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(“Privia Health”, “we”, “our”, or the “Company”) is a technology-driven, national physician-enablement company that collaborates with physician practices, health plans, and health systems to achieve the quadruple aim of better outcomes, lower costs, improved patient experience, and happier and more engaged providers.
−Removed: We seek to accomplish the quadruple aim by entering markets and organizing existing physicians and non-physician clinicians into a unique practice model that combines the advantages of a partnership in a large regional medical group (each, a “Medical Group”) with significant provider autonomy for the physicians (collectively, “Privia Physicians”) and non-physician clinicians (collectively “Privia Clinicians” and, together with the Privia Physicians, the “Privia Providers”) joining our Medical Groups.
+Added: We seek to accomplish the quadruple aim by entering markets and organizing existing physicians and non-physician clinicians into a unique practice model that combines the advantages of a partnership in a large regional medical group (each, a “Medical Group”) with significant provider autonomy for the physicians (collectively, “Privia Physicians”) and non-physician clinicians (collectively “Privia Clinicians” and, together with the Privia Physicians, the “Privia Providers”) in our Medical Groups.
We organize physicians into cost efficient, value-based and primary-care centric networks bolstered by strong physician governance, and promote a culture of physician leadership.
−Removed: Our platform (the “Privia Platform”) is powered by our Privia Technology Solution that integrates both Privia-developed and third-party applications into a seamless interface and workflow that manages all aspects of our Privia Providers’ provision of healthcare services.
+Added: Our technology and service solutions (collectively, the “Privia Platform”) are powered by our Privia Technology Solution that integrates both Privia-developed and third-party applications into a seamless interface and workflow that manages all aspects of our Privia Providers’ provision of healthcare services.
We enhance the patient experience, improve practice economics and influence point of care delivery through investments in data analytics, revenue cycle management (“RCM”), practice and clinical operations and payer alignment.
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Our value proposition and comprehensive solution set address needs across the spectrum of physician practices.
−Removed: We believe our technology-enabled platform is differentiated and well positioned to drive sustainable long-term growth.
−Removed: The Privia Platform has the following key attributes:
+Added: We believe the Privia Platform is differentiated and well positioned to drive sustainable long-term growth because it:
• Addresses a large and growing total addressable market (“TAM”) of providers
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• Built on a comprehensive cloud-based technology-enabled platform that is designed to optimize provider workflow across the full continuum of reimbursement environments in virtual and in-person care settings
−Removed: • Focused on establishing scaled provider groups across each geographical market, resulting in increased relevance with payers and patients (over 1,200 care center locations across 14 states and the District of Columbia)
+Added: • Focused on establishing scaled provider groups across each geographical market, resulting in increased relevance with payers and patients
• Designed to transition care delivery in each market from FFS to VBC and to enhance the ability of Privia Providers to manage higher risk patients
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• Led by a team with significant experience leading payer, provider and healthcare information technology organizations
−Removed: We operate in 14 states and the District of Columbia.
+Added: We currently have a presence in 24 states and the District of Columbia, including 9 states in which we only participate in VBC arrangements.
Generally speaking, we define a market as a geographic area covered by one of our Medical Groups under a single Tax ID Number (“TIN”).
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We aim to build relationships with key constituents including physicians, non-physician clinicians, patients, government programs, commercial payers and employers.
−Removed: As of December 31, 2024, we had 4,789 Privia Providers on the Privia Platform who are credentialed and bill for medical services, in both Owned and Non-Owned Medical Groups (as defined below), (“implemented providers”).
−Removed: Our implemented providers operate in over 1,200 care center locations.
−Removed: Privia cares for over 5.2 million patients, including in VBC arrangements approximately 782,000 commercial patients who have selected one of our Medical Groups as their provider of primary care services, as measured at the end of a particular period (“attributed lives”), approximately 185,000 Medicare Advantage attributed lives, 196,000 Medicare Shared Savings / Maryland PCP+ Program attributed lives, and approximately 97,000 Medicaid attributed lives.
+Added: As of December 31, 2025, we had 5,380 Privia Providers who are credentialed and bill for medical services, in both Owned and Non-Owned Medical Groups (as defined below), (“implemented providers”).
+Added: Our implemented providers operate in over 1,300 practice locations.
+Added: Privia cares for over 5.8 million patients, including in VBC arrangements approximately 910,000 commercial patients, as measured at the end of a particular period (“attributed lives”), approximately 212,000 Medicare Advantage attributed lives, 298,000 Medicare Shared Savings / Maryland PCP+ Program attributed lives, and approximately 120,000 Medicaid attributed lives.
