Reinventing Rural Health

Rural America faces unique healthcare challenges. Rural Americans are older, sicker, and have higher rates of chronic diseases than urban and suburban Americans. Despite this, rural Americans have less access to care.

Population Over Age 65

Hospitalizations per 1,000 Residents

PCPs per 100,000 Residents

Specialist per 100,000 Residents

At Main Street, our team members have experience living and working in rural areas. We have witnessed the impact that limited access to healthcare and uncoordinated care can have on individuals and families. Main Street partners with primary care practices to provide value-based care solutions to rural America in ways that ensure rural Americans receive the care they deserve.

Our Leadership Team

Brad Smith

Chairman & CEO

Brad was most recently the Director of the Center for Medicare and Medicaid Innovation (CMMI), where he helped oversee value-based healthcare programs across the country. Brad was previously the Co-Founder and CEO of Aspire Health, the nation’s largest palliative care provider. Much of Brad’s family is from rural East Tennessee, and his wife is from rural Alabama.

Bennett Graham


Bennett was most recently Senior Vice President of Operations at Aspire Health. At Aspire, Bennett scaled the operations to support 10x revenue growth across 25 states. He also built a full-risk, capitated care model focused on patients with the greatest needs. Bennett is a proud Tennessean as his family has farmed in Trousdale County for over a hundred years.

Sarah Chouinard

Chief Medical Officer

Dr. Chouinard was the Chief Medical Officer of Community Care of West Virginia for the past 15 years. Sarah also served as National Faculty for quality improvement initiatives at the Center for Medicaid and Medicare Service. She recently served as Medical Director for West Virginia’s Public Employees Insurance Agency (PEIA) where she worked on value-based care initiatives.

Diane Seloff

Chief Operating Officer

Diane most recently served as Chief Operating Officer at CareBridge Health. She also served as Chief Operating Officer at Aspire Health, where she led several key functions including the company’s central operations. Prior to Aspire, she spent eight years at Vanderbilt University Medical Center where she served in several senior leadership roles.

Amy Gleason

Chief Product Officer

Amy previously led the healthcare team at the United States Digital Service at the White House where she spearheaded the technology efforts for the federal COVID-19 response, built modern surveillance tools for the CDC, and helped CMS advance interoperability. Prior to that, she co-founded CareSync, where she served as Chief Operating Officer and Chief Strategy Officer.

Alan Huffman

Chief Technology Officer

Alan previously served as Chief Technology Officer at Aspire Health. Alan has 20 years of experience in application development, advanced analytics, machine learning, and information security. Among other things, Alan built a Hospital EHR system used by hundreds of critical access hospitals that serve rural communities.

Our Team Across Rural America

  • smiling patient and navigator
  • Group Selfie
  • Navigator and Patient matching
  • Alligator
  • Doctor Selfie
  • Bob Evans
  • Navigator holding door for patient
  • Lobster

This site uses cookies to offer you a better browsing experience. If you continue using our website, we'll assume that you are happy to receive all cookies on this website and you agree to our Privacy Policy.

I Accept