Comparing Forthright Health to Aledade

Forthright Health and Aledade launched on almost the exact same day.

Thus far, I’m a big fan of what I have heard of Aledade.  It has a terrific and much needed mission and business model.

However, since both companies are focused on helping primary care physicians, I thought it would be worthwhile to make a distinction between our two efforts.

First the obvious:

  • Aledade is run by Dr. Farzad Mostashari, a former Obama administration official (National Coordinator for Health Information Technology, to be exact) while Forthright is run by me – a single entrepreneur naïve enough to be dangerous to the status quo.
  • Dr. Mostashari is a trained medical doctor with two Ivy League degrees while I received a B in high school biology (however I can say I have an Ivy degree as well, but it is in economics.  Is that considered a science???).  In no way would I compare myself to these men, but I’m comforted in my hopes to change an industry by the fact that Jobs wasn’t a coder, Bezos wasn’t a publisher, and Musk wasn’t a car guy.
  •  Aledade is backed by a successful VC firm, Venrock, while Forthright has a few straps on my boots.

Overall, we are both trying to accomplish the exact same thing – improve healthcare service and quality while reducing cost by unleashing the power of primary care.

The biggest difference between the two companies is our approach to achieving that goal.

To use a different industry to illustrate – the financial industry – Aledade would like to turn primary care physicians into mutual fund managers while Forthright Health would like to make primary care physicians function like financial advisers.

Both roles are hugely important to trying to manage money effectively and grow it, just like both Aledade and Forthright are trying to manage health and improve it.

Aledade is focused on population health, much like a mutual fund manager focuses on a whole portfolio.  Forthright is focused on individual patient-to-physician relationships, much like an individual financial adviser.

From an incentive standpoint, Aledade does well when the population it manages saves the system cost – similar to a fund manager that does well when his portfolio increases in value.  Forthright Health does well by removing fee-for-service and allowing physicians to have as many strong relationships with individual patients as possible – somewhat like the financial adviser at Merrill Lynch, UBS or Edward Jones who changed ~10 years ago from commission compensation to a set fee from each happy client.

Aledade, like a mutual fund manager who is intimately integrated with traders, research and technology, will help primary care physicians manage population health by intimately integrating with specialists, ancillary services and technology.  Forthright Health, like a financial adviser who is free to use different tools and to counsel on different financial matters, frees primary care physicians to use whatever means necessary to increase service and quality while reducing cost for individual patients.

Forthright Health’s expectation of each primary care physician is that they build a strong relationship with each patient.  According to the work of the late Barbara Starfield, the physician-to-patient relationship is the key factor in producing positive outcomes.  We need to create an environment where those relationships are allowed to flourish.

If we do that, the primary care physician can finally effectively manage the patient with multiple comorbidities.  If we do that, the patient will finally seek advice from her primary care physician instead of the ER or higher cost specialists.  And if we do that, primary care physicians can finally compete for patients based on service, quality and cost, and thus improve healthcare for all of us.

Aledade is guaranteed to be a success.  They have too many smart and connected people involved for it not to be.  Most importantly, they are focused on the most crucial part of our healthcare system – primary care physicians.

Forthright Health is focused on primary care as well.  However, it needs the help of many to make it a success.  I’m not afraid to admit what I don’t know.  I could use your help.

Will you join with me?


Tom Valenti


Forthright Health Management




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