In some instances, we also move into and expand in new and existing markets through our Privia Care Partners model, which offers an affiliation model to providers who are looking solely for VBC solutions.
−Removed: For those practices, we furnish population health services, reporting and analytics, along with certain management.
+Added: For those practices, we furnish population health services, reporting and analytics, along with certain management services.
Under our Privia Medical Group model, Privia Physicians join the Medical Group in their geographic market as an owner of the Medical Group.
−Removed: We own a majority interest in certain of our Medical Groups (each, an “Owned Medical Group”), with Privia Physicians collectively owning a minority interest, and we own no interest in certain other Medical Groups (each, a “Non-Owned Medical Group”).
−Removed: In those markets in which state regulations do not allow us to own Medical Groups, the Non-Owned Medical Groups may be owned by the Privia Physicians or majority owned indirectly by a licensed physician holding a Privia leadership position (each such Non-Owned Medical Group owned in this manner, a “Friendly Medical Group”) with Privia Physicians collectively owning a minority interest.
−Removed: In those markets where we partner with health systems, our health system partner owns a majority interest in the Non-Owned Medical Groups, with Privia Physicians owning a minority interest.
+Added: We own a majority interest in certain of our Medical Groups (each, an “Owned Medical Group”), with Privia Physicians collectively owning a minority interest, and we own no interest in certain other Medical Groups for which we provide services through a services agreement (each, a “Non-Owned Medical Group”).
+Added: In those markets in which state regulations prohibit us from owning Medical Groups, the Non-Owned Medical Groups may be owned by the Privia Physicians or majority owned indirectly by a licensed physician holding a Privia leadership position (each such Non-Owned Medical Group owned in this manner, a “Friendly Medical Group”) with Privia Physicians collectively owning a minority interest.
+Added: In certain markets where we partner with health systems, our health system partner owns a majority interest in the Non-Owned Medical Groups, with Privia Physicians owning a minority interest.
Privia Physicians furnish healthcare services through our Medical Groups and continue to own their historical practice entities (“Affiliated Practices”), which provide certain services to the Medical Groups, such as use of space, non-physician staffing, equipment and supplies.
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Additionally, we hold the provider contracts, maintain the patient records, set reimbursement rates, and negotiate payer contracts on behalf of the Owned Medical Groups.
−Removed: We principally derive our revenues from the following three sources:
+Added: We principally derive our revenues from the following four sources:
(i) FFS-patient care revenue generated from providing healthcare services to patients through Privia Providers of Owned Medical Groups and Friendly Medical Groups, in addition to management and administrative services earned for administrative services provided to Non-Owned Medical Groups (“FFS-administrative services”), (ii) per member per month (“PMPM”) care management fees, including management and administrative fees, (iii) VBC revenue collected on behalf of our Privia Providers in the form of (a) capitated revenue and shared savings, including quality performance-based bonuses, and (iv) other revenue from additional services offered to Privia Providers or directly to patients or employers, such as concierge services, virtual visits, virtual scribes and coding, clinical trials, behavioral health management, and partnerships with self-insured employers to offer direct primary care to their employees.
The operations of our Owned Medical Groups, owned ACOs, owned MSOs and Friendly Medical Groups are reflected within our consolidated financial results.
−Removed: We seek to reimagine the approach to managing physician organizations and optimize their performance by (i) focusing on technology and population health, (ii) establishing a single-TIN Medical Group and governance model in each geographic market, (iii) owning and operating an MSO in each local market, (iv) building ACOs to capture VBC opportunities, and (v) offering a high quality, low cost provider network for purchasers and payers.
+Added: We seek to reimagine the approach to managing physician organizations and optimize their performance by (i) focusing on technology and population health, (ii) establishing a single-TIN Medical Group and governance model in each geographic market, (iii) owning and operating an MSO in each local market, (iv) building or acquiring ACOs to capture VBC opportunities, and (v) offering a high quality, low cost provider network for purchasers and payers.
Trends impacting the U.S.
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Rising Healthcare Costs
−Removed: Healthcare spending in the United States reached nearly $4.9 trillion in 2023 or $14,570 per person, according to Centers for Medicare and Medicaid Services (“CMS”), representing approximately 17.6% of U.S.
−Removed: National health expenditures are projected to reach $7.7 trillion or 19.7% of GDP by 2032, according to CMS, outpacing both GDP and inflation expectations.
+Added: Health expenditures in the United States grew 7.2% to reach $5.3 trillion in 2024, or $15,474 per person, according to Centers for Medicare and Medicaid Services (“CMS”), representing approximately 18.0% of U.S.
+Added: National health expenditures are projected to reach $8.6 trillion or 20.3% of GDP by 2033, according to CMS, outpacing average GDP growth.
Transition to VBC
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With our experience working in all reimbursement environments and expertise in VBC and assisting providers in the transition to VBC, Privia enables providers to accelerate and navigate this transition.
−Removed: We accelerate our go-to-market strategy using on the ground market intelligence and a data driven approach to add new practices to our medical group.
+Added: We accelerate our go-to-market strategy using on the ground market intelligence and a data driven approach to add new practices to our Medical Groups.
As our Medical Groups grow, we transition our markets to VBC programs as demonstrated by the increase in our attributed risk lives across various programs.
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as of May 2024.
−Removed: Nephron Research estimated in its December 2024 research report titled “Healthcare Services 2025 Outlook” that the “physician enablement”
−Removed: market in which we participate represents up to $2.4 trillion of that total healthcare spend.
+Added: Nephron Research estimated in a December 2024 research report titled “Healthcare Services 2025 Outlook” that the “physician enablement” market in which we participate represents up to $2.4 trillion of that total healthcare spend.
We believe the flexibility of our model uniquely positions us to address this large market opportunity.
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Single-TIN Medical Group:
−Removed: In each of our markets, we establish a primary care centric single-TIN Medical Group that facilitates payer negotiation, clinical integration and alignment of financial incentives.
+Added: Generally, we establish a primary care centric single-TIN Medical Group in our markets that facilitates payer negotiation, clinical integration and alignment of financial incentives.
Our Medical Group governance structure allows Privia Providers to build a clinical culture that adapts to consumers’ and a region’s unique and evolving needs.
Privia Providers in our Medical Groups collaborate in physician-organized delivery meetings to review performance data, share best practices, create an environment of accountability, and advance evidence-based medicine while maintaining significant provider autonomy.
−Removed: At the local leadership level, Privia Physicians across different practice locations, or care centers, meet regularly with support from Privia performance team members to drive local population health initiatives, engagement and performance.
+Added: At the local leadership level, Privia Physicians across different practice locations meet regularly with support from Privia performance team members to drive local population health initiatives, engagement and performance.
At the market Medical Group level, Privia Physicians, along with Privia team members, advise on priorities, set annual objectives, and approve payer contracts and performance distribution.
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Our scale and quality metrics allow us to enhance reimbursements for delivering high-quality care.
−Removed: The Privia Technology Solution identifies quality gaps, sends patient satisfaction surveys, automates patient outreach and education, and generates reports and alerts to improve care coordination.
+Added: The Privia Platform identifies quality gaps, sends patient satisfaction surveys, automates patient outreach and education, and generates reports and alerts to improve care coordination.
Our platform proactively shares critical information at various points along the continuum of care to advance population health and streamline provider workflow.
Our integrated tools result in cost savings for Privia Providers in both commercial and federal programs by diverting costly patient encounters.
−Removed: In 2023, Privia operated ten ACOs that delivered care to more than 194,000 Medicare beneficiaries, achieving shared savings of $176.6 million through the MSSP, a shared savings increase of 34.1% over 2022.
+Added: In 2024, Privia operated nine ACOs that delivered care to more than 194,000 Medicare beneficiaries through MSSP, achieving shared savings of $233.1 million, an increase of 32% over 2023.
Our per capita expenditures per member per year were 8% lower than the median MSSP ACO and 22% lower than total FFS Medicare.
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Our approach has been successful across Commercial, Medicare Advantage, MSSP, and Medicaid, from simpler pay-for-performance programs to more complex partial capitation and risk-based programs.
−Removed: For the 2024 MSSP performance year, Privia had a total of nine ACOs serving over 192,000 Medicare beneficiaries across the District of Columbia and eleven states, including California, Connecticut, Florida, Georgia, Maryland, Montana, North Carolina, Tennessee, Texas, Virginia and Washington state.
−Removed: Out of the nine ACOs, five were participating in the MSSP Enhanced Track with potential upside and downside financial risk.
−Removed: For the 2025 MSSP performance year, Privia will have nine ACOs participating in the MSSP
−Removed: serving approximately 196,000 Medicare beneficiaries.
−Removed: Five of the nine ACOs are participating in the MSSP Enhanced Track in the 2025 MSSP performance year.
+Added: For the 2025 MSSP performance year, Privia had a total of ten ACOs serving over 298,000 Medicare beneficiaries.
+Added: Out of the ten ACOs, six were participating in the MSSP Enhanced Track with potential upside and downside financial risk.
Network for Purchasers and Payers:
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The Privia Technology Solution:
−Removed: Our Purpose-Built, End-to-End Technology-Enabled Platform
−Removed: Our end-to-end, cloud-based technology-enabled platform streamlines the provider, patient and care team workflows focusing on each of the following aspects:
+Added: Our End-to-End Technology-Enabled Platform
+Added: The Privia Technology Solution streamlines the provider, patient and care team workflows focusing on each of the following aspects:
(i) patient access through various avenues (patient portal, mobile app and search engine optimization), (ii) pre-visit analytics and preparation, (iii) in-person or virtual care delivery and (iv) post visit analytics, care-coordination and reporting.
−Removed: Our technology-enabled platform enables us to scale operations across approximately 4,800 implemented providers in multiple markets, enhance performance across multiple payer contracts and deliver superior quality care to patients across the demographic spectrum.
−Removed: Our technology-enabled platform supports providers, including by leveraging machine learning and artificial intelligence to reduce or automate certain administrative tasks.
−Removed: In addition, our technology-enabled platform helps us scale operationally, as our product designers and engineers collaborate closely with clinical and operational teams to optimize workflows as we enter new markets and new payer contracts.
−Removed: Our platform is built on a modern cloud-based technology stack employing agile development cycles.
+Added: The Privia Technology Solution enables us to scale operations in multiple markets, enhance performance across multiple payer contracts and deliver superior quality care to patients across the demographic spectrum.
+Added: The Privia Technology Solution supports providers, including by leveraging machine learning and artificial intelligence (“AI”) to reduce or automate certain administrative tasks.
+Added: In addition, the Privia Technology Solution helps us scale operationally, as our product designers and engineers collaborate closely with clinical and operational teams to optimize workflows as we enter new markets and new payer contracts.
+Added: The Privia Technology Solution is built on a modern cloud-based technology stack employing agile development cycles.
Our technology architecture utilizes API standards for ease of implementing new functionalities and integrating with multiple external systems.
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We optimize practices’ web presence so patients can find and schedule an appointment with a provider online and receive appointment reminders.
−Removed: We offer a mobile app and patient portal that allow patients to access personal health information and stay connected with their providers.
−Removed: by equipping physicians with the tools they need to deliver quality, affordable care when, where, and how patients need it.
+Added: We offer a mobile app and patient portal that allow patients to access personal health information and stay connected with their providers by equipping physicians with the tools they need to deliver quality, affordable care when, where, and how patients need it.
We also provide 24/7 Nurse Triage Call Center and 24/7 On-demand Virtual Visits for immediate or primary care.
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Privia’s solutions identify opportunities before the patient visit, using huddle reports and patient stratification.
−Removed: Our platform allows providers to identify patient attribution, open quality gaps, open coding gaps, assess patient risk level and determine care management eligibility.
+Added: The Privia Platform allows providers to identify patient attribution, open quality gaps, open coding gaps, assess patient risk level and determine care management eligibility.
During Visit:
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Our patients can also use the telehealth platform to schedule a virtual visit with a provider of their choice, an in-person follow-up visit or a referral to a specialist.
−Removed: Virtual visit volume increased rapidly during the COVID-19 pandemic and we continue to offer virtual visits, including through our 24/7 Virtual Clinic.
As of December 31, 2025, over 1.5 million distinct Privia Health patients have completed over 4.7 million virtual visits.
Of all patients seen by a Privia Provider virtually, over 95% did not return to the same doctor or another doctor in the same specialty for a follow-up visit within seven days.
−Removed: During the year ended December 31, 2024, approximately 7% of our visit volume was delivered virtually across our markets and specialties.
Governance and Physician Leadership Culture
−Removed: Our multipurpose governance model includes a local governance structure tailored to each market and is intended to improve aspects of our patient, physician and payer relationships.
−Removed: Privia Physicians hold the majority of board positions in our Owned Medical Groups and ACOs, including sole authority over matters related to the practice of medicine, and we either have exclusive authority over certain strategic issues such as mergers and acquisitions, and termination of our MSA or veto authority relative to certain strategic decision making.
−Removed: In addition, our National Physician Advisory Council (“NPAC”) brings together the clinical and executive local market leadership across the country to provide valuable input to improve our common technology-enabled platform, physician facing data reporting, common quality initiatives, marketing and product performance.
+Added: Our multipurpose governance model includes a local governance structure tailored to each market that is intended to improve aspects of our patient, physician and payer relationships.
+Added: Privia Physicians hold the majority of board positions in our Owned Medical Groups and ACOs, including authority over matters related to the practice of medicine, and we either have exclusive authority over certain strategic issues such as mergers and acquisitions, and termination of our MSA or veto authority relative to certain strategic decision making.
+Added: In addition, our National Physician Advisory Council (“NPAC”) brings together the clinical and executive local market
+Added: leadership across the country to provide valuable input to improve the Privia Platform, physician facing data reporting, common quality initiatives, marketing and product performance.
Under the auspices of the NPAC, various individual specialty collaboratives meet both locally and nationally to address common issues, bring best practices and models of success to the forefront.
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• Focus on same store growth of patients attributed to value-based contracts in each existing geographic market;
−Removed: • Increase our revenue opportunity on a per patient basis by continuing to improve performance and continuing to take increasing levels of risk in existing value-based programs across commercial, MSSP, Medicare Advantage, Medicaid and other existing and emerging direct payer and employer contracting programs;
+Added: • Increase our revenue opportunity on a per patient basis by continuing to improve performance and financial value in existing and new value-based programs across commercial, MSSP, Medicare Advantage, Medicaid and other existing and emerging direct payer and employer contracting programs;
• Develop new products and programs in partnership with aligned payers that are built with and around our network of physicians and providers.
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• We evaluate the broader market landscape for opportunities on a continuous basis and proactively develop relationships before committing to enter a market.
−Removed: Acquisitions and Investments in Full Service Care Models
+Added: Disciplined and Strategic Acquisitions and Investments
• Our growth playbook also factors in the opportunity to acquire minority or majority ownership of provider groups or clinically integrated networks in existing and new markets and we may also open de-novo, wholly or partially owned, sites of care in existing and new markets.
Sales, Marketing and Business Development
−Removed: We aspire to continue growing our national platform by expanding geographically into new markets and increasing density within our existing markets.
+Added: We aspire to continue growing our national platform by expanding geographically into new markets and growing within our existing markets.
Our business development, sales and marketing initiatives focus on the following avenues to drive growth:
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• Consumer sales and marketing —As our medical groups grow in each market, we look to transition the market to value-based programs by increasing the patient panels of our providers and adding attributed risk lives across various VBC programs.
−Removed: Our marketing and communications team operates our brand management, enterprise web presence and care center websites, and creates other forms of patient communication and engagement materials.
+Added: Our marketing and communications team operates our brand management, enterprise web presence and certain practice location websites, and creates other forms of patient communication and engagement materials.
Our branding and marketing strategy to drive growth to our practices have continued to result in increased engagement with new and existing patients and expanded enterprise web presence.
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We run targeted advertisements through print, direct mail, Google search, and social media for provider and patient acquisition.
−Removed: We also develop thought leadership content such as whitepapers, e-brochures, and blog posts and use public relations to secure earned media placements.
+Added: We also develop thought leadership content such as white papers, e-brochures, and blog posts and use public relations to secure earned media placements.
Additionally, we participate in industry conferences, and collaborate with media outlets, industry associations, event venues, and local businesses to increase brand awareness.
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Intellectual Property
−Removed: We believe that our intellectual property rights are important to our business.
We rely on a combination of trademarks, service marks, copyrights and trade secrets to protect our proprietary technology and other intellectual property.
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quality of medical equipment and services;
−Removed: patient, workforce, and public safety;
+Added: patient, workforce, and public safety, as well as patient rights;
qualifications and supervision of, and reimbursement for services provided by, medical and support personnel;
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the confidentiality, maintenance, interoperability, exchange, and security of medical records and other health-related and personal information, including data breach, ransomware and identity theft issues;
−Removed: the development and use of artificial intelligence and other predictive algorithms, including those used in clinical decision support tools;
+Added: the development and use of AI and other predictive algorithms, including those used in clinical decision support tools;
restrictions on the provision of medical care, including reproductive care;
permitting, facility and personnel licensure, certification and accreditation requirements;
+Added: mandatory reporting requirements for providers;
enrollment standards and requirements for participation in government healthcare programs;
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debt collection, balance billing and billing for out of network services;
+Added: translation services and accessibility requirements;
communications with patients and consumers;
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Adverse findings from such investigations and audits could bring severe consequences that could have a material adverse effect on our business, results of operations, financial condition, cash flows, reputation and stock price.
−Removed: In addition, commercial payers could require pre-payment audits of claims, which can negatively affect cash flow, or terminate contracts for repeated deficiencies.
+Added: In addition, commercial payers could require pre-payment audits of claims, which can negatively affect cash flow, or terminate contracts, including for repeated deficiencies.
Furthermore, if a state in which we currently operate, or in which we seek to expand, views the participation of the Company or its Medical Groups in risk-sharing arrangements as the assumption of insurance risk, the arrangement may fall within the purview of state insurance or managed care laws and regulations, and we or the Medical Group may be required to obtain a state insurance or managed care license or similar registration.
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If we or our Medical Groups fail to comply with insurance laws and regulations, including licensure and oversight requirements, we may be required to make changes to our operations and could be subject to civil and/or criminal penalties, denial of future licensure applications and termination of payer contracts.
−Removed: These laws and regulations may affect the operation of, for example, ACOs, direct primary care programs, provider-sponsored organizations, independent practice associations, and provider capitation models.
+Added: These laws and regulations may affect the operation of, for example, ACOs, direct primary care programs, provider-sponsored organizations, independent practice associations, clinically integrated networks, and provider capitation models.
At the state level, our ability to conduct business and the structure of our operations depends on each state’s laws, regulations, and policies governing, among other issues, the corporate practice of medicine, fee-splitting, and the assumption of financial risk.
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Possible sanctions for violations of these restrictions include loss of a physician’s license and civil and criminal penalties.
−Removed: In addition, agreements between the Company and physicians may be considered void and unenforceable, our MSAs and management fees could be adversely affected, and we may be required to restructure the Company’s relationships with Medical Groups and Privia Physicians, any of which could have a material adverse effect on our business, financial condition and results of operations.
−Removed: Federal Anti-Kickback Statute, Stark Law and Similar State Laws
−Removed: Some healthcare laws apply to the financial relationships we have or our Medical Groups have with physicians and others who either refer or influence the referral of patients to our Medical Groups and Privia Physicians or who are the recipients of referrals.
+Added: In addition, agreements between the Company and physicians may be considered void and unenforceable, our MSAs and management fees could be adversely affected, and we may be required to restructure the Company’s relationships with Medical Groups and Privia Providers, any of which could have a material adverse effect on our business, financial condition and results of operations.
+Added: Federal Anti-Kickback Statute, Stark Law and Similar State and Federal Laws
+Added: Some healthcare laws apply to the financial relationships we have or our Medical Groups have with physicians and others who either refer or influence the referral of patients to our Medical Groups and Privia Providers or who are the recipients of referrals.
The federal Anti-Kickback Statute, for example, is a criminal law that prohibits, among other things, the solicitation, receipt, offering or payment of any remuneration with the intent of generating referrals or orders for services or items that may be paid for by a federal healthcare program.
−Removed: The OIG has enacted safe harbor regulations that outline practices deemed protected from prosecution under the federal Anti-Kickback Statute.
+Added: The Office of the Inspector General for the U.S.
+Added: Department of Health and Human Services (“OIG”) has enacted safe harbor regulations that outline practices deemed protected from prosecution under the federal Anti-Kickback Statute.
+Added: In addition to the Anti-Kickback Statute, in October 2018, the U.S.
+Added: enacted the Eliminating Kickbacks in Recovery Act of 2018 (“EKRA”), as part of the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act.
+Added: EKRA is an all-payer anti-kickback law that makes it a criminal offense to pay any remuneration to induce referrals to, or in exchange for, patients using the services of a recovery home, a substance use clinical treatment facility, or laboratory.
+Added: While EKRA may have been intended to address inducements related to substance use recovery and treatment, the language in EKRA is broadly written.
+Added: No regulations have yet been issued clarifying EKRA’s scope and intent.
While we and our Medical Groups endeavor to comply with applicable safe harbors, certain current arrangements, including joint ventures and financial relationships with physicians and other referral sources and persons and entities to which our Medical Groups refer patients, may not qualify for safe harbor protection.
Failure to qualify for a safe harbor does not mean the arrangement necessarily violates the federal Anti-Kickback Statute, but may subject the arrangement to greater scrutiny.
−Removed: The Stark Law is a strict liability civil law that prohibits physicians from making referrals for “designated health services” payable by Medicare or Medicaid to entities with which the physician or an immediate family member of the physician has a financial relationship, unless an exception applies.
Allegations of violations of the federal Anti-Kickback Statute may also be brought under the federal Civil Monetary Penalty Law, which requires a lower burden of proof than other fraud and abuse laws.
−Removed: The Stark Law further prohibits entities that have received such referrals from filing claims with Medicare (or billing another individual, entity or third party payor) for those referred services.
+Added: The Stark Law is a strict liability civil law that prohibits physicians from making referrals for “designated health services” payable by Medicare or Medicaid to entities with which the physician or an immediate family member of the physician has a financial relationship, unless an exception applies.
+Added: The Stark Law further prohibits entities that have received such referrals from filing claims with Medicare (or billing another individual, entity or third party payer) for those referred services.
The financial relationships of our Medical Groups with referring physicians and their immediate family members must comply with the Stark Law.
We and our Medical Groups attempt to structure those relationships to meet an exception to or otherwise comply with the Stark Law, but the regulations implementing the Stark Law, including the requirements to meet exceptions, are detailed and complex.
−Removed: We do not always have the benefit of significant regulatory or judicial interpretation of the Stark Law and its implementing regulations.
+Added: We do not always have the benefit of significant regulatory or judicial
+Added: interpretation of the Stark Law and its implementing regulations.
Additionally, violations of the federal Anti-Kickback Statute or Stark Law, improper billing for services to federal healthcare programs, or improper retention of overpayments from federal healthcare programs may be the basis for finding a violation under the federal False Claims Act (the “FCA”), either under a suit brought by the government or by a private person under a qui tam, or “whistleblower,” suit.
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However, in many of the states we operate, these state self-referral prohibitions are often drafted broadly to cover all payers (i.e., not restricted to Medicare and other federal health care programs) or certain programs within the state such as the state Medicaid program or state workers’ compensation program.
−Removed: however, the exceptions or exemptions under state fraud and abuse laws, are less robust and developed than their federal counter parts.
−Removed: If we, our Medical Groups or participants in our ACOs fail to comply with these or other applicable laws and regulations, which are subject to change, any such failure could result in significant penalties, adversely impact our business, results of operations, financial condition and/or result in reputational harm.
+Added: Generally, however, the exceptions or exemptions under state fraud and abuse laws, are less robust and developed than their federal counter parts.
+Added: If we, our Medical Groups, Privia Providers or ACO participants fail to comply with these or other applicable laws and regulations, which are subject to change, any such failure could result in significant penalties, adversely impact our business, results of operations, financial condition and/or result in reputational harm.
Data Protection
−Removed: The data protection landscape is rapidly evolving, and the Company, its Medical Groups and ACO participants, are and may become subject to numerous state and federal laws, requirements and regulations governing the collection, use, disclosure, retention and security of health-related and other personal information.
+Added: The data protection landscape is rapidly evolving, and the Company, its Medical Groups, Privia Providers and ACO participants, are and may become subject to numerous state and federal laws, requirements and regulations governing the collection, use, disclosure, retention and security of health-related and other personal information.
For example, the HIPAA privacy and security regulations extensively regulate the use and disclosure of personal health information (“PHI”) and require covered entities, including healthcare providers and health plans, and vendors (known as “business associates”) that perform certain services that involve creating, receiving, maintaining or transmitting PHI on behalf of covered entities or other business associates, to implement administrative, physical and technical safeguards to protect the privacy and security of PHI.
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Reductions in the number of insured individuals or the scope of insurance coverage may have an adverse effect on our business.
−Removed: In addition, Medicare and Medicaid policies are subject to change, including as a result of changes in the presidential administration and Congress.
−Removed: Legislation and administrative actions at the federal level may impact funding for, or the structure of, the Medicaid or Medicare program, and may shape administration of the Medicaid program at the state level and Medicare Advantage Programs.
+Added: In addition, Medicare and Medicaid policies and programs, such as MSSP, are subject to change, and have changed, including as a result of changes in the political landscape.
+Added: Legislation and administrative actions at the federal level may impact funding for, the structure of, or who may be covered by, the Medicaid or Medicare programs, and may shape administration of the Medicaid program at the state level and Medicare Advantage Programs.
Other recent health reform initiatives and proposals at the federal and state levels include those focused on price transparency and out-of-network charges as well as pharmacy and pharmacy benefit manager reform efforts, which may impact prices, the relationships between hospitals, patients, payers, and providers, total cost of care and patient outcomes, and lead to further uncertainty in other participants in the healthcare industry, including employers.
2 unchanged sentences
PRVA) was incorporated in Delaware in 2016.
−Removed: Our Telephone number is (571) 366-8850.
Our website is priviahealth.com.
−Removed: The information contained on, or that can be accessed through, our website is not incorporated by reference into this filing and you should not consider any information contained on, or that can be accessed through, our website as part of this filing.
Our Annual Reports on Form 10-K, quarterly reports on Form 10-Q, current reports on Form 8-K and, if applicable, amendments to those reports filed or furnished pursuant to Section 13(a) of the Securities Exchange Act of 1934, as amended, are available free of charge on or through the Privia Health Investor Relations website at ir.priviahealth.com., as soon as reasonably practicable after we electronically file such material with, or furnish it to, the Securities and Exchange Commission, or the SEC.
The SEC’s website, http://www.sec.gov, contains reports, proxy and information statements, and other information regarding issuers that file electronically with the SEC.
+Added: The information contained on, or that can be accessed through, our websites is not incorporated by reference into this filing and you should not consider any information contained on, or that can be accessed through, our websites as part of this filing.
We announce material information to the public through a variety of means, including filings with the SEC, press releases, public conference calls, and our website.
We use these channels to communicate with investors and the public about our Company, our products and services, and other matters.
−Removed: Therefore, we encourage investors, the media, and others interested in our Company to
−Removed: review the information we make public in these locations, as such information could be deemed to be material information.
+Added: Therefore, we encourage investors, the media, and others interested in our Company to review the information we make public in these locations, as such information could be deemed to be material information.
Information on or that can be accessed through our websites is not part of this Annual Report on Form 10-K, and the website addresses are included as inactive textual references only.
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None of our employees are represented by labor unions or covered by collective bargaining agreements.
−Removed: We consider our relationship with our employees to be good and we have not experienced any work stoppages or reductions in force.
+Added: We consider our relationship with our employees to be good and we have not experienced any work stoppages.
We believe our geographically dispersed employees are a competitive advantage.
While certain employees work onsite, the majority of our workforce is either remote or a blend of in-office and remote.
−Removed: Our flexible workforce strategy allows us to hire the qualified talent irrespective of geographic constraints across many functional roles.
+Added: Our flexible workforce strategy allows us to hire qualified talent irrespective of geographic constraints across many functional roles.
Our internal systems and processes are designed to ensure our remote employees are productive, contribute meaningfully, and are able to exceed expectations in their roles.
Talent Development and Engagement
−Removed: At Privia Health, we value all of our employees and the exceptional talent they bring to our organization, in order to support our physicians, providers, care center staff, and patients.
+Added: At Privia Health, we value all of our employees and the exceptional talent they bring to our organization, in order to support our physicians, providers, practice location staff, and patients.
One of our strategic corporate goals is to grow and develop our workforce, and we have established ongoing leadership development and retention programs intended to support employees in their career progression.
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Put People First
−Removed: Privia Health employees are committed to improving patient care through their support of the physicians, providers, and care center staff.
−Removed: The Nominating and Corporate Governance Committee assists our Board of Directors in its oversight of talent management, including corporate culture, employee experience, recruiting, retention, attrition, career development and progression, succession, and employee relations.
+Added: Privia Health employees are committed to improving patient care through their support of the physicians, providers, and practice location staff.
+Added: The Nominating and Corporate Governance Committee assists our Board of Directors (“Board”) in its oversight of talent management, including corporate culture, employee experience, recruiting, retention, attrition, career development and progression, succession, and employee relations.
Privia Health has been honored to be named a Top Workplace for the last three years by Energage locally and nationally both as a large-size company and a healthcare organization.
−Removed: In 2024, we earned additional culture excellence awards from other organizations, highlighting our efforts in employee appreciation, our culture of respect, belonging, and continuous learning , employee well-being, professional development, purpose and values, leadership, innovation, compensation and benefits, and work-life flexibility.
+Added: In 2024, we earned additional culture excellence awards from other organizations, highlighting our efforts in employee experience, engagement practices, employee well-being, professional development, purpose and values, leadership, innovation, compensation and benefits, and work-life flexibility.
Serving Our Communities
−Removed: We encourage and actively support our employees who want to have a meaningful and positive impact on their communities and charitable causes by giving their time, talents and resources.
−Removed: The Company supported various charitable organizations throughout the year, focused on heart health, food disparities across our geographies, and holiday donations for certain communities.
−Removed: Additionally, we have a task force that is activated in advance of weather events or impending natural disasters.
−Removed: The task force coordinates outreach to each employee in the potential impact area and remains in touch throughout the duration and recovery.
−Removed: The task force assesses impact and provides resources to address the most pressing, time-sensitive needs.
−Removed: Should a disaster occur that impacts employees in any of our geographies, the Privia Employee Disaster Relief Fund, originally established in August 2017, is reopened.
−Removed: Through donations to the relief fund, employees are able to support their colleagues who applied for help.
+Added: We encourage and actively support our employees to have a meaningful and positive impact on their communities and contribute to charitable causes by giving their time, talents and resources.
+Added: The Company supports various charitable organizations throughout the year, focusing our efforts on support for the communities in which Privia Physicians practice.
+Added: In an effort to provide support to employees in times of a weather event or natural disaster, we have a communication protocol we activate.
+Added: In advance of an anticipated
+Added: weather event, we reach out to all employees and our practices in the area of impact to provide resources and support for appropriate disaster preparation and maintain contact with them throughout the event and until they are fully recovered.
Compared sentence by sentence after normalising whitespace, quotation marks, case and digits, so re-formatting and restated figures do not read as changed language. Wording changes appear as one removal and one addition. The current filing and the prior one are authoritative.