Health Plan Administration Company Flume Health Raises $10 Million

By Annie Baker ● May 27, 2021
  • Flume Health, a health plan administration platform for the modern fragmented healthcare ecosystem, announced it raised $6 million. These are the details.

Flume Health — a health plan administration platform for the modern fragmented healthcare ecosystem — announced that it has raised $6 million in equity funding led by new investor Crosslink Capital with participation from new investors Route 66 Ventures and Convene CEO Ryan Simonetti. And existing investors Accomplice, Founder Collective, and Primary Venture Partners also participated in the Seed II round — which brings Flume’s total raise to $10 million.

Launched last year, Flume Health is a new generation of health plan administrator intentionally built to reduce healthcare costs, improve quality of care and transform the user experience for both employers and members. And Flume’s administrator model allows self-insured employers and their workforces to unbundle their health plans and augment or replace legacy off-the-shelf plans with specialized providers who address specific populations with conditions such as MSK pain, diabetes, mental health, and many more. 

By combining active employer and member engagement with a tech- and data-forward product, Flume leapfrogs legacy health plan administrators’ capabilities. And on average, Flume-designed plans save employers nearly $5,000 per employee per year.

New care models such as virtual primary and behavioral care, insurance navigation and digital therapeutics have emerged during healthcare’s current digital transformation moment. And each play a role in reducing costs and improving quality of care, but all are limited in their ability to create systemic change. Sustainable change requires not only that plan members can access new care models, but that they can intelligently and pro-actively navigate their care landscape in real-time, as their care needs arise.

Flume is essentially bringing tech- and data-enabled proactive plan management and member engagement into one of healthcare’s most opaque legacy spaces: third-party (health plan) administration (TPA). 

TPAs help with the design, launch, and ongoing management of self-insured employers’ health plans. Since their relational orbit includes employers, members, payers, providers, brokers, TPAs are a single store of truth with a universal view into member eligibility and every pre-certification or pre-authorization request. And TPAs also pay and process every medical claim, gaining insight into members’ healthcare journeys.

KEY QUOTES:

“Employers increasingly feel the burden of rising healthcare costs, with healthcare overhead doubling every four years. Companies don’t want to pass these costs on to their talent through higher deductibles or fewer benefits and are looking to unbundled plans and the digital health ecosystem for solutions. Yet utilization of these services is low, due to increased administrative burden. Flume is proving that innovation at the health plan administrator level is a fundamental ingredient to activating sustainable system-wide change.”

— Gabby Contro, who led the investment for Crosslink Capital

“TPAs are in an incredible position to empower employers to run leaner, more efficient plans and improve quality of care, but most are stuck in the pen and paper era. By supercharging the role of the TPA through digital transformation, real-time data and true proactive member engagement, care access improves and care costs go down. For small and medium-sized businesses, saving hundreds of thousands of dollars on healthcare can mean the difference between thriving or shutting down.”

— Cedric Kovacs-Johnson, CEO and founder, Flume Health