ProgenyHealth

ProgenyHealth

Telephonic case management for maternal health

Overview

ProgenyHealth provides utilization review and case management services focused on maternal and infant health for health plans and other healthcare entities. Its telephonic care management is delivered by a team of medical directors and case managers to improve outcomes and lower costs. The service addresses clinical needs and non-clinical drivers, helping plans scale maternal‑infant care even with limited local resources. The goal is to reduce NICU admissions and postpartum complications while containing overall healthcare spending for members.

Significant Headcount Growth

About ProgenyHealth

Simplify's Rating
Why ProgenyHealth is rated
C+
Rated B on Competitive Edge
Rated B on Growth Potential
Rated D+ on Differentiation

Industries

Data & Analytics

Consulting

Healthcare

Company Size

201-500

Company Stage

N/A

Total Funding

N/A

Headquarters

Plymouth Township, Pennsylvania

Founded

2003

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Simplify's Take

What believers are saying

  • Humana Healthy Horizons Kentucky launched ProgenyHealth NICU care management in late May 2026.
  • April 29, 2026 added CFO Mark Sprague and CMO Tom Lundquist.
  • Nebraska Blue's May 4, 2026 rollout expands ProgenyHealth's Medicaid footprint.

What critics are saying

  • April 14, 2026 ProgenyHealth sued Progyny; brand confusion threatens search traffic and sales.
  • June 1, 2026 claim validation at BCBSNE pressures margins and exposes coding disputes.
  • One lost Medicaid contract can crater revenue within 90 days.

What makes ProgenyHealth unique

  • May 4, 2026 BCBSNE integrated ProgenyHealth directly into NICU notification and discharge workflows.
  • ProgenyHealth's 2026 report showcases 20-plus years of maternal and infant claims data.
  • Cressey's May 20, 2025 investment and Sunstone backing fuel specialized healthcare-services scaling.

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Growth & Insights and Company News

Headcount

6 month growth

13%

1 year growth

13%

2 year growth

13%
MyChesCo
May 7th, 2026
ProgenyHealth adds board member, names CFO and chief medical officer.

ProgenyHealth adds board member, names CFO and chief medical officer. PLYMOUTH MEETING, PA - ProgenyHealth LLC named Paul Diaz to its board of managers and appointed Mark Sprague as chief financial officer and Dr. Tom Lundquist as chief medical officer, adding healthcare, finance and clinical leadership as the maternity and NICU care-management company works to expand its services. Diaz is a managing partner at Cressey & Company and previously served as president and chief executive officer of Kindred Healthcare and Myriad Genetics. He has held board roles across healthcare and remains active in national nonprofit organizations. Sprague will oversee financial operations, healthcare economics and enterprise analytics. He previously served as chief financial officer at Healthmap Solutions, where he led finance and medical economics teams. He also held senior roles at Magellan Healthcare in finance, pricing, underwriting and corporate development. Before Magellan, Sprague led actuarial and underwriting functions for Aetna International. He holds a bachelor's degree from the University of Connecticut and is a fellow of the Society of Actuaries. Lundquist will lead ProgenyHealth's medical management program, with responsibility for clinical performance and outcomes. He has nearly 30 years of leadership experience across healthcare companies, care delivery systems, managed care organizations, self-insured employers and government agencies. Lundquist earned his medical degree from The Johns Hopkins University School of Medicine and completed his residency at Johns Hopkins Children's Center. He also holds a master's degree in medical management from Carnegie Mellon University. He is a fellow of the American Association for Physician Leadership and the American Academy of Pediatrics. Chief Executive Officer Susan Torroella said the appointments bring "deep expertise across clinical care, financial strategy and healthcare operations" as the company seeks to expand its maternal and infant health programs. ProgenyHealth provides technology-enabled maternity and neonatal intensive care unit care-management services. Support the local news that supports Chester County. MyChesCo delivers reliable, fact-based reporting and essential community resources - free for everyone. If you value that, click here to become a patron today.

PR Newswire
Apr 29th, 2026
ProgenyHealth names Paul Diaz to board, appoints Mark Sprague CFO and Dr Tom Lundquist CMO

ProgenyHealth has announced three senior appointments to strengthen its leadership team. Paul Diaz, a managing partner at Cressey & Company, has joined the company's Board of Managers, bringing extensive healthcare services experience from previous CEO roles at Kindred Healthcare and Myriad Genetics. Mark Sprague has been named chief financial officer. The Fellow of the Society of Actuaries brings over 25 years of financial leadership experience, most recently serving as CFO at Healthmap Solutions and Magellan's Healthcare division. Dr Tom Lundquist has been appointed chief medical officer. With nearly 30 years of healthcare leadership experience, he will lead ProgenyHealth's medical management programme. ProgenyHealth specialises in maternity and NICU care management, serving women and infants across the United States.

