In a recent episode of The Strategy of Health, we sat down with CEO Eric Reimer and Chief Growth Officer Tom Gaffney to dissect how Healthmap Solutions has delivered its most successful growth year since 2019. Their insights offer a masterclass in strategic focus: shifting care upstream to Stage 3 Chronic Kidney Disease, integrating advanced digital platforms without losing the human touch, and leveraging AI to empower—not replace—clinical teams. For executive leaders and industry observers, Healthmap’s trajectory is a blueprint for scaling value-based care in an era that demands relentless execution.
Healthmap Solutions grew in 2025 by delivering undeniable savings and clinical outcomes during a period when health plans were ruthlessly culling underperforming vendors. While the broader health tech market contracted, Healthmap secured four new health plan clients—accounting for $1.5 billion in total spend—and renewed contracts with four existing major clients. In the current climate, payers are not looking for experiments. They want partners who can actively manage trend. According to Reimer, the economic pressure on health plans actually worked in Healthmap’s favor.
“I think delivering for the plans in troubled times has really gotten us to be viewed as partners,” he explained. “Being part of this effort to drive their turnaround.”
This dynamic suggests a meaningful shift in the vendor-payer relationship heading into 2026. Health plans are moving away from passive “downstream risk” models where they simply hand off populations. Instead, there is intense scrutiny on how vendors manage chronic conditions. Reimer noted that “a lot of those deals haven’t worked out,” leading to a market correction where only vendors who can prove effective management of the sickest populations—keeping them out of the hospital and adherent to medications—are winning contracts.
The core of Healthmap’s strategy lies in moving upstream to manage patients at Stage 3 CKD, rather than waiting for the catastrophic costs associated with End-Stage Renal Disease. This approach captures patient risk before it spirals, enabling interventions that slow disease progression and significantly reduce total cost of care. Historically, kidney care management focused almost exclusively on the late stages—dialysis coordination and transplant preparation. Gaffney emphasizes that the real opportunity for population health lies earlier in the disease trajectory. By identifying and engaging Stage 3 members, Healthmap can address comorbidities like hypertension and diabetes before they cause irreversible kidney damage. The work involves proactive identification of patients who are often undiagnosed or under-managed, direct collaboration with primary care providers, and management of the whole patient rather than the organ alone.
Gaffney highlighted the specific burden on primary care, noting that PCPs are frequently overwhelmed with general preventive care—vaccinations, screenings, acute needs—and may lack the bandwidth to aggressively manage early-stage kidney decline. By stepping in as a collaborative partner, Healthmap provides the specialized focus that PCPs cannot always offer. “If you’re truly going to slow the progression of the disease, the only way you’re going to do that is to get with the patient early,” Gaffney stated. This upstream focus allows the company to titrate interventions based on the specific stratification of each member, moving away from a one-size-fits-all model to highly personalized care plans.
In the rush to adopt AI, many healthcare organizations fall into the trap of viewing technology as a substitute for human labor. Reimer and Gaffney take a contrarian view: while AI excels at synthesis and prediction, it cannot replicate the human connection required to change patient behavior.
Healthmap deploys AI across three phases of the clinical workflow. Before a call, AI synthesizes patient history, labs, and gaps in care so the nurse is fully prepared before dialing. After the call, AI handles backend documentation, freeing clinicians from data entry. In between, the system predicts the optimal time and channel to contact a patient and suggests the highest-impact clinical intervention—a “next best action” engine that keeps the care team focused on what matters most. Reimer was explicit about the limits of technology in driving adherence.
“It’s not about throwing facts in front of people. Most people know what they need to do… yet they’re not doing those things,” he observed. “You need a human to connect with them and make it clear what the implications of not staying on course are.”
Following the acquisition of Carium, Healthmap has moved from piloting digital tools to fully integrating a multi-channel engagement platform that meets patients on their own terms. If 2025 was the year of foundational integration, 2026 will be the year of feature expansion and daily utility. The integration was driven by a need to modernize member engagement. Patient preferences are not monolithic—some respond to phone calls, others only engage via text. By acquiring Carium, Healthmap gained a “digital front door” supporting biometric monitoring, medication adherence tracking, and secure communication.
Critically, the integration solved what Reimer calls the “stale message” problem. “You can tell a member on a call that they really need to be adherent… four days after, 12 days after, 26 days after, the message gets stale.” Digital tools provide the constant reinforcement and reminders necessary to sustain behavior change between visits. The 2026 roadmap focuses on increasing the platform’s daily utility—encouraging members to log vitals and medications daily to create a richer data set for clinicians—and expanding provider connectivity so data flows seamlessly back to physicians, not just the Healthmap care team.
Healthmap projects 2026 to be a year of “enormous growth,” with plans to increase spend under management by 30 to 40 percent and expand their clinical scope to address broader comorbidities.
The roadmap for the next 12 to 24 months involves aggressive expansion in both client volume and clinical depth. The team is currently implementing four to five new major accounts simultaneously—a significant test of operational scalability. They are deepening the clinical model to manage cardiac and metabolic conditions more aggressively, potentially intervening in patients before they develop kidney disease. And Reimer predicts that 2026 will deliver their best savings rate in company history, driven by a maturing tech stack and the tenure of their clinical teams.
Reimer went on record with a bold prediction: “I believe we’ll have more spend under management than we’ve ever added before.” That confidence stems from a pipeline of upsell opportunities within their current book of business and a market increasingly hungry for proven value-based care solutions.
For healthcare executives, the Healthmap story distills to a simple lesson: in a tightening market, performance is the only currency that matters.
Healthmap didn’t survive 2025 by chasing hype cycles. They thrived by identifying a high-cost, high-complexity population, moving upstream to manage risk early, and executing relentlessly on savings and outcomes. They used AI not to replace their workforce but to arm clinicians with better data. They used digital tools not to replace the doctor but to reinforce the care plan.
If you want to secure renewals and drive growth in 2026, the formula is clear: focus on the chronics, empower your people with technology, and prove your value every single day.
