Upstream is working to achieve impact at scale across the United States. In 2024 Upstream continued to expand nationally toward our goal to reach 5 million patients with the addition of 53 new partnerships serving 398,000 patients of reproductive age. As of the end of 2024 Upstream has established partnerships with healthcare organizations in 34 states and DC: Alabama Arkansas Arizona California Colorado Connecticut District of Columbia Delaware Florida Iowa Idaho Illinois Indiana Kansas Louisiana Massachusetts Maryland Michigan Missouri Mississippi North Carolina New Jersey New Mexico Nevada New York Ohio Oregon Pennsylvania Rhode Island South Dakota Texas Utah Virginia Washington and Wisconsin.