ProgenyHealth
Nov 13th, 2025
ProgenyHealth Announces Collaboration with Humana Healthy Horizons in Kentucky to Provide NICU Care Management to Members

ProgenyHealth announces collaboration with Humana Healthy Horizons in Kentucky to provide NICU Care Management to members. Company to provide case management services to premature and medically complex infants, along with offering valuable support services for family members to improve outcomes Louisville, KY (November 12, 2025) - ProgenyHealth, LLC, a leading, tech-enabled women's health care company dedicated to maternity and NICU care management, has announced a collaboration with Humana Healthy Horizons in Kentucky. Progeny Health will provide case management services for some of the health plan's most vulnerable members - premature and medically complex infants. The program will also offer support services to parents and family members. According to the March of Dimes, Kentucky had received a 2024 pre-term birth grade report of D-. The most recent 2024 Report Card highlights the current challenging state of maternal and infant health throughout the state, based on infant mortality figures. Despite recent incremental improvements, Kentucky's preterm birth rate remains at 11.3%, worse than the national average of 10.4%. These poor outcomes are due to several factors, including the overall mental and physical health of women, substance use disorder, air pollution, and chronic health conditions such as diabetes and hypertension. "Partnering with Progeny Health allows us to more deeply invest in the health and well-being of our plan members' families, especially those facing the challenges of a NICU stay," said Sarah Moyer, MD, MPH, chief medical officer, Humana Healthy Horizons in Kentucky. "We understand that when an infant enters the NICU, it is an incredibly stressful and uncertain time for families. That's why we are dedicated to providing compassionate, comprehensive support through their NICU journey and beyond, supporting them throughout their child's critical first year. While our state faces significant obstacles in infant and maternal health, our commitment remains steadfast - to improve outcomes, experiences, and quality of life for our members and their loved ones. Together, we are making a meaningful difference." As an example, one of Humana Health Horizon's members delivered eight weeks early due to pre-eclampsia. While her newborn was admitted to the NICU, the mother struggled to get a follow-up appointment for her high blood pressure. Experiencing concerning symptoms, she and her Progeny Health nurse case manager contacted her obstetrician and secured a same-day visit. Because she also screened high for postpartum depression, her case manager referred her to behavioral health and connected her with a Progeny Health social worker for additional support. The social worker ensured she received baby essentials - diapers, wipes, clothing, and a car seat. The care management team continues to coordinate closely with the hospital and the mother to ensure a smooth discharge and transition home when the baby is ready. "The first year of an infant's life sets the stage for their safety and development. This crucial period is extremely important for their ongoing health and wellness," said Susan Torroella, CEO, Progeny Health. "We are grateful for the opportunity to help Humana Healthy Horizons improve the lives of their members and are honored to provide the expertise that is needed to help improve maternal and infant health outcomes throughout Kentucky." The collaboration between the two organizations launched in late May and is already beginning to show early indicator enrollment success among plan members. About Humana Healthy Horizons Humana manages Medicaid benefits for more than 1.5 million members nationally under the Humana Healthy Horizons(TM) brand, which reflects its expertise in managing complex populations, its commitment to creating solutions that lead to a better quality of life for its members, and its efforts to deliver human care that makes the healthcare experience easier, more personalized and more caring. During more than two decades of serving people with Medicaid, Humana and Humana Healthy Horizons have developed a wide range of capabilities to serve children, parents, childless adults, and beneficiaries that are aged, blind or disabled. ProgenyHealth, LLC integrate physical health, behavioral health, pharmacy, long-term care, and social services for a whole-person approach to improve the health and well-being of its members and the communities ProgenyHealth, LLC serve. Humana Healthy Horizons is a Medicaid Product offered by affiliates of Humana Inc. About Progeny Health Progeny Health is a leading national, tech-enabled women's healthcare company dedicated to Maternity and NICU Care Management. ProgenyHealth, LLC serve women, infants, and families through the milestones of maternal care - from conception and pregnancy to postpartum and parenting, with special expertise in managing premature and complex births and resulting NICU admissions. With more than 20 years of experience, its board-certified physicians, nurses and social workers improve health outcomes and enhance the member experience.

Femtech Insider
May 21st, 2025
ProgenyHealth Expands with New Investment

ProgenyHealth, a leader in maternity and NICU care management, has secured a strategic investment from Cressey & Company, with continued support from Sunstone Partners. This investment aims to expand ProgenyHealth's reach and improve maternal and infant health outcomes. Since Sunstone's 2017 investment, ProgenyHealth has quadrupled its business. The financial terms were not disclosed.

PR Newswire
Dec 3rd, 2024
Sage Growth Partners Announces Marketing And Public Relations Partnership With Chroniccareiq

Baltimore-based healthcare growth strategy and marketing firm to provide public relations, thought leadership, and digital marketing services. BALTIMORE, Dec. 3, 2024 /PRNewswire/ -- Sage Growth Partners (SGP), a healthcare growth strategy and marketing firm, has announced its selection as the communications and marketing agency partner for ChronicCareIQ, a leader in chronic care management solutions. Founded in 2014, ChronicCareIQ helps relieve suffering for millions of chronically ill and medically fragile patients. The company's solutions are designed to reduce hospitalizations and ER visits by leveraging technology to better connect physicians and patients. Clinical care teams depend on the ChronicCareIQ platform to proactively capture and track changing health indicators before interventions and costly complications can occur

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