The last few years have been brutal for value-based care. Some of the most well-intentioned companies in this space have sold off assets, wound down, or quietly retreated from the highest-need patients they were built to serve. Amidst this, we have a different story to share: today, Cityblock is announcing that we have signed a definitive agreement to acquire Homeward Health in an all-stock transaction, alongside a $116 million Series E led by General Catalyst. We're doing this from a position of real momentum: we now serve almost 200,000 members across the country, and our annualized revenue is $2.2 billion—up 77% year-over-year, and more than 4x what it was at our last fundraise in 2021. We are positioned to be the leading outcomes-based provider platform serving government programs: caring for populations who are covered by Medicare, Medicaid or both—and in particular those with the most complex and difficult-to-manage needs. That’s the position we’ve spent almost a decade building toward, and we certainly don’t intend to slow down now.

Under Dr. Jenny Schneider and Amar Kendale, Homeward built something significant: a rural-first Medicare Advantage model that has deep ties with plans like Blue Cross Blue Shield of Michigan, nearly 50,000 members, and rural care expertise few competitors match. Like Cityblock, Homeward went after a space with the biggest challenges in our health system at a time when the stakes couldn’t be higher, where funding challenges and rural provider access shortages have resulted in a desperate need for care, particularly among the most vulnerable and hard to reach populations. And they did the work of figuring out how to engage populations in relationships tailored to their needs and capable of improving access, cost, and outcomes. Homeward has built a company that when combined with Cityblock’s deep experience serving urban Medicaid and dual-eligible populations, means we now have the scale and capability to reach deeper to serve the nation’s 120 million people receiving government-funded healthcare.

The timing couldn’t be more critical. Federal Medicaid funding is being cut significantly over the next decade, reimbursement rates for Medicare Advantage are tightening, and healthcare costs are rising faster than the system is built to absorb. That’s real pressure on exactly the members both Cityblock and Homeward have spent almost a decade learning how to serve in trusted, longitudinal relationships. We think the answer to funding pressures in government programs isn’t to retreat from them—it’s to get radically better and more efficient at delivering outcomes for the people who depend on taxpayer-funded healthcare. 

That’s exactly why we’re going to serve more Medicare Advantage members alongside continuing to serve individuals who are dual-eligible and those who receive Medicaid. We believe the same AI-native, outcomes-first model that has enabled us to win in Medicaid is exactly what rural Medicare Advantage and dual-eligible populations need too. These aren’t three separate bets. They’re one bet: that scaling provider capability which improves outcomes is the only way to make government-funded healthcare sustainable for the people who need it most, at a moment when access and affordability are getting harder.

Every healthcare company says it’s ‘AI-native’ now. Here’s what that actually looks like inside ours: CORE—our Care Orchestration and Resourcing Engine—the operating system underpinning our outcomes-based care platform. Instead of simply flagging a member as ‘high-risk,’ CORE uses our almost ten years of member data to predict which specific action will close a specific care gap for that specific member. It weighs that across our entire population at once, and turns the answer into a ranked worklist for care teams—why this member, why this action, why now. 

And it’s working. Our predictions are right 62-87% of the time. CORE doesn’t operate alone. We are building and deploying a growing ecosystem of AI tools handling routine engagement and administrative work that have already freed up 44,599 hours of clinician time this year, including 42,148 calls handled by AI agents. This is the resource-matching vision in practice: routine work increasingly flows to AI, while CORE directs human hours to the moments where judgment and relationships matter most. 

Imagine you are a care team member reaching out to a high-need patient. In the past you’d be working off a directional algorithm alerting you that the person might be at high risk. Now imagine having specific, AI-driven intelligence on that exact person—insights gleaned from their entire medical history, any calls they’ve had with their care team, missed gaps in care, and specialist visits. Insights that would otherwise take hours of chart review to piece together.

The proof is in the numbers: since our last fundraise in 2021, we’ve grown the business in ways that we’re truly proud of. We have increased revenue by 323%, improved corporate opex as a percent of revenue by 64%, scaled from five to 18 customers, improved EBITDA margins by 81%, and delivered positive operating margins in our markets. All of this while maintaining industry-leading net promoter scores, delivering meaningful improvements in quality and member retention, and hearing directly from our members about the life-changing impact of Cityblock’s care model. And we have attracted the best and brightest tech, clinical and operational talent to drive this work. While the past five years have exposed many of the deep flaws in our traditional fee-for-service healthcare delivery system, we’ve been hard at work building proof points that demonstrate how a focused, AI-native, human-centered approach to care delivery can drive real results, at scale. 

In this next chapter, we’re excited to continue on the trajectory we’ve established. To continue to be the company that shows, rather than tells. To continue to do the hard and essential work of delivering for the populations with the most complex health and social needs, producing results for payers, providers, patients and taxpayers alike. We’ll take the experience from this first acquisition to do more: grow our platform, organically and inorganically, so that we can serve as many people as we can, wherever they may be.

We called our company Cityblock because a block signifies the unit of measurement in a community where people know who lives next door, where someone notices when a light’s been off too long, where folks know their neighbors and look out for one another. That idea holds just as true on a county road in rural Michigan as it does on a block in Brooklyn. What makes it a block isn’t the skyline—it’s the fact that someone is paying attention to the people who live there. That’s what Homeward has built for communities in rural counties, and it’s exactly what we mean when we say Cityblock.

Onwards!