Diabetes, heart disease and poor circulation are each manageable on their own. Together they make each other worse. A small sore on a foot can end in a hospital stay, an amputation, or worse. We call that decline the cascade. The warning signs appear at home, between visits to the doctor. We take accountability for patients heading into a cascade, and for helping them stay well at home. First market, early 2027.
Illustrative pattern for one patient, drawn from published studies of diabetic foot wounds. Silver Health Plus is pre-revenue; the outcome shown is the designed one.
Hospitals. Up to 3% of base Medicare inpatient payments are lost to readmission penalties. Complex patients hold beds that surgery needs.
Insurers. Medicare pays them a fixed amount per senior, set from last year. Medicare’s price formula pays $40 to $200 a month too little for members with seven or more conditions. A cascade comes out of the insurer’s pocket.
Two in three seniors live with two or more long-term conditions. CDC, 63.7% of adults 65 and over. $300B sums published Medicare spending by condition; the populations overlap, so the figure is gross rather than deduplicated. CMS Hospital Readmissions Reduction Program. CMS-HCC V28 model evaluation. Sheehan et al., Diabetes Care 2003; Izumi et al., Diabetes Care 2006; Beeson et al., PRS Global Open 2023.
Detect the cascade early. Plan across every condition. Intervene in the home. Take accountability for the outcome, and be paid on it.
Cross-condition judgment models read how her conditions interact and flag who is at risk or already declining, before the first visit.
One plan across all her conditions, shared with everyone who treats her. The hub re-plans it after every visit and every signal.
A clinician from an affiliated practice, in her home, as often as her risk requires. The models carry thirteen specialties into the visit. The hub sets up monitoring in her home and watches it every day, escalates when something moves, and coordinates her doctors, pharmacy and home care. The clinician keeps the final call.
A defined group of patients. A defined outcome. Measured every month. Paid on it. No contract is signed yet.
The designed operation. The visit software and the judgment models are live today; the hub and monitoring launch with the first market.
Before. The clinician gets a briefing on what changed since the last visit, an assessment tailored to this patient, and a kit list. The briefing plays as audio on the drive.
During. The software listens, suggests findings from her answers, and the clinician confirms or rejects each one. Goals and actions follow from what she confirms, across conditions.
After. The note is drafted from the visit. The clinician signs each diagnosis with the evidence behind it. Orders go out. The patient gets a summary. The plan updates.
Between. The hub is being built to read her devices and her reports every day. A change triggers a re-plan, a call, or a visit brought forward. The hub also keeps her other doctors in the loop, so nobody works from an old picture.
The visit software and the tool clinicians write into are live as of October 2026, shown with invented test patients. Remote monitoring and the hub launch with the first market.
They ask us to help those patients stay well, at home. We are accountable for the result. First contracts are planned for 2027; none is signed.
They ask us to help her recover at home and stay there. Frequent visits, tailored to her, with several specialties’ judgment brought together, for as long as her risk holds. Usually a month. Longer if she needs it.
They ask us to help her avoid it, or heal it before it costs her a foot or a hospital stay. Months of the same care, for the wound and the conditions beneath it.
Hospitals pay a fee per patient for the period after discharge, $875 to $1,750. They get $1.05 to $1.72 back for each $1, modeled.
Insurers pay a monthly fee per member plus 20 to 25% of the savings on the members we take on. They get $1.58 back per $1, rising to $2.31 by the third year, modeled.
Affiliated practices deliver the visits. We hold a stake in each practice. They run on our clinical standards and our platform and keep billing Medicare for each visit. We share in the practice’s profit.
Two kinds of revenue, in two companies. The hospital and insurer contracts sit in Silver Health Plus. They pay on the outcome. The affiliated practices sit in Silver Care Group. They are paid by Medicare for each visit, as they are today. The outcome contracts carry the higher margin. The practices run at about a 20% margin on visits, and we hold a stake in each. On the insurer contracts, about 59% of what we are paid is left after paying for the care, by the third year. Both modeled.
Why this is priceable. A hospital or insurer is responsible for everything that happens to a senior. We take responsibility for a defined group of patients and a defined result. A narrow, measurable piece is one we can price and one they can trust. The contracts carry no downside risk at the start.
Prices and returns from our October 2026 financial model. No contract is signed.
Three blocks, built once. The factory assembles them into a service for each group of patients and each outcome we are accountable for.
The models carry the judgment of thirteen specialties and apply it across a patient’s conditions at once. Every rule rests on published science, with the evidence behind it, and every suggestion shows its reasoning. The science base is led by our chief scientist, with 160 peer-reviewed publications behind it.
The agents are being built to digitize the administrative side of care delivery, end to end. Scheduling, notes, coding, billing, orders, authorizations, coordination. That is what lets the economics hold at scale, and it is what AI changed.
