Expanding Value-Based Kidney Care To 375K Patients

Strive-Oak, Interwell-Humana, and the road to $1 trillion in enterprise value

Update: Below is part one of my VBC series. Part Two includes a table of 11 companies in VB kidney care along with their funding, growth, and outcomes.

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Value-based care is here to stay in kidney care. Some say we’re only “in the 2nd inning of what will inevitably be an extra innings ball game.”

The continued growth and momentum in value-based kidney care paints an exciting picture of what’s ahead for providers and patients managing CKD and ESKD. Kidney care continues to attract massive investment in 2023 — nearly two-thirds of a billion dollars between three megadeals in Monogram Health ($375 million), Strive Health ($166 million), and Healthmap ($100 million).¹²

Combined, the companies included in today’s brief serve an estimated 375,000 patients and manage over $8 billion in spend.³

Today we look at the latest news, key players, why it matters, and what it means for the future of this [space].

VB Kidney Care Universe From Part Two (Link)

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IN THIS ISSUE

• Strive Health partners with Oak Street in 21 states

• Interwell expands with Humana in 13 states

• Healthmap raises $100M to scale VB kidney care

• Why it matters and what’s next in this space

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1. Strive Health partners with Oak Street in 21 states⁴

• Strive began rolling out the services to Oak Street's 21-state footprint in 2022's fourth quarter and plans to complete the rollout by the end of this year.

• CSO Will Stokes estimates Strive can serve 7,000 Oak Street patients with stage-4 chronic and end-stage kidney disease.

• CVS completed its $10.6 billion acquisition of Oak Street the same month Strive closed its Series C, which included CVS Health Ventures.

Milestones: Strive serves more than 90,000 patients across 30 states and plans to exceed 100,000 by the end of the year.

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2. Interwell expands with Humana in 13 states⁵

• Interwell has the largest network of nephrologists in the country, with more than 1,700 nephrologists, renal care coordinators and in-home virtual support specialists.

• The agreement will reach members living in Arizona, Arkansas, Colorado, Kansas, New Mexico, New York, North Carolina, Ohio, Oklahoma, Pennsylvania, South Carolina, Texas and West Virginia.

Milestones: Interwell also added 20 new physician practices to its network last month, and now covers 125,000 members.

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3. Healthmap raises $100M to scale VB kidney care⁶

• Healthmap aims to detect kidney disease early and recommend evidence-based interventions to delay or slow disease progression.

• Their care navigation team works with patients and providers across primary care and specialties to deliver personalized, whole-person care.

Milestones: Healthmap serves more than 160,000 people and manages over $3 billion in healthcare spend through risk-based arrangements.

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Why It Matters

More than 1 in 7 adults, or 37 million Americans, are estimated to have chronic kidney disease. Yet as many as 9 in 10 do not know they have it. Payers and health systems are looking for kidney solution partners because of the cost and scale of the problem.

Kidney care represents 1 in 5 Medicare dollars annually between kidney disease (CKD) and kidney failure (ESKD). That’s north of $120 billion. The average monthly spending on all services for ESKD patients is 33 times higher than spending for those without ESKD.⁷

With the rising demand for cost-effective disease management in mind, kidney care tech and coordination companies are uniquely positioned to help providers address these complