1215: Building Finance for the Long Game | Jessica Somers, CFO, Aledade

Rather than viewing investments as isolated projects to be stack-ranked strictly by ROI, Somers wants leaders to understand how different investments interact and compound. That became particularly important as Aledade weighed continued progress toward profitability against the opportunity to make larger AI investments. The result was a willingness to make bigger bets where leadership saw the potential to extend the company’s advantage.

Somers’ perspective is shaped by an earlier career in investment banking, private equity, and corporate development. Moving from advising on transactions to operating inside the businesses themselves taught her that financial results reflect countless everyday decisions—and that finance creates the most value when it deeply understands the business behind the numbers.

Her agenda now extends that philosophy to AI: not simply using technology to make finance faster, but reimagining work so the team has greater capacity for judgment, insight, and strategic partnership.

As I mentioned earlier, value-based care attempts to change the standard approach to healthcare, where volume is how providers get paid. Instead, we bring technology, data, predictions, and insights to our providers that encourage proactive and preventive care.

So we try to stop a stroke from happening so that a patient doesn’t have to, let’s say, first go to urgent care, then go to the ER, then end up in a hospital, then perhaps get discharged from the hospital but get readmitted, which is very common in this country. And when we do that well, it actually saves the system money. You’re preventing that entire chain of what is both very expensive care and, frankly, a lot of human suffering.

For us at Aledade, we have a very simple but lofty mission that is our North Star, and that is to deliver better health, better care, and lower costs by building a solution that is good for patients, good for practices, and good for society. We deeply believe in this mission. It shapes, I would say, every decision we make at this organization, and we’ve actually built it into our governance model as a public benefit corporation.

CFOTL: Aledade has grown considerably. How have its investment choices shaped what the company has become?

Somers: I think there are a number of fundamental, what we would call first-principles decisions that our co-founders made when starting the business more than a decade ago that continue to hold true for us today. That brings a certain amount of clarity, which helps a business growing and operating in a complex environment.

Some of those fundamentals are that we are long-term oriented. I think that’s represented through our status as a public benefit corporation. We care certainly about our shareholders and our investor base that have supported us over the years, but we also take into account what our decisions mean for our practice partners, for the patients that we have the privilege to serve, and for our employees.

We have that long-term, mission-oriented lens as we make investment funding decisions, for example. Over the last dozen years, we’ve become one of the largest independent value-based care platforms in the country. We serve more than 3,000 practices. We touch more than 3.6 million patients. And our goal is to multiply those numbers over time.

How do we let every senior in this country have the benefit of the type of proactive and preventive care that we help to deliver? That’s our guiding light.

CFOTL: When you have this long-term view, how does that translate into capital allocation? What capital allocation matters most?

Somers: We are always talking about reinvesting in the business. It allows you to make those long-term bets, those long-term decisions, because you have conviction around the impact it’ll drive over time.

It’s also led us to be focused on really controlling our destiny. That shows up in a bunch of decisions. We’ve built our own technology platform since the very beginning. We didn’t want to be beholden to someone else’s roadmap, right? We wanted to control that critical part of how we deliver our product to our partners.

I think there’s a clarity that comes from having mission so clearly at the forefront and being able to say, yes, that might be a short-term hit, but long-term valuable. I know where that decision’s going to land every time, right? So again, we’re deeply committed, and I think that long-term lens ultimately has worked, and we’re committed to it going forward from here.

CFOTL: When it comes to the revenue model, can you help us understand how Aledade makes money, very simply? Which part of this model best reveals the opportunity and the economics?

Somers: Sure. I’m going to use one of our value-based care programs, our largest program, as an example here to answer your question. We’re the largest participant in the Medicare Shared Savings Program. This is a program for traditional Medicare members, so seniors across the country who are in traditional Medicare. It is administered by CMS, so it’s a government program. And again, we’re the largest participant.

In the program, effectively, we take accountability for the total cost of care for members who are seen by our practice partners. So I’m going to use 2024 as an example. That’s the last year in which there were final published results for the program. In 2024, we had accountability with our practice partners for 1.2 million members for their total cost of care.

What we try to do is bring down the cost of their care relative to what CMS would otherwise expect. That’s our medical spend under management. In 2024, those 1.2 million members, CMS expected them to have total healthcare expenditures of $15.2 billion.