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Alignment Healthcare Nabs $135M Series C

Alignment Healthcare, which sells Medicare Advantage insurance plans, has found more believers in its goal to be a $1 billion company.

The Orange-based company, founded in 2013, last week said it raised $135 million from Fidelity Management & Research Co., funds and accounts advised by T. Rowe Price Associates Inc., and Durable Capital Partners LP.

The Series C round brings Alignment’s funding to date to $375 million.

Private equity firms General Atlantic Service Co. and Warburg Pincus LLC, who have invested more than $240 million in the company over the past five years, retained their stakes in Alignment.

The newest stakeholders are “cross-over investors” who decided to invest now when Alignment is a private firm rather than wait after a possible initial public offering, Alignment Healthcare founder and Chief Executive John Kao told the Business Journal.

“There are not a lot of billion-dollar companies growing at a 40% annual compounded rate,” Kao said. “When they looked at the publicly traded companies, they said, ‘We’re going to bet on Alignment.’”

The latest round was oversubscribed with about 20 potential investors, he said.

The company is on pace to top $1 billion this year, he said.

Fast Grower

The funding marks another example of Alignment’s rapid rise in the insurance sector.

Medicare Advantage plans, like the ones Alignment offers, are required to cover traditional Medicare expenses such as doctor visits and hospital costs. They are also increasingly popular because they offer extra coverage for things such as vision, dental and hearing exams, and prescription drugs.

The company reported $805 million in sales in 2019, topping the company goal of $800 million. It was the fastest-growing OC-based private company on last year’s Business Journal list in the large company category—those with more than $100 million in sales.

Alignment Healthcare’s tech-focused approach to business has driven a 43% annual growth in revenue between 2014 and 2019 as the company now approaches $1 billion in projected 2020 revenue.

Kao last September won the Business Journal’s Innovator of the Year Award.

The company said it will use the latest batch of funding to help expand its technology, geographies and plans offered.

Footprint Doubling

The company currently has 600 employees, up from 432 employees last June 30.

The company’s number of clients has jumped from 60,000 last year to 70,000 currently and it may reach 80,000 by the end of this year, Kao said.

The company will be concentrating on California, where it serves 61,500 clients, Kao said. The combined number of senior citizens in Orange and Los Angeles counties is greater than 40 other states, he said.

“It behooves us to go deep and increase our market share in California,” he said. “There is so much opportunity.”

It is offering preferred provider organization (PPO) plans to give more choices to seniors. It has aligned with Sutter Health, a giant non-for-profit provider of healthcare, to double its market in Northern California. The company is expanding its Access On-Demand Concierge “black card” that currently helps members buy things such as over-the-counter drugs to other products such as purchasing groceries. It also partners with select health plans in North Carolina.

AI Platform

The company developed a platform, Alignment Virtual Application, or AVA, an artificial intelligence-driven “command center.” The platform, which is designed to scale, has more than 100,000 unique data signals per member that identify changing care needs in real time to provide care when and where seniors need it most.

Alignment patients are monitored wirelessly at their home for items like weight, heart rate, blood sugar and blood pressure information. The platform then uses this data to monitor each member every 30 minutes, 24 hours a day—identifying any signs for needed immediate intervention or changes in care—from oxygen deficiencies to lapses in medication pickups.

The goal is to reduce the average length of hospital stays for its patients and continue to manage care after discharge, whether at home, a rehabilitation center, or another facility.

Alignment’s home-based care model “can bend the cost curve,” thus lowering costs and enabling the firm to provide richer benefits, Kao said.

Last year, it received an overall 4.5 star rating out of a possible 5 stars from the Centers for Medicare & Medicaid Services.

Secret to Growth

Kao has more than two decades in healthcare. He and other investors in 2006 acquired Downey-based CareMore Medical Enterprises Inc., where he became president. It was sold for about $800 million in 2011 to Indianapolis-based WellPoint Inc., later renamed to Anthem Inc.

Alignment is in a growing industry, as the estimated current population of 60 million individuals older than 65 will increase to 75 million in a decade and 95 million in 25 years.

Kao has long attributed the fast growth to the company’s motto.

“It’s the simple fact of treating every member as if they were my mom or dad. The value of the company is putting that first and doing whatever it takes to satisfy that member,” Kao told the Business Journal in September.

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Peter J. Brennan
Peter J. Brennan
With four decades of experience in journalism, Peter J. Brennan has built a career that spans diverse news topics and global coverage. From reporting on wars, narcotics trafficking, and natural disasters to analyzing business and financial markets, Peter’s work reflects a commitment to impactful storytelling. Peter’s association with the Orange County Business Journal began in 1997, where he worked until 2000 before moving to Bloomberg News. During his 15 years at Bloomberg, his reporting often influenced financial markets, with headlines and articles moving the market caps of major companies by hundreds of millions of dollars. In 2017, Peter returned to the Orange County Business Journal as Financial Editor, bringing his heavy business industry expertise. Over the years, he advanced to Executive Editor and, in 2024, was named Editor-in-Chief. Peter’s work has been featured in prestigious publications such as The New York Times and The Washington Post, and he has appeared on CNN, CBC, BBC, and Bloomberg TV. A Kiplinger Fellowship recipient at The Ohio State University, he leads the Business Journal with a dedication to uncovering stories that matter and shaping the local business community and beyond.

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