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West Health

Nonprofit reducing healthcare costs for seniors

Overview

West Health is a nonprofit family of organizations that works to lower healthcare costs and help seniors age in place with affordable, high-quality health and support services. The work is carried out through research, policy analysis, and programs funded by philanthropy (Gary and Mary West Foundation, West Health Institute, and West Health Policy Center). Their products are not physical goods but research, policy recommendations, and program initiatives aimed at reducing costs, expanding access, and improving care coordination for older adults. West Health differentiates itself by being a nonprofit, nonpartisan group focused specifically on policy, research, and practical programs to cut costs and support aging in place, rather than operating as a traditional healthcare provider. The goal is to lower overall healthcare expenses while preserving seniors’ dignity, quality of life, and independence.

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About West Health

Simplify's Rating
Why West Health is rated
B
Rated B on Competitive Edge
Rated B on Growth Potential
Rated B on Differentiation

Industries

Data & AnalyticsHealthcare

Company Size

51-200

Company Stage

Grant

Total Funding

$25M

Headquarters

San Diego, CA

Founded

2009

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What believers are saying

  • April 2026 NCQA launched testing across 100 provider groups and 5 million patients.
  • West Health’s Northwestern Medicine program spans 80 clinics and 500,000 patients.
  • The Kennedy Forum partnership targets brain health screening, treatment, and recovery at work.

What critics are saying

  • Billing complexity and unclear payer coverage slowed CoCM adoption at Northwestern Medicine.
  • Medicaid attestation rules and consent friction suppress referrals before treatment starts.
  • Without reimbursement, West Health’s measurement work becomes a pilot without a business model.

What makes West Health unique

  • Gary and Mary West funded West Health with over $700 million in a decade.
  • NCQA partnership gives West Health a national behavioral-health measurement platform.
  • Northwestern Medicine’s 80-clinic accelerator shows real-world scaling beyond policy research.

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Funding

Total Funding

$25M

Above

Industry Average

Funded Over

1 Rounds

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Benefits

  • Health Insurance
  • Dental Insurance
  • Vision Insurance
  • Short-Term Disability
  • Long-Term Disability
  • Life Insurance
  • Health Savings Account/Flexible Spending Account
  • 401(k) Company Match
  • Hybrid Work Options
  • Remote Work Options
  • Performance Bonus
  • Paid Vacation

Growth & Insights and Company News

6 month growth

0%

1 year growth

1%

2 year growth

6%
Informa Connect Life Sciences
Oct 30th, 2026
Patient access: same conclusion, different data sources.