How the judgment gets in. Clinicians from thirteen specialties write it into the platform in plain language, each rule tied to the published evidence behind it. The models apply it in every visit and every hub decision. The treating clinician keeps the final call.
Traced. Every suggestion traces back to the rule, the evidence and the clinician who wrote it. That is what hospitals and regulators ask of clinical software.
Different from the AI you have read about. Generative AI drafts text. Ambient AI listens. Predictive AI scores risk. Ours carries clinicians’ judgment from what is observed to what is done, and shows its work.
The loop. What happens in every visit and every hub decision flows back into the platform. The next patient’s care and the next contract’s pricing both improve.
The visit software and the authoring tool are live as of October 2026, with 919 rules across 13 specialties. Remote monitoring, the hub and the agent layer launch with the first market.
We enter our first market, Houston, in early 2027. Silver Care Group goes first, with a stake in a practice already seeing these patients. It keeps running.
Its patients, clinicians and relationships join on day one. It was profitable before we arrived, and stays so.
The practice already serves the hospital’s patients. We add the service and the accountability.
Total cost of wound care, on the same network. Revenue becomes monthly.
A stake, not an acquisition. The affiliate path is funded inside this round. The stakes are available at today’s prices because government payment cuts have squeezed these practices, and owners welcome a stake, contracts and a platform.
Four markets to start. Houston from early 2027, with the first hospital and the first insurer. Dallas and New Jersey in late 2027. Philadelphia in 2028. All are planned, none is signed.
The affiliation. Silver Care Group will take an equity stake in each practice. The affiliation agreement carries clinical standards, technology, reporting and contracting. The owner keeps running the practice and a majority of its economics.
Why it compounds. One patient in both services adds $9,940 a year of margin before fixed costs, about $5,280 of it ours. Each new service in a market lands on costs already paid.
Our October 2026 financial model.
Two customer segments run on one operating infrastructure and one platform. Margin compounds through density. In a market, each new service lands on costs already paid. In a customer, one hospital buys several services and one insurer’s members trigger hospital episodes. At the patient, one person can sit in both services at once.
a year. Revenue at our prices across every senior whose insurer or doctor group is paid a fixed amount for their care, plus every hospital discharge.
a year. Houston, Dallas, New Jersey, Philadelphia.
Seven insurer contracts and eleven hospital programs. 8% of the four-market figure.
Market size counts the revenue we earn, not the medical spend we manage. The spend is far larger and is what funds the savings.
Critical mass comes from the affiliates. Margin and value growth come from the hospital and insurer services. The affiliates take each market from zero to one and carry 2027 at 58% of revenue. By 2029 they are 37%, and the hospital and insurer services are 61%.
Revenue by source, with our share of EBITDA under each year. Affiliate visits are Silver Care Group revenue. Hospital and insurer contracts are Silver Health Plus revenue. EBITDA is ours, after the affiliate owners’ share and after risk allowances set by management. Cash-positive from March 2028. Our October 2026 financial model, $17M plan.
Timing. 2026 is two months of platform build. Houston launches in 2027. Dallas and New Jersey follow in late 2027. Philadelphia opens in 2028. Operating EBITDA turns positive in the fourth quarter of 2027.
Contracts. Insurer and hospital contracts, members and start dates are planning assumptions until signed. None is signed.
Market size. National revenue is 49.5M seniors whose insurer or doctor group is paid a fixed amount for their care, at $730 a year each. Add 3.3M hospital discharges a year at $1,275. The four-market figure uses the same prices on about 3.1M seniors and 216K discharges. The 2029 target is 8% of the four-market figure.
Sources. KFF 2026. CMS ACO participation 2026. CMS county enrollment, June 2026. Our October 2026 financial model.
The base plan uses $17M. Up to $5M more brings faster market entry and a wider affiliate base, on the same terms. The accelerator is spread across the four tranches, so each one draws more and the gates come sooner. Each tranche opens when the one before it clears its gate, so capital follows proof. Tranche 1 draws $3M now. Commitments of up to $8M are welcome at the first close and draw at the gates. Investors buy units in Silver Health Holdings, which owns both companies.
Every leader has worked with the founder before. Names and backgrounds in the management presentation.
Silver Health Plus takes $12M by SAFE, with a valuation cap and a discount to the next round. Silver Care Group takes $5M of priced equity with a 1× non-participating preference. Holdings owns stakes in both and releases money to each company as its gates are met.
Same terms every tranche. Units in Holdings are bought at one price in every tranche, so a later tranche never reprices the first. At a sale, the founder transfers a share of his founder holding to first-round investors.
Ownership at $17M and at $22M, the cap, the discount, the gates and the full model are in the data room and confirmed in definitive documents under NDA.
The cascade is visible months before it is expensive. We are building the company that takes accountability for acting in that window. First market, early 2027.
Request a meeting and a demo → Full deck, model and data room, under NDAThe demo is the working visit software and the judgment models, on invented test patients.
