SAN DIEGO COUNTY — With the success of its initial pilot program targeting the health care needs of some of the most vulnerable people with some of the highest costs in the region, health tech startup Presidium Health is now scaling its operations in San Diego County and other California markets.
Presidium Health’s service-directed technology focuses on creating innovative health solutions for the most in-need patients, bringing them personalized care and services away from a doctor’s office, hospital or emergency room setting.
Co-founder & Chief Medical Officer
Presidium Health
“What you have here economically is a patient base that is treated so inefficiently that the value within each patient is an economy unto itself,” Presidium Health co-founder and Chief Medical Officer Dr. Ashkan Hayatdavoudi said.
Using home-based medical and social services to help nearly 100 of the highest-costing Community Health Group patients in a pilot program completed in 2022, Presidium Health showed a 53% reduction in hospitalizations — a $6 million savings. A follow-up program this year with more than 400 patients netted savings of more than $14 million.
With that validation in San Diego County, Presidium Health, founded locally in 2015, is extending its services with other health plans in Orange County, Los Angeles County and the Inland Empire.
Co-founder & CEO
Presidium Health
“Our scale will be facilitated by these contracts as well as our technology platform, STAT (Secure Text Activated Triage),” said Presidium Health co-founder and CEO Dr. Pouya Afshar.
Created by Presidium Health’s in-house technology team, STAT is a virtual health system capable of coordinating care services on a population level throughout California.
In July, the company was awarded a grant through the Los Angeles County CalAIM (Cal Advancing and Innovating Medi-Cal) Incentive Payment Program (IPP). Launched in 2022, the CalAIM initiative is a four-year, $6.8 billion Department of Health Care Services program to promote equitable care by expanding care and services to the neediest of patients.
The grant will support onboarding the state’s underserved Medi-Cal beneficiaries onto Presidium Health’s STAT coordination of care platform.
Presidium Health is part of a larger movement in health care called “value-based care,” where outcomes can be improved at a reduced cost.
Its model of whole-person, holistic care includes in-home medical providers, mobile diagnostics, behavioral health, social support and concierge-level advanced primary care. It also includes food delivery, transportation, internet access, mobile phones, employment help and personal fitness training.
Healthy Background
Two years ago, Presidium Health contracted with and completed a program with San Diego’s largest nonprofit Medicaid plan, Community Health Group, targeting 93 patients with a historical annual cost in healthcare needs of $17.9 million.
Using its home-based model of care with 24/7 access and in-home urgent care (including Xrays and laboratory needs), the company was able to reduce hospitalizations by 53%, resulting in $6 million of savings on just those 93 patients.
“This amounts to an average of $65,000 of annual savings per patient — a number that is truly unprecedented,” Afshar said.
Presidium and CHG were able to identify members within that organization who were in the top 1%, take their model of care and “go to them wherever they’re at and provide what some people would call concierge care,” said Afshar, who noted that “it’s not concierge care for someone living in La Jolla, it’s concierge care for the truly underserved, marginalized patient population.”
Presidium Health recently completed a second value-based contract with Community Health Group with an exponentially larger group of in-need individuals.
Similar to the first contract, Presidium Health targeted what he calls “ultra-high risk, underserved patients” with high rates of ER/hospital visits.
“By delivering our home-based medical and social services, we showed a net annual savings of over $14 million on 419 patients,” Afshar said. “To date, we’ve now saved $20 million in annual healthcare costs for a population of more than 500 patients.”
Savings become more important with healthcare costs continuing to rise to astronomical levels.
The most recent California budget includes $35.9 billion general fund spending in 2024-25 on Medi-Cal. The budget assumes an average monthly Medi-Cal caseload level of 14.8 million in 2023-24, more than 1/3 of Californians. Overall Medi-Cal spending is estimated to be $157 billion in 2023-24.
According to the Centers for Medicare and Medicaid Services, in 2022, U.S. health care spending reached $4.5 trillion, equivalent to roughly $13,493 per capita. The insured share of the population hit a historic high, reaching 92%. Private health insurance enrollment increased by 2.9 million individuals, with Medicaid enrollment seeing a boost of 6.1 million individuals, but there were still 26.6 million uninsured individuals.
Afshar said he and Hayatdavoudi long believed that a certain population in the United States consumes a disproportionate amount of healthcare costs and put that belief to the test with the pilot program.
“It’s mostly attributed to unnecessary hospitalizations, and it was a combination of not just medical complexity but social complexity rolled into one,” Afshar said. “It was driving these patients to be very dependent on the ER, the hospital for their basic care needs.”
Safety Measures
Aside from financial considerations, he said what made him most uncomfortable was putting people in environments that aren’t necessarily safe.
“It was not safe before the pandemic, and the pandemic certainly exposed a lot of the risks associated with being in a hospital,” Afshar said. “And now I think the general public as a whole has become a lot more aware and informed that the hospital necessarily isn’t the place where we all need to be when we get sick.”
Hayatdavoudi also described Presidium Health as not a healthcare company but rather “a care company.”
“Many of our patients don’t require any health services but require services related to housing and financing,” he said.
He said the company is now at a point where its model has been proven, has garnered interest and is now expanding its model.
Presidium Health has been in a fundraising round for the last two months, looking for capital “to really allow our model to take off,” he said.
“The main purpose of the fundraise is to advance our technology components and make our services more scalable across state lines and throughout California, in addition to expanding throughout California and to a few other states,” Hayatdavoudi said.
Presidium Health
FOUNDED: 2015
CEO: Pouya Afshar
HEADQUARTERS: San Diego
BUSINESS: Healthcare group
EMPLOYEES: 60
WEBSITE: presidiumhealth.com
SOCIAL IMPACT: The company seeks to care for vulnerable populations and are most in need.
NOTABLE: Presidium’s pilot program with Community Health Group saved an average of $65,000 per patient; it has since expanded for more savings