Patient access: same conclusion, different data sources. Soaring launch costs mask a deeper problem: too few patients fill prescriptions on time. Lisa Henderson, VP, Editorial, Informa Life Sciences October 30, 2026 ICER's second annual Launch Launch Price and Access Report, developed this year in partnership with West Health, found that the median price for drugs launched in 2025 was $250,000. But that high price is only half the story. Analyzing more than 200 novel drugs using IQVIA's longitudinal real-world data, the report found that only about one-third of outpatient prescriptions were filled within 30 days of being written. Medicare patients fared worse, facing the steepest barriers and paying two to five times more out-of-pocket than those with commercial insurance. This report set the stage for a recent ICER webinar on the topic, which was only slightly skewed to a drug launch to one year post focus. A recent report from digital hub and direct-to-patient platform provider PHIL, surveying biopharma professionals on their direct-to-patient (DTP) intentions, also addressed the barriers to patient affordability and access across the board. Here we look at the similarities and the differences of these two different data sets - one tracking rising launch prices and access gaps, the other measuring the rapid growth of DTP infrastructure. One barrier raised in the panel, and one that market access professionals are crucially aware of is co-pay assistance and other financial assistance programs. The tool meant to soften the blow of high list prices, has itself come under fire from payers. Magda Rusinowski, MS, vice president at the Business Group on Health, cautioned that the benefit is far from universal among commercial populations. As a non-profit organization based in Washington, D.C., that represents large employers on national health care and employee benefits policy, Rusinowski nodded to employers trying to figure out how to help themselves and their employees to drive them to lower drug costs. She described the hub function this way: "There's a group of vendors that are inserted between the doctor visit and the prescription, and the point of access to the medication, to help navigate to better cost, better cost, higher efficacy, maybe some sort of access to manufacturer assistance so the patients can lower their out-of-pocket cost. All of this is a very, very active space for patients." These navigators, as access professionals know, are designed to: * Direct patients toward lower-cost, higher-efficacy treatment options * Connect patients to manufacturer assistance programs to reduce out-of-pocket spending * Support employer-driven "preferred drug lists" that steer utilization while attempting to protect affordability And while employers may be interested in DTP programs for their employees, biopharma leaders have definitely found DTP a plus. "The DTP Breakthrough: A Deep Dive on Pharma's Direct-to-Patient Next Generation" report found that 70% of pharma respondents say DTP programs have already had a "transformative or significant" impact on patient access - a signal, the report argues, that these programs have "matured from an experimental approach into established access infrastructure." The report's authors highlighted that DTP has moved from an experiment to an established access infrastructure. "Maturing programs have increasingly embraced hybrid models as the industry standard, dynamically routing patients to the most affordable pathway between cash-pay and coverage." However, the panel noted their concerns with putting patients outside of schemes that don't involve benefits as an affordability solution. Offerings such as flat monthly rates like $299 for a GLP-1 medication - drew pointed skepticism. Panelists agreed that this model removes patients from the protective structure of traditional health plans, including deductibles and out-of-pocket maximums, and does not constitute genuine affordability reform. Namrata Kaur Uberoi, PhD, MPH, executive director of Health Care Cost and Affordability, West Health, raised a similar caution about cost-sharing caps, a popular policy proposal. While well-intentioned, she argued these caps "do not address the underlying issues of price and cost" and instead shift costs elsewhere - often into higher premiums. She described this dynamic using a balloon metaphor: squeeze costs down in one place, and they bulge out somewhere else. Rebecca Kirch, JD, executive vice president of policy and programs for the National Patient Advocate Foundation, noted that technology and vendor networks alone are not enough. She argued for normalizing "needs navigation" across every healthcare setting - a dedicated human point of contact who can help patients process financial anxiety and proactively support them no matter what care situation. Kirch pointed to data showing many hospitals fail to notify patients of available financial assistance for services, calling this gap "low hanging fruit" ripe for improvement. What Kirch describes as needed in the healthcare setting, is what patients are asking for in the medication setting. The PHIL report ranked what patients' priorities as follows: * Multiple affordability pathways: 55% * Flexible intake options: 39% * Speed of access: 38% * Digitally supported access experience: 22% * Lowest available medication cost: 22% In summary, the two data sets point toward the same conclusion from different directions. The pharmaceutical and employer-driven innovations reshaping how patients reach therapy are measurably improving access and satisfaction. But without transparency and reform targeting the underlying cost of drugs themselves, advocates warn that navigation services and assistance programs will remain necessary workarounds rather than permanent fixes - treating the symptoms of an affordability crisis that remains, at its root, unresolved. Nov 16, 2026 TO Nov 19, 2026 Philadelphia, PA The Patient Support Services Congress is uniting with the Copay, Reimbursement and Access Congress to create Patient Pathways 2026, a unified event to explore comprehensive strategies for optimizing patient access, affordability and support services, all in one transformative experience. VP, Editorial, Informa Life Sciences Lisa Henderson has over 20 years of experience covering the biopharma drug development industry, from clinical trials to commercialization. She began her B2B publishing career in information technology, college recruitment, and managed care before transitioning to biopharma through CenterWatch, a pioneering media company founded by Ken Getz that focused on the clinical trials enterprise. As Editor-in-Chief of Applied Clinical Trials, Lisa expanded her role to Editorial Director of Pharmaceutical Executive and Pharmaceutical Commerce, driving the shift from legacy publishing to digital-first media. At Informa Life Sciences, she leads media strategy and content for BioXconomy and Bioprocess International, aligning the division's media platforms, events, and audiences under a unified thought-leadership framework. Nov 12, 2026 Oct 22, 2026 Spotlight. Sponsored Content Jul 8, 2026 Sponsored Content Apr 1, 2026 More on this topic. Oct 22, 2026 Oct 8, 2026 From Partnering and Investment insights to Scientific developments to Commercialization strategies, sign up to receive free to your mailbox

