Digital health · Patient engagement
CareMessage
A 501(c)(3) nonprofit that sends text messages on behalf of the clinics serving America’s poorest patients. Thirteen years in it has a Stanford randomized trial behind it, a $12 million annual expense base on the IRS record, and no shareholders.
A clinic in the Tenderloin
In 2014 a health worker named Jaime Martinez had the problem every free clinic recognizes. Patients in the diabetes program at St. Anthony’s Free Medical Clinic, in the Tenderloin, kept missing appointments and there was no way to reach them. Most had no email. Almost all had a phone.
“A lot of my time is spent on the phone trying to bring patients in. I could be working on other things, planning classes or seeing patients. I’m excited for this,” Martinez told a Forbes reporter who came to watch the pilot start.
The pilot, funded by the Packard Foundation, ran on software from a nonprofit that had left Y Combinator two months earlier. It sent text messages. That was the whole product. Twelve years later the organization claims 22 million people engaged, and it still sends text messages.
Why a text message
The case for SMS is not that it is clever. It is that nothing else reaches the population. People in low income households live 10 to 15 years less than people in high income households, and the technology built to close that gap has mostly widened it. Patient portals, the standard answer to engagement, show adoption as low as 20 percent among these patients, partly because they often support only English.
Over 90 million people live at or below 200 percent of the Federal Poverty Level. In 2014 CareMessage found more than 90 percent of its patients used SMS and 80 percent had unlimited texting, when many still carried feature phones. It now writes every message at a sixth grade reading level or below, in more than 60 languages, an expansion paid for by Johnson & Johnson.
Two Stanford students and a feature phone
Vineet Singal was born in India and arrived at Stanford on a path to medical school. He took a break to volunteer at St. Vincent’s Free Clinic in Galveston, Texas, after Hurricane Ike. Texting patients there is where the idea started. He graduated, turned down a medical school acceptance, and built the organization instead.
Cecilia Corral grew up between Mexico and the Rio Grande Valley of Texas, on Medicaid and food stamps. She studied product design engineering at Stanford, the first in her family to finish college, then started a PhD at the University of Texas at Austin. In 2013 her father died of prostate cancer. She left and joined Singal. A third co-founder, Manuel Rivera, is named in the 2014 announcement but not on the current team page.
The nonprofit structure was deliberate. “Because our focus and mission is serving a segment that fundamentally can’t afford our technology, that’s the reason we chose to be non-profit,” Singal told Forbes in 2014. Paying institutions subsidize free clinics, which pay a nominal fee or nothing.
The money, and the year it nearly ran out
In November 2014 the Pershing Square Foundation led a first round of more than $3.7 million in multi year grants, joined by Draper Richards Kaplan, the Ralph M. Parsons Foundation, the William K. Bowes Jr. Foundation and two dozen others. Two months later VentureBeat put the total past $6 million, including a $2.3 million Google.org Impact Award.
Then came the part no press release covered. The IRS record shows three straight deficit years, 2017 through 2019, totaling $8,330,451. Net assets fell from $9,293,932 at the end of 2016 to $1,009,003 at the end of 2019, a drop of 89 percent, about 37 days of spending at the 2019 rate.
Customers pulled it back. Program service revenue, meaning fees paid by clinics, overtook contributions in 2019 and reached 67.4 percent of revenue by 2023. Then 2024 flipped it again: contributions jumped 147 percent to $7,084,596 and philanthropy took the majority once more.
What it sells now
The platform pulls patient data from Epic, NextGen, athenahealth and OCHIN Epic, segments cohorts, and sends messages without staff effort. In November 2024 it added an AI Assistant, built on Google Gemini and paid for by the Ballmer Group and the Patrick J. McGovern Foundation, that classifies inbound replies. A year later came Wellness Copilot for Diabetes.
Recognition followed. Singal and Corral took the Schwab Foundation Award at Davos in January 2025, and in April 2026 TIME named CareMessage to its 100 Most Influential Companies list as the sole global recipient of the Impact in Equality Award. The language shifted with it: the 2025 impact report says the organization evolved from a technology nonprofit into a social impact organization, and by 2026 its releases call it a social enterprise. Its IRS status has not changed.
