include Humana, Aetna, Oak Street Health and Blues plans.
"What's different about us is we integrate into the physician community. We're integrated with more than 6,500 providers, 700 of those are nephrologists that we're in some form of arrangement with, either through the KCC (CMMI Kidney Care Choices) program, or just through our local integration and market. We believe, and I think our success is proving it out, that when you integrate in the community where the care is being delivered, you can have a bigger impact on the patient journey," Chris Riopelle, co-founder and CEO of Strive Health, said in an interview.
Through Strive Health's model, patients are paired with a dedicated care team, what Strive calls its "kidney hero" care team for continuous support between nephrologist visits. That care team, led by a nurse practitioner, includes case managers, care coordinators, social workers, dieticians and pharmacists, Riopelle said.
"This team is responsible for a patient and are coordinating and activating care. We're not the cardiologist, but we're making sure they go to the cardiologist and they follow up with the treatment plan that the cardiologist is engaged with. We aren't the nephrologist, but we are co-located, in some cases, and partner with nephrologists to make sure that we're delivering incremental care," he said.
He added, "We're delivering what no one else is, and, without us, the patient will be left to their own devices. That means, if they want access to care, they'll access it through the ER, very inefficiently, and have a more complex, lower-quality, higher-cost existence in the healthcare world."
Strive’s value-based care approach to kidney disease focuses on early intervention and preventative care to slow the progression of chronic kidney disease, reduce hospitalizations and enable more optimal starts on renal replacement therapy like dialysis. Since its founding, Strive has conducted over 1.3 million patient touchpoints, the company says.
"We're seeing huge results and major cost of care reductions over 20%. We're also seeing a 41% reduction in hospitalizations or five-fold improvements on preemptive transplants in markets," Riopelle said.
Strive claims it has saved its health plan and provider partners more than $400 million.
Chronic kidney disease affects 1 in 7 adults, with most unaware they have it. Each day, about 360 Americans begin dialysis to treat kidney failure – an expensive, life-altering stage of the disease. Specialty care has emerged as a major driver of increasing U.S. healthcare spending and value-based models could substantially lower those costs, by more than $100 billion a year, according to a McKinsey & Company analysis.
Strive Health plans to use the fresh funding to build out AI-driven tools and analytics.
"We have been investing in AI before it was cool," Riopelle quipped. The company started out using machine learning and analytics to stratify patients and direct the right care intervention.
"Where we're seeing opportunities, and some that we've deployed already, is predictive AI, which we've been doing for a while, and that's getting more precise along with agentic AI, ambient scribes, working with genAI and LLMs (large language models), every part of our business, both in care delivery, administration and making my kidney heroes' jobs more efficient and effective, we're seeing huge improvements," he noted.
"This capital will allow us to accelerate technology investments and will also allow us to accelerate the buildout of other comorbid condition management. We manage a lot of congestive heart failure patients today, and so we continue to invest in our clinical model around those patients," he said.
"We have, without a doubt, the strongest capital position in specialty kidney care. We think as the market matures that puts us in a great position to continue to grow and expand," Riopelle noted.
The company is profitable on a unit economic basis, he said. "It's all about how much we want to grow. We're growing so quickly. Our profitability is something that exists. It depends on how fast we want it to be there. We're on that path to profitability," he said.
Asked about the potential for an initial public offering, Riopelle said the company was not focused on an exit "at this stage."
"We are very focused on continuing to grow the business. Being public would be an interesting opportunity to access capital. While that can be attractive, we also are able to raise capital privately, and I think that's a broad change in the market over the years," he said.
Through the tail end of 2025, the company also will focus on growing its partnerships with payers, health systems and providers.
"We've worked really hard to have very aligned partnerships, both on quality and economic terms. Part of expanding with them is looking at what are the lines of business? What are their geographies? What other disease states can we partner with you on now that we're integrated in the community and our technology is driving real results in terms of our effectiveness. We think there's an opportunity to keep going," he said.
Strive Health continues to be bullish on the shift to value-based care and is a key participant in the Centers for Medicare & Medicaid Services Innovation Center's (CMMI) Kidney Care Choices (KCC) model, specifically through the Comprehensive Kidney Care Contracting (CKCC) options.
"Our country needs to have a stable and flourishing value-based care ecosystem to continue to manage this incredibly large annual spend. I think value-based care is without a doubt here to stay in terms of specialized populations like kidney disease," Riopelle said. "Has VBC had its ups and downs? Yes. And will it continue? Of course it will. We're not going to get this right overnight. We can't change 60 years of healthcare mechanics in a week or a year or even a decade. And so it needs to be the intrepid among us who have the confidence to say we are going to change this, and we're going to prove it each and every year along the way. And when you combine that over a decade or longer, it's going to be here to stay."