The Geriatric Emergency Department Collaborative
Aug 20th, 2026
GEDA success story | Kaiser Permanente Southern California.

GEDA success story | Kaiser Permanente Southern California. Preventing falls through standardized care and system-wide accreditation August 20, 2026 Serving an aging population. Emergency departments (EDs) across the United States face pressure to care for a rapidly growing population of older adults. To address this challenge head on, Kaiser Permanente Southern California (KP SCAL) partnered with West Health to pursue Geriatric Emergency Department Accreditation (GEDA) across all 15 EDs in its network. Focused on fall prevention. Early on, KP SCAL identified fall prevention as a key regional priority. Through a coordinated effort to adopt data-driven care and foster shared accountability, KP SCAL lowered the risk of falls across the region by 22%. Steps to Success * Designated physician, nurse, and regional clinical champions * Embedded the Hester Davis (HD) Falls Risk Screening Tool into triage workflows * Optimized EHR to track real-time screening completion and interventions * Ensured timely interventions for positive screens through a standardized fall-prevention bundle and clearly defined safety behaviors * Provided fall prevention education to patients and caregivers in the ED - and before admission or discharge * Gave sites flexibility to adapt new practices to existing workflows Standardizing care and delivering value. Backed by strong executive support, KP SCAL achieved GEDA accreditation across all its EDs, turning evidence-based care into standard practice. In terms of implementation, they exceeded a 90% completion rate when screening adults aged 65 and older at triage. Similarly, 90% of patients who screened positive for fall risk received at least one intervention in the ED. These outcomes aligned with broader organizational goals around patient safety and reducing preventable harm. More importantly, the work helped ensure older adults in the region received consistent quality care, while positioning KP SCAL to meet the CMS Age-Friendly Hospital Measure. Read the full case study. Explore all the details of the KP SCAL success story. By pursuing GEDA accreditation, your hospital or health system can meaningfully improve care for older adults while meeting broader organizational goals. Learn more about the advantages of GEDA accreditation and how to apply. Discover how GEDA strengthens CMS compliance. GEDA care processes embed core tenets of the CMS Age-Friendly Hospital Measure into ED workflows. Explore how this helps improve geriatric emergency care while meeting national standards. Get the latest GEDC updates and insights straight to your inbox

San Diego Business Journal
Jun 24th, 2026
West Health partners with NCQA.

