Sacra estimates that Carbon Health generated roughly $77.5M in revenue in the first half of 2023, down from $180M in 2022.

Carbon’s revenue trajectory mirrors that of many pandemic-era healthcare companies that scaled rapidly around Covid services and then had to rebuild a sustainable core once that demand evaporated. Revenue previously peaked at roughly $230 million in 2021, when about 60% of sales came from Covid testing and vaccination programs. That revenue stream has since gone to zero.

Following the pandemic surge, Carbon’s revenue declined materially in 2022 and again in 2023, forcing the company to re-anchor the business around urgent care, primary care, and virtual visits as it works to stabilize the topline and narrow losses.

Carbon Health's most recent valuation is $1.4 billion following a $100 million Series D round led by CVS Health Ventures in January 2023. This is a decline from the company's peak valuation of over $3 billion in 2021.

The company has raised an additional $50 million beyond the announced $100 million round, bringing the total Series D to $150 million.

Previously, Carbon raised $350 million in July 2021 at its peak valuation, with participation from Blackstone, BlackRock, Brookfield Technology Partners, Dragoneer Investment Group, Silver Lake, Lux Capital, Homebrew, and DCVC.

In total, Carbon Health has raised approximately $674 million across all funding rounds since its founding in 2015.

Carbon Health’s product strategy centers on owning the full care stack, from patient experience to clinical workflow to backend billing and analytics.

Patients interact with Carbon through a unified mobile app that supports appointment booking, telehealth visits, chat-based follow-ups, and care coordination. The physical layer consists of approximately 120 clinics offering urgent care, primary care, pediatrics, and mental health services, designed to support same-day access and standardized workflows.

Virtual care is not positioned as a standalone telehealth offering but as a front door and continuity layer that wraps around physical visits. This allows Carbon to manage care longitudinally while retaining the ability to escalate patients into in-person settings when necessary.

At the core of Carbon’s differentiation is CarbyOS, its proprietary electronic health record and operating system. Unlike legacy EHRs retrofitted with add-ons, CarbyOS was built to integrate scheduling, documentation, billing, and patient engagement into a single system.

The most visible component is AI-powered ambient scribing, which converts clinician–patient conversations into structured medical notes in minutes. Carbon reports that this reduces documentation time by roughly 75% and has increased patient throughput by around 30% in pilot locations without adding staff.

These gains matter because documentation burden is one of the largest drivers of clinician burnout and visit inefficiency. If sustained at scale, software-driven throughput improvements represent one of the few levers capable of materially changing clinic economics.

Beyond visits, Carbon’s Connective Care model supports ongoing patient engagement. Patients can set health goals, stream data from connected devices such as glucose monitors and blood pressure cuffs, and receive asynchronous support from care teams between visits.

This infrastructure enables condition-specific programs, such as diabetes management, that combine remote monitoring, tele-specialty care, and in-clinic services. The platform also integrates with national labs, imaging providers, pharmacies, and employer clinics through APIs.

Carbon operates a hybrid B2C care delivery model that blends fee-for-service medicine with emerging value-based and care-management revenue.

The company generates revenue from insured patient visits, direct-pay visits with transparent pricing, employer contracts, and payer partnerships. Unlike membership-based primary care models, Carbon does not charge upfront subscription fees to consumers, instead monetizing through utilization and ongoing care relationships.

As Carbon signs more value-based contracts, revenue increasingly includes care-management fees and shared savings tied to outcomes such as reduced emergency room utilization and improved chronic condition control.

Carbon’s model relies on software to create leverage inside a capital-intensive business. Proprietary EHR workflows, AI documentation, and integrated billing are designed to lower cost per visit and increase clinician productivity relative to traditional urgent care chains.

That said, fixed costs remain substantial. Clinic leases, staffing, and regulatory compliance create a cost base that cannot flex quickly. Carbon expanded aggressively during the pandemic and now carries leases that were sized for higher utilization levels.

Profitability depends on increasing visit volume at existing locations, improving payer reimbursement, and scaling longitudinal care programs that raise lifetime value per patient. New clinics typically take 18 to 24 months to reach maturity, and a large portion of Carbon’s current footprint is still relatively young.

Carbon Health competes across three overlapping healthcare markets that increasingly bleed into one another: retail urgent care, primary care delivery, and virtual-first care sold to payers and employers. Each market has different economic constraints, customer buyers, and scaling dynamics, which is why Carbon’s hybrid model is both strategically compelling and operationally difficult.

The unifying competitive axis is control of the care stack. Incumbents tend to dominate one layer (distribution, reimbursement, or physical footprint) while Carbon’s bet is that owning clinics and software and patient relationships enables compounding advantages over time. The risk is that each layer is brutally competitive on its own.

The most formidable competitors are national retail platforms that combine massive consumer reach with healthcare delivery.

Amazon’s One Medical sits closest to Carbon’s long-term ambition. One Medical blends primary care clinics with national virtual access and layers that into Amazon’s Prime ecosystem.

The strategic advantage is not clinical differentiation but distribution: Amazon can subsidize care, bundle visits with Prime, and use its logistics and pharmacy assets to create a low-friction healthcare experience. Carbon cannot match Amazon on customer acquisition efficiency, but it arguably has more flexibility in care models, payer experimentation, and software iteration speed.

CVS Health represents a different kind of threat: payer-backed retail healthcare. With MinuteClinic, Oak Street Health, and Aetna under one roof, CVS can steer insured lives directly into its clinics, control reimbursement, and capture margin across the value chain.

