Devoted Health value-based provider model

This choice keeps Devoted asset light where Medicare Advantage usually gets operationally heavy. Instead of buying clinics and employing large local care teams in every market, a contract led model lets a plan expand county by county by signing providers to shared savings or capitation deals, while keeping the insurer focused on pricing risk, member service, Stars performance, and care coordination technology. That is the same basic scaling logic behind Alignment, but it contrasts with Devoted's broader in house care stack.

• Alignment ended 2024 with 189,100 members and its first full year of positive adjusted EBITDA. That shows the provider partnership model can scale meaningfully without owning a large clinical footprint, if the plan can steer members, manage utilization, and keep medical benefits ratios tight.
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• Devoted has gone further into vertical integration. It pairs the insurance product with Devoted Medical, personal guides, virtual care, in home visits, and an internal operating system that connects claims, care tasks, and compliance work. Owning more of the workflow can improve control, but it also adds hiring and execution burden in each market.
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• The broader market has become less forgiving of Medicare Advantage complexity. Oscar left Medicare Advantage before the 2024 plan year, and industry filings describe plan cancellations and market exits tied to higher medical costs and regulatory pressure. In that environment, partnership models look attractive because they need less fixed clinical infrastructure.
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Going forward, the winning Medicare Advantage startups are likely to look more like operating systems for provider networks than clinic roll ups. Plans that can plug into doctors' existing practices, pay them for better outcomes, and layer in software, navigation, and Stars execution should be able to expand faster and defend margins as seniors get more expensive to serve.