West Health partners with NCQA. HEALTHCARE: Multi-Year Initiative Develops Behavioral Health Quality Measures June 24, 2026 LA JOLLA - Local healthcare nonprofit West Health is reimagining behavioral health treatment through a new partnership with the National Committee for Quality Assurance (NCQA). The multi-year initiative led by the organizations will align payers and providers around a core set of behavioral health quality measures in order to streamline care and improve patient experience. "When you think about how American healthcare ranks compared to other developed countries, we definitely lead on the innovation side. I'm talking about medical devices, technology, drugs," West Health CMO Zia Agha said. "When it comes to healthcare delivery, we are not the best... The work West Health does is bring the innovation model to healthcare delivery." Within the first three years of the partnership, West Health will develop, test and validate a set of quality measures across care settings and payer environments. The vision is for those tested standards to be implemented on a national level. "We're really excited about this partnership," said Julie Siebert, NCQA Assistant Vice President of Behavioral Health. West Health was selected as NCQA's West Coast partner for this initiative and will lead implementation alongside NCQA as it expands across the country. Gary and Mary West founded West Health in 2006 after selling their stake in the tech-driven communications company they founded, called WATS Telemarketing. The couple has contributed over $700 million to the foundation's work over the last 10 years, Agha said. West Health is comprised of the Gary and Mary West Foundation, West Health Institute and West Health Policy Center, which is based in Washington, D.C. The organization's primary focus has been healthcare for older adults. Behavioral health has become a more central focus in recent years. Pivotal time for beahavioral health. Coming out of the pandemic, the mental health burden nationwide skyrocketed. Both Siebert and Agha said they observed that trend firsthand. "One in four Americans has some sort of mental health or brain health condition today. There's a tremendous need," Agha said. "We saw that need through our engagements." Most patients present their initial mental health complaint through primary care, which does provide some care for behavioral health conditions, whether through screenings or prescriptions. Agha said, however, that level of care is not as well-organized as it needs to be. "The primary care system is neither supported nor incentivized to provide that level of care," he said. "Traditionally, mental health has been carved out as its own domain, almost separate from physical health. There's a major need to bring these two areas together, because from a patient's perspective, it's one body." The key driver to provide a more streamlined, effective level of care is to create a measurement framework. Agha explained what that framework would look like in practice for behavioral health. "I'll use the example of when you go see your doctor for high blood pressure or diabetes," he said. "They have specific numbers they use for diagnosis, but as they start treating you, they also track those numbers to see if you're getting better. "That does not universally exist for mental health," Agha continued. "While there's a long history of measurement frameworks, tools and questionnaires, they're not fully adopted." Multi-Year Initiative with national reach. One of the challenges preventing adoption is that there isn't a major incentive, in terms of payment, for clinicians to demonstrate that they are screening, identifying and treating patients with mental health conditions to a target. The measures developed by West Health and NCQA aim to bridge that gap. "Ultimately, the hope is we will demonstrate to the payers what they are asking for - to show them the data - which then will allow them to provide better reimbursement for patients," Agha said. "That helps patients access care but also helps the primary care system and providers get better billings, so they can continue to provide that level of care." West Health and NCQA have already been researching, developing and building policy frameworks for their set of measures for over six months. Soon, the partnership will be launching those measures in over 100 clinical sites throughout California. That first set of implementations will allow the partnership to demonstrate that they can effectively measure and track conditions, show patient improvement and, hopefully, provide better reimbursement. Siebert said that their work with West Health is the first step in a nationwide rollout. Once their measures are proven, NCQA will look for additional partners to join the effort in the central and eastern regions of the U.S. This kind of initiative is important because behavioral health conditions impact people in every area of their life, whether personally, professionally or recreationally, Agha said. "All of this is in service of our goal of improving the cost, quality and access to these critically needed services," Agha said. "We strongly believe that the primary care and integrated care settings have a huge opportunity to serve this patient population alongside specialists." Born and raised in San Diego, Madison takes great pride in local storytelling. Her coverage at the San Diego Business Journal includes tourism, hospitality, nonprofits, education and retail. An alumna of San Diego State University's journalism program, she has written for publications including The San Diego Union-Tribune and The San Diego Sun. At the 2024 San Diego Press Club awards, Madison was recognized for her exemplary profile writing. She was also a speaker for the 2023 TEDx Conference at Bonita Vista High School. When she's not working on her next story, Madison can be found performing music at a local restaurant or on one of San Diego's many hiking trails.

News Deli
Jun 22nd, 2026
West Health launches initiative to scale integrated Mental Health care in Primary Care settings nationwide.