Carbon’s partnership with CVS Health Ventures suggests CVS may see Carbon less as a head-on competitor and more as a technology and operating system partner that can modernize its own footprint. Whether that relationship evolves into deep collaboration or competitive overlap will matter materially to Carbon’s future.

Walgreens and VillageMD illustrate the counterpoint. Walgreens’ multibillion-dollar impairment and clinic closures underscore how unforgiving clinic economics can be at scale. This retrenchment may ease local competitive pressure for Carbon in some markets, but it also validates the core risk of Carbon’s model: retail healthcare is easy to expand and hard to operate profitably.

The second competitive cohort consists of startups attempting to deliver primary care without carrying a full clinic footprint.

Companies like Forward Health pursue a premium, preventive-care angle with heavy biometric monitoring and higher price points aimed at affluent consumers. These models trade scale for margin, and while they don’t directly compete with Carbon’s urgent care volume, they compete for the same narrative: tech-enabled primary care as a superior alternative to legacy medicine.

Virtual-first players such as Firefly Health, Galileo Health, and Included Health attack the employer and payer channel directly. Their advantage is capital efficiency; without clinics, they can scale nationally with far less fixed cost.

Their disadvantage emerges when patients need labs, imaging, physical exams, or urgent intervention, which are handoffs that degrade experience and outcomes. Carbon’s hybrid model exists precisely to close that gap, but it pays for that advantage with real estate, staffing, and regulatory overhead.

In practice, Carbon often competes not by displacing these players outright but by positioning itself as a higher-acuity, more comprehensive option for payers that want fewer downstream referrals and better control over total cost of care.

At the ground level, Carbon competes clinic by clinic with established urgent care operators such as CityMD, GoHealth Urgent Care, and health-system-backed regional chains.

These incumbents have three structural advantages: mature payer contracts, predictable utilization patterns, and operational muscle memory. They generally know how to make urgent care profitable at steady-state volumes. What they lack is a unified technology stack; most operate with fragmented EHRs, outsourced billing, and limited patient engagement between visits.

Carbon’s wager is that software can be a wedge even in a mature category. Ambient documentation, integrated scheduling, automated billing, and unified patient apps are meant to compress cost per visit and increase clinician throughput. The question is whether these gains are incremental or transformative enough to overcome the incumbents’ reimbursement and utilization advantages.

Carbon’s current revenue base reflects what it is today: a large urgent care and primary care operator with a growing virtual layer. Its long-term TAM story, however, depends on what it becomes: a longitudinal care platform that monetizes outcomes, not just visits.

The U.S. healthcare system spends over $4.5 trillion annually, but most of that spend sits in chronic disease management, emergency care, and hospital services, areas where poor primary care access creates downstream cost explosions. Carbon’s expansion strategy is about intercepting patients earlier, more often, and more continuously.

Chronic disease management is the most obvious and economically meaningful expansion vector. Diabetes, hypertension, obesity, and metabolic disease represent hundreds of billions of dollars in annual spend, much of it tied to preventable complications.

Carbon’s diabetes program is an early template: combine continuous glucose monitoring, tele-endocrinology, in-clinic labs, and ongoing remote support into a single care loop. This model converts episodic interactions into monthly revenue streams and qualifies for value-based reimbursement structures that reward reduced hospitalizations and improved outcomes.

If Carbon successfully extends this model into adjacent chronic conditions, it moves from being a place you go when you’re sick to a platform that manages your health over years. That shift is existential for unit economics, because longitudinal care smooths demand, improves capacity planning, and raises lifetime value per patient.

Employers and insurers are increasingly desperate buyers. With healthcare costs projected to continue rising mid-single digits annually, buyers are willing to experiment with new care delivery models that promise lower total cost of care.

Carbon’s hybrid footprint gives it flexibility here. It can sell virtual-first plans nationally, layer in physical clinics in dense markets, and use omnichannel triage to divert expensive emergency room visits. For payers, this enables shared-savings and capitation models that simply aren’t feasible with urgent-care-only operators.

The CVS relationship is again instructive. If Carbon proves it can deliver equivalent or better outcomes at lower cost, it becomes a lever for payers to reshape networks—steering members away from hospitals and into tech-enabled outpatient settings.

The most speculative, but potentially highest-margin, TAM expansion is software.

CarbyOS is a full-stack operating system for outpatient care, spanning documentation, scheduling, billing, and patient engagement. The ambient scribing component alone addresses one of healthcare’s most universal pain points: clinician time spent on paperwork.

If Carbon licenses parts of this stack to third-party clinics, health systems, or retail partners, it decouples growth from clinic count. CVS piloting Carbon’s technology inside its own stores hints at this direction. In that future, Carbon looks less like a regional clinic operator and more like a healthcare infrastructure company whose software runs on top of other people’s real estate, and Carbon’s clinics become proving grounds where new workflows are battle-tested before being exported to partners.

Unit economics: Carbon continues losing $64 per patient visit despite operational improvements, making profitability dependent on dramatic volume increases or cost reductions. The company cannot grow its way out of negative unit economics without fundamental changes to its cost structure or reimbursement rates.

Payer leverage: Small networks like Carbon typically lack negotiating power with major insurers, resulting in lower reimbursement rates than established competitors. Carbon's public dispute with Anthem Blue Cross over inadequate payment rates illustrates this structural disadvantage that could persist as the company scales.

Capital intensity: Healthcare clinic expansion requires significant upfront investment in leases, equipment, and staffing before locations reach profitability. Carbon's experience signing too many leases during the pandemic demonstrates how quickly fixed costs can outpace revenue, particularly in economic downturns or market corrections.