Premise Cross Merger: Inside the $2B Driving New Employer Health Model
Access to primary care is collapsing in the United States, creating opportunities for new models that reduce costs and improve outcomes.
This week, Premise Health and Crossover Health seized on that opportunity, announcing an agreement to merge into a company focused on expanding primary care services. The combined organization will provide on-site, near-site and virtual care to more than 400 employers and millions of members, operating nearly 900 health centers nationwide.
The new entity will be led by Premise CEO Stu Clark. He described the deal as a fusion of two companies that share the same thesis: advanced primary care is the lever to disrupt U.S. health care. Both companies define advanced primary care as an integrated portfolio of primary care, behavioral health, pharmacy services and care navigation.
“Crossover and Premise have proven that when you deploy our advanced primary care model, a few things happen: access increases, health improves and costs go down. Costs go down for both employers and families,” Clark said.
He said the company's target customers will be large self-insured employers, primarily Fortune 1000 companies, unions, Native tribes and government entities.
He noted that employers are turning to advanced primary care because traditional health plans cannot control costs or improve access.
“Healthcare is now an earnings-per-share issue for American employers. It's one of the biggest cost risks they face when running their business. It affects their ability to deploy capital and it affects their competitiveness,” Clark commented.
The company will be paid a flat fee directly by employers, rather than using a fee-for-service model. Clark explained that higher clinic utilization will lead to better health outcomes, lower costs to employers and greater value for fixed fees.
This model aligns incentives around prevention and engagement, rather than volume-driven billing, he noted.
Premise's annual revenue is about $1.6 billion, and the combined company is expected to be closer to $2 billion, Clark said. He noted that while Premise is the larger organization, Crossover brings strategic assets to the table.
Crossover's near-site clinics fill geographic gaps in Premise's footprint, while Premise's national scale enables Crossover's clients to expand into multiple markets. Crossover also brings more advanced digital member engagement tools, which Premise plans to roll out across its broader customer base.
Crossover CEO Scott Shreeve said the two companies have long competed, but the opportunity to expand their reach is now greater than the competition.
“How can we be part of solving the triple aim of cost, quality experience in healthcare? I don't think we can do it alone. I appreciate that Premise feels the same way – we feel the urgency, and we feel we see the opportunity,” Shreeve declared.
He said the new company's goal is to expand its advanced primary care model nationwide, with a focus on team-based care and member engagement.
The deal is still subject to regulatory approvals and customary closing conditions, but as employers look for alternatives to traditional health plans, the merger could test whether advanced primary care can deliver real savings and access nationwide.
Photo: Richard Drury, Getty Images
