Upstream USA Inc

Nonprofit profile at a glance

EIN
352581424
IRS 990 coverage
2017–2025
Forms available
Form 990 2025
Location
Boston, MA, USA
Phone
6176559864
Rating
73
Verdict
SUPPORTED
Rating confidence
Moderate
Sector
Community Health Systems

Reported finances

Revenue
$142,056,007
Expenses
$47,685,527
Assets
$338,965,808
Liabilities
$4,467,451

Source: IRS Form 990. Selected filing: tax year 2025. Amounts in USD.

Leadership & pay

23 people listed

Executive titles in this filing

  • Mark Edwards (Co-Founder and CEO)
  • Jessica Foster (President and COO)

Highest reported compensation

  • Mark Edwards (Co-Founder and CEO): $563,142 total reported compensation
  • Jessica Foster (President and COO): $414,783 total reported compensation
  • Jessica Greenfield (Treasurer and CFO): $382,861 total reported compensation

Source: IRS Form 990. Selected filing: tax year 2025. Names and roles reflect this filing, not necessarily current officeholders.

Overview

Mission

Upstreams mission is to ensure that equitable patient-centered contraceptive care is basic healthcare.

What it reported doing in 2025

Upstream is working to achieve impact at scale across the United States. In 2025 Upstream continued to expand nationally toward our goal to reach 5 million patients with the addition of new partnerships serving 445,000 patients of reproductive age. As of the end of 2025 Upstream has established partnerships with healthcare organizations in 36 states including DC: Alabama Arkansas Arizona California Colorado Connecticut District of Columbia Delaware Florida Georgia Iowa Idaho Illinois Indiana Kansas Louisiana Massachusetts Maryland Michigan Missouri Mississippi North Carolina New Jersey Nevada New York Ohio Oregon Pennsylvania Rhode Island South Dakota Texas Utah Virginia Washington Wisconsin and West Virginia.

Operating model

Revenue model
Donor-supported. 94% of the money available for current operations came from contributions and gifts.
Distribution model
Direct operator. The filing allocates 92% of reported program-service expenses outside its grant, affiliate-payment, and member-benefit lines. This expense classification does not rule out separately announced grant awards.
  • Includes noncash contributions: Reported contributions include donated property or goods.

The verdict

SUPPORTED - The filed numbers largely add up and most voting board members are independent. A relatively small share of available resources goes toward mission work and fundraising costs are high for each dollar raised.

Rating breakdown

  • Financial Efficiency: 49
  • Transparency & Controls: 84
  • Accountability: 95
  • Sustainability: 81
  • Growth: 100

Detailed rating inputs

Financial Efficiency

  • Mission deployment rate: 30.6%; rating input score 31
  • Program expense ratio: 77.9%; rating input score 78
  • Fundraising efficiency: $31.42 raised per $1 spent on fundraising; rating input score 56; 56th percentile among comparable filings

Transparency & Controls

  • Consistency checks: 94.1%; rating input score 94; 25th percentile among comparable filings
  • Pay-setting controls: 4 of 6 controls in place; rating input score 67
    • Compensation committee: Pass
    • Independent consultant: Pass
    • Other Form 990s reviewed: Missing
    • Written employment contract: Missing
    • Compensation survey or study: Pass
    • Board or committee approval: Pass
  • Foreign activity oversight: Limited
  • Grant itemization coverage: 97.5%; rating input score 98; 38th percentile among comparable filings
  • Major donor itemization: Yes; rating input score 100
  • Related-party transparency: Limited

Accountability

  • Independent voting board: 92.3%; rating input score 92; 23rd percentile among comparable filings
  • Governance controls: 9 of 9 controls in place; rating input score 100
    • Conflict-of-interest policy: Pass
    • Whistleblower policy: Pass
    • Document-retention policy: Pass
    • CEO compensation review process: Pass
    • Other executive compensation review process: Pass
    • Form 990 shared with the board: Pass
    • Board meeting minutes documented: Pass
    • Audit committee oversight: Pass
    • Independent financial-statement audit: Pass

Sustainability

  • Operating margin: 66.4%; rating input score 95; 95th percentile among comparable filings
  • Total-asset coverage ratio: 7.11; rating input score 83; 83rd percentile among comparable filings
  • Liabilities to assets ratio: 0.01; rating input score 91; 91st percentile among comparable filings
  • Officer compensation ratio: 7.2%; rating input score 9; 9th percentile among comparable filings

Growth

  • Program expense growth: 16.1% per year; rating input score 100; 85th percentile among comparable filings
  • Revenue growth: 17.3% per year; rating input score 100; 91st percentile among comparable filings
  • Asset growth: 24.3% per year; rating input score 100; 95th percentile among comparable filings

Details

  • Where the money goes: 30.6% of revenue deployed · 77.9% of spending went to programs
  • Governance: 12 of 13 board members independent · 9 of 9 filing controls reported
  • Programs: 3 filed program accomplishments · $37.2M in reported program spending
  • Leadership: top reported pay $563K · 23 people listed · 4 of 6 pay-setting controls reported
  • Highest-paid contractors: 5 contractors listed · $3M reported
  • Consistency: 47 of 48 current checks pass · 1 finding to review
  • Schedules: 9 filed schedules · includes major donors, grants, and executive pay
  • Filing history: 9 filing years from 2017 to 2025
  • Contacts: How to reach this organization
  • Money network: 99 filed money-flow records
  • Related organizations: 89 filed related-organization links
  • Grant readiness: Federal tax and exclusion status, award history, and grant-maker relationships.
  • People: Everyone the filings name, and which of them the filings identify by more than a name.
  • Staff and benefit plans: Retirement and health plans the organization files with the Department of Labor, and the people in them.

Key Signals

Signals prioritize questions for review. They are not findings of misconduct.

  • Moderate — Financial Efficiency: Mission deployment rate scored 31/100.
  • Review — Financial Efficiency: Fundraising efficiency scored 56/100.
  • High — Sustainability: Officer compensation ratio scored 9/100.
  • Review — Transparency & Controls: Domestic grant itemization did not reconcile in the filed values.