West Health launches initiative to scale integrated Mental Health care in Primary Care settings nationwide. SAN DIEGO, CA, UNITED STATES, June 22, 2026 / EINPresswire.com / - West Health, a nonpartisan nonprofit organization focused on healthcare and aging, has published a new analysis titled" Accelerating Mental Health Integration in Primary Care: From Implementation to Sustainable Impact," outlining the organization's work to bring evidence-based mental health care into primary care at scale and establish a national standard for measuring its quality. The article opens a new series examining mental health care in America and draws on real-world implementation with three strategic partners: Northwestern Medicine, the Meadows Mental Health Policy Institute, and the National Committee for Quality Assurance (NCQA). The case for action is significant. Thirty-three million Americans are living with depression or anxiety severe enough to require treatment. Research from West Health-Gallup Center on healthcare in America shows that roughly 7 in 10 Americans want mental health addressed in primary care, yet many report these conversations do not happen consistently. According to West Health, the gap is not a lack of effective treatments, but how care is organized. The Foundation: Collaborative Care Model West Health's approach is grounded in the Collaborative Care Model (CoCM), developed at the University of Washington and validated by more than 90 randomized controlled trials. CoCM embeds behavioral health directly into primary care teams and has demonstrated clinical results, including reducing depressive symptoms at twice the rate of usual care, improving patient engagement, and reducing unnecessary emergency department use. The model also carries a financial case. Studies show savings from reduced acute care utilization can exceed program costs within the first year, with longer-term savings of $3,000-$6,000 per patient annually. To put that model into practice at scale, West Health launched the Northwestern Medicine West Health Accelerator alongside Northwestern Medicine and the Meadows Mental Health Policy Institute in 2024. The collaboration now spans 80 clinics, more than 500 primary care physicians, and a patient panel of more than 500,000 people. What Implementation Is Revealing After a full year of operating CoCM across Northwestern Medicine primary care practices, West Health reports that clinical evidence alone does not drive adoption; operational infrastructure and strong system leadership also have a role. Key barriers include billing complexity, unclear payer coverage for CoCM codes, consent requirements that create friction at the point of referral, and Medicaid attestation rules that suppress referral volume. Dashboard and registry development also took roughly twice as long as anticipated, underscoring the technology investment required to scale integrated care models. Defining a National Measurement Standard A central focus of the initiative is closing a critical gap in behavioral health: the absence of a consistent, shared framework for measuring what high-quality integrated mental health care looks like. Without that clarity, even proven models struggle to demonstrate their value, justify investment, or sustain funding. To address this, West Health is partnering with NCQA to develop a standardized core set of behavioral health quality measures, currently being tested across more than 100 provider groups and 5 million patients in multiple states. Northwestern Medicine serves as the implementation partner, connecting real-world care delivery with national measurement efforts. Payer coalitions and national partners are also being convened to ensure broader alignment and adoption. The analysis frames quality measurement as the bridge between innovation and scale. Without shared definitions of success, integrated care remains optional. With them, it becomes expected, measured, and sustained. Policy, Workforce, and Technology as Enabling Levers West Health researchers identify three additional levers required to scale integrated mental health care: policy reforms that remove adoption barriers, workforce strategies that extend the reach of clinicians, and technology that enables data sharing, workflow integration, and population-level management. Quality measurement, analysts argue, is what connects these levers and translates effort into measurable progress. More than 33 million Americans with unmet mental health needs are not waiting for new discoveries, but for a system organized to deliver care. Establishing a national approach to measurement is a critical step in building that system. "Accelerating Mental Health Integration in Primary Care: From Implementation to Sustainable Impact" is now available on the West Health website. About West Health Solely funded by philanthropists Gary and Mary West, West Health is a family of nonprofit and nonpartisan organizations, including the Gary and Mary West Foundation and Gary and Mary West Health Institute in San Diego and the Gary and Mary West Health Policy Center in Washington, D.C. West Health is dedicated to lowering healthcare costs to enable seniors to successfully age with access to high-quality, affordable health and support services that preserve and protect their dignity, quality of life, and independence. Legal Disclaimer: EIN Presswire provides this news content "as is" without warranty of any kind. News Deli do not accept any responsibility or liability for the accuracy, content, images, videos, licenses, completeness, legality, or reliability of the information contained in this article. If you have any complaints or copyright issues related to this article, kindly contact the author above.

West Health
Sep 23rd, 2025
West Health Partners with The Kennedy Forum to Elevate Brain Health in the Workforce

West Health partners with The Kennedy Forum to elevate brain health in the workforce.

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