Waymark

Waymark is a technology-enabled community care provider and public benefit corporation dedicated to improving access, equity, and health outcomes for individuals enrolled in Medicaid programs. Operating as an extension of the existing healthcare ecosystem, Waymark partners directly with primary care providers and Medicaid Managed Care Organizations (MCOs) to deliver multidisciplinary, local care. By deploying specialized local care teams—consisting of community health workers, care coordinators, pharmacists, and licensed behavioral health therapists—the company meets patients exactly where they are to help them successfully navigate complex medical treatments, manage prescription adjustments, and overcome everyday socio-economic challenges.

Waymark Signal is a proprietary, peer-reviewed machine learning platform built on a dataset of over thirty million Medicaid patients to forecast and mitigate health risks before they lead to medical emergencies. The platform includes hyper-specialized predictive modules, such as Signal for Rising Risk (which predicts future avoidable hospital or emergency room visits with 90% accuracy) and Signal for Maternity Risks (which identifies prenatal care coordination opportunities fifty-five days earlier than traditional methods). Rather than delivering standard, passive risk scores, the AI integrates claims, pharmacy, and behavioral data to recommend the optimal moment and specific next-best-action required for clinical teams to step in effectively.

Waymark recognizes that a significant portion of preventable hospitalizations are driven by non-medical, systemic factors, prompting them to deeply embed the management of Social Determinants of Health (SDOH) into their care protocols. Because community health workers are hired directly from the specific regions they serve, they are uniquely equipped to establish deep trust and identify underlying vulnerabilities like housing instability, food insecurity, and a lack of reliable transportation. By coordinating directly with local community partners and health plans, Waymark helps patients secure essential resources, complete complex benefits renewals or redeterminations, and maintain continuous insurance coverage, resolving the core obstacles that prevent patients from prioritizing their long-term health.

Waymark's value-based care model aligns financial incentives directly with positive patient outcomes, replacing traditional fee-for-service systems with shared savings structures that have been validated in peer-reviewed research. Independent evaluations show that Waymark's targeted interventions achieve a 48% reduction in avoidable hospitalizations, a 20% drop in preventable emergency department visits, and a 35% improvement in HEDIS quality gap closures compared to standard care management methods. Financially, this proactive prevention model generates an average annual savings of $2,347 per enrolled member, delivering an impressive three-to-one return on investment (ROI) within the first year for partnering health systems and insurance plans.