Reduce · Prevent · Reverse
First, Prevent Chronic Disease. Then Manage It If You Must.
What is healthcare? With the vast data we have on on disease, powerful prediction tools, and preventive reimbursements already codified into the system, the old ways of wait-and-see and manage-and-maintain sickcare is obsolete. Today's healthcare economy runs 90% on chronic revenue — a system built by finance for investors, and forced upon good doctors with few alternative models. We are rebuilding independent primary care around prediction and prevention, using proven reimbursement pathways to incentivize prevention. The practice succeeds when the patient stays healthy, and the old approach to "manage and maintain" chronic disease becomes the reluctant secondary revenue stream.
01 The economic reality
Prevention becomes the primary focus of the practice.
Managing chronic disease becomes the side hustle.
The ounce of prevention is already reimbursable — you just need to do it and bill for it. And you may think we are trail-blazing on medicine's bleeding edge - nope, we are simply maximizing preventive care with the fee schedule as it exists today. Pressing prevention at every opportunity.
Medicare and every major commercial payer already reimburse the services that reverse metabolic dysfunction and work to prevent chronic disease: AWV, APCM, CCM, RPM, MNT, BHI, IBT (obesity), DSMT, cardiac/pulmonary rehab, and so much more.
The codes and the coverage not only exist, they are codified and protected by the supreme court (Kennedy v. Braidwood, 2025). What does not exist in most independent practices is the machinery — the operational apparatus that analyzes each patient, predicts their possible futures, and suggests preventive interventions to providers based on evidence and data. We build and run that machinery on top of the practice you already have.
We work a stack of more than eighty preventive and care-management interventions that would otherwise sit unused in the average practice, and undelivered to the average patient.
of U.S. healthcare revenue is earned managing and maintaining chronic disease, not preventing it
of national health spending is directed at prevention
reimbursable preventive and care-management codes in the Prevendio stack
per-patient revenue in a fully implemented panel
| Line | Unchanged practice | Prevention-first |
|---|---|---|
| Net-new reimbursable preventive services, annually | — | $650,000 – $850,000 |
| Contribution margin on delivered preventive services | — | 30% – 60% |
| Practice EBITDA | 5% – 10% | 30% – 40% |
| Net revenue per engaged Medicare patient, annually | $300 – $1,500 | $2,400 – $8,000 |
Basis. Ranges are modeled from Prevendio's own reimbursement research against 2024–2025 Medicare and regional commercial fee schedules, and assume partial panel enrollment rather than universal uptake. Actual results depend on payer mix, panel composition, documented eligibility, and enrollment rate. These are planning models, not projections of your practice and not a guarantee of revenue. We will model your panel specifically before either party commits to anything.
02 The panel, patient by patient
The gap is structural. It repeats every year, in every chair.
The same patient, on the same insurance, in the same exam room. What changes is whether the practice is equipped to do the thing the payer already covers.
| Patient profile | Unchanged | Prevention-first | Difference in trajectory |
|---|---|---|---|
| 43, pre-diabetic, BMI 29, sedentary | $400 | $3,500 | Diabetes within 3–5 years, versus insulin resistance addressed while it is still reversible |
| 55, new type 2 diabetes, A1c 8.1% | $600 | $5,000 | Metformin and a 5–7 year march toward insulin, versus structured nutrition therapy and monitoring |
| 60, hypertensive, early arterial disease | $800 | $5,500 | Medication titration and a predictable cardiac event, versus supervised exercise and metabolic intervention |
| 55, diabetic 15 years, CKD stage 3 | $1,200 | $6,500 | Nephrology referral and dialysis in 5–7 years, versus intensive control and a delayed timeline |
| 67, dual-eligible, five chronic conditions | $1,500 | $8,000 | Polypharmacy and rising admissions, versus coordinated management and fewer hospitalizations |
Basis. Profiles are composites drawn from Prevendio's clinical and reimbursement modeling, not case reports from named patients. Revenue figures reflect the reimbursable services a fully implemented practice can deliver to a patient with that documentation. Clinical trajectories describe the published natural history of these conditions and the interventions indicated for them; they are not outcome promises for any individual, and every clinical decision remains the treating physician's.
03 Why we exist
A declaration against managed chronic disease.
Prevention is the business plan. America's chronic disease rate is the northstar.
We believe every human being is made in the image of God, and that this makes a patient something other than a revenue stream to be maintained at a profitable level of illness.
The current system is a house of cards built on diagnosis harvesting and coding theater. We reject, categorically, any model that pays a practice more for a well-managed disease than for a resolved one — because a model like that will eventually produce exactly what it pays for, no matter how good the people inside it are. (Looking at YOU, Medicare Advantage.)
Healthcare is a good and noble profession, it is the system that needs to change. Good doctors just need the tools to monetize prevention before chronic disease shows up.
Reimbursement follows the intervention, not the diagnosis
Our revenue comes from services ordered, delivered, and documented. It does not come from risk scores, severity capture, or how sick a chart can be made to look, or how sick and complex a patient can become.
The physician keeps the medicine
Prevendio provides non-clinical insights into predictive modeling and preventive interventions. Clinical protocols, treatment decisions, and the physician-patient relationship stay entirely with licensed clinicians. We are structurally prohibited from touching them, and we designed it that way on purpose.
A disease avoided is the outcome we are paid to pursue
Where disease can be predicted, prevented, reduced or reversed, that is the goal — not a stable manage-and-maintain approach that bills reliably for the unpleasant final 20 years of a patient's life.
04 The platform
Prevendio: Prevention Engine that plays well with your EMR.
No system migration. No new EMR. No new staff. This is a clinical and financial operating layer that sits on top of your existing record and supplies the part that is missing — programmatic prediction and profitable prevention.
The hub
Own the primary care relationship
We build the year around the visits that anchor everything else so prevention has a standing appointment instead of competing with acute complaints for the last four minutes.
- AWV and IPPE scheduling and documentation
- APCM and chronic care management enrollment
- Third-party care delivery where appropriate
- Transitional care management after discharge
- Panel-wide care gap identification and outreach
The spokes
Deliver care without adding headcount
The services are delivered in-house, or through a vetted network working under your clinicians' orders and general supervision. Your staffing model barely moves.
- Medical nutrition therapy and obesity behavioral therapy
- Remote physiologic monitoring, including CGM
- Behavioral health integration and collaborative care
- Diabetes self-management training, cardiac and pulmonary rehab referral
The ledger
Documentation that holds up
A parallel overlay that tracks, per patient, what they are eligible for, what has already been billed, what the frequency limit is, and what documentation each code requires — so claims go out supported the first time and patient responsibility is transparent and managed.
- Eligibility logic mapped to diagnosis and payer
- Next-due dates and frequency-limit guardrails
- Documentation checklists per code
- Prior authorization generation and tracking
- Time logs and an audit trail behind every claim
Prevendio supports billing accuracy and completeness for services actually rendered. It does not upcode, does not alter clinical documentation, and does not submit claims for services that were not delivered.
05 Practice transition
If you have been told your practice is unsellable, you were told the truth about the old model.
Roughly two out of three retiring primary care physicians simply close the doors, because a practice running on 5% margins and one irreplaceable doctor is not an asset anyone wants to buy. Meanwhile good young clinicians are priced out of ownership entirely, and private equity takes only the practices that were already thriving.
Prevendio is founder-owned and self-funded. We take on the practices the market has written off, install the prevention-first model, and rebuild the intrinsic value that was never in the P&L — then hand operational continuity to the next generation of owner-clinicians.
For the retiring physician, that means a real exit instead of a liquidation sale: your patients keep their clinic, your staff keep their jobs and their tenure, your name stays on something that is working, and you choose whether to walk away at closing or stay on in a supervisory role and take a larger payout over time.
01
Assessment
We model your actual panel — payer mix, documented conditions, current billing — and show you the delta before anyone signs anything.
02
Structure
Entity transfer rather than asset sale, so the tax ID, payer contracts, and credentialing survive intact and nobody has to recredential from zero.
03
Installation
Prevendio goes in, the service network is connected, and staff are trained on the new workflows. Your EMR stays where it is.
04
Transition
A two-year runway with you in a supervisory role if you want one, while scalable clinical staffing takes over day-to-day volume.
Clinical entities are owned and controlled by licensed physicians. Prevendio's role is limited to non-clinical management services provided under a management services agreement at fair market value. Terms vary by practice and by state.
06 The clinical spine
Management and reversal are different goals. They need different numbers.
The protocols target metabolic dysfunction — the shared upstream driver behind type 2 diabetes, cardiovascular disease, chronic kidney disease, and cognitive decline — rather than treating each downstream diagnosis as its own unrelated problem.
| Marker | What it indicates | Reference target |
|---|---|---|
| Fasting insulin | Insulin resistance, years before glucose moves | < 5 µIU/mL |
| Triglyceride / HDL ratio | Practical proxy for insulin resistance and cardiometabolic risk | < 2.0 |
| hs-CRP | Systemic inflammatory tone | < 1.0 mg/L |
| Triglycerides | Metabolic response to dietary carbohydrate load | < 100 mg/dL |
| HDL cholesterol | Metabolic and cardiovascular reserve | > 50 mg/dL |
| Coronary artery calcium | Actual established disease burden, not estimated risk | Score 0 |
Reference targets reflect the metabolic-health literature the protocols are built on and are provided for orientation, not as clinical guidance. Ordering, interpretation, target-setting, and every treatment and medication decision belong to the treating physician. Nothing on this page is medical advice, and Prevendio does not practice medicine.
07 Next step
Evaluate your practice.
We will model your panel against the codes you are not billing and show you the arithmetic. If the number is not worth your time, we will tell you that.
Healing is the business plan.