What is proven, and what is still claimed
| Evidence | What the record shows | Source type |
|---|---|---|
| IRS Form 990 record | Twelve filed years. Revenue grew from $478,484 to $13,410,145, expenses from $317,219 to $12,016,710. Cumulative revenue $84,099,320. | Public record |
| Financial stress | Deficits in 2017, 2018 and 2019 totaling $8,330,451. Net assets fell from $9,293,932 to $1,009,003, about 37 days of spending. | Public record |
| Executive pay | The reported officer line rose from $145,609 in 2015 to $2,229,100 in 2024, from 6.8 to 18.6 percent of expenses. Named for 2024: Cecilia Corral $301,177, Vineet Singal $297,904, Jeremy Wight $296,900. The filing also reports Schedule L transactions with interested parties. | Public record |
| Randomized trial | JAMA Network Open, Sep 2, 2025. 280 inactive adults of Latin American descent, NCT02385591. SMS coaching raised walking 113.6 minutes per week at 12 months against 116.4 for human phone advisors. Difference 2.8 minutes, P = .86, inside the 30 minute equivalence margin. | Public record |
| Cancer screening cohort | J Med Internet Res, May 13, 2026. 4,822 adults aged 45 and over at two FQHC networks in Texas and California. Three week reminders raised screening odds (aOR 1.27, 95% CI 1.05 to 1.53). The six week arm did not beat control. | Public record |
| Registered trial | NCT03487692, University of Chicago, 265 participants, completed. | Public record |
| Reach | 22 million people across 45 states since 2013, per 2026 releases. In October 2023 the organization said 16.8 million patients in 48 states. The patient count rose while the state count fell. | Claims differ |
| Cost recovery | A 2020 independent profile said “fees paid by health centers and free clinics cover 72% of their yearly expenses.” On the 990s fees never reached that share. The high is 69.5 percent in 2021; 2024 was 51.9 percent. | Differs from record |
Read plainly: the clinical evidence is better than most digital health companies can show, and it is not self published. A Stanford led trial found text coaching equivalent to a human advisor over twelve months, and a 2026 cohort study found a modest screening effect that vanished when messages got too frequent. The claims needing care are the marketing ones: reach figures that move in inconsistent directions, and a cost recovery number the filings do not support.
What to watch
- The fiscal 2025 Form 990, and whether the 2024 contribution jump repeats.
- Fee growth. Program service revenue rose 2.6 percent in 2024, the slowest rate on the filed record.
- What the Schedule L transactions in the December 2024 filing were.
- Whether Wellness Copilot for Diabetes converts into paid contracts rather than grant funded pilots.
- Independent outcomes for the AI Assistant. Published results are single clinic figures in company releases.
In their words
“A lot of my time is spent on the phone trying to bring patients in. I could be working on other things, planning classes or seeing patients. I’m excited for this”
Jaime Martinez, health worker, St. Anthony’s Free Medical Clinic, to Forbes, 2014 · Independent
“Because our focus and mission is serving a segment that fundamentally can’t afford our technology, that’s the reason we chose to be non-profit.”
Vineet Singal, co-founder and CEO, to Forbes, 2014 · Independent
“We’re sort of a tech company inside of a nonprofit. We’re fully not-for-profit, but at our essence, we are a technology company in terms of building products and being at the cutting edge of technology.”
Vineet Singal, Rx Foundation interview, November 2024 · Interview
“100% of our messaging is at 6th grade reading level or below, 80% is at 4th grade reading level or below.”
Vineet Singal, Rx Foundation interview, November 2024 · Interview
“We saw patients trying to have conversations with their providers critical to addressing health inequities, and facing barriers with stricter response logic that could not interpret their intent,”
Cecilia Corral, co-founder and chief strategy officer, November 2024 release · Company release
“Pairing CareMessage and Maple City’s efforts across multiple features, we’ve been able to reduce our no-show rates by 27.7% since the beginning of the year, getting them down to 9.9% in October.”
Paul Shetler Fast, executive director, Maple City, Goshen, Indiana, November 2024 release · Customer, via company
“We are building the person who’s in your corner, at scale, for the millions of Americans the rest of healthcare keeps missing.”
Vineet Singal, April 2026 TIME100 announcement · Company release
Related companies
Sources
- Public recordIRS Form 990, EIN 27-3252911, FY2024
- Public recordIRS Form 990 series, FY2013 to FY2023
- Public recordNonprofit Explorer record and financial series
- Public recordHuman Telephone vs Text Message Counseling and Physical Activity
- Public recordText Messaging and Behavior Theory to Improve Colorectal Cancer Screening
- IndependentY Combinator Startup CareMessage Takes Health Care To Low-Income Patients
- IndependentCareMessage raises $6M for text-based patient outreach platform
- InterviewLeveraging Technology for Health Equity: Meet CareMessage
- IndependentCareMessage profile with pricing detail
- CompanyCareMessage Raises Over $3.7 Million In Its First Round
- Company2024 CareMessage $2.2M Impact Fund Established
- CompanyCareMessage Introduces AI Assistant
- CompanyAbout Us, Our Team, Publications and 2025 Impact Report
Profile researched and written by Healthcare Discovery. Last updated September 29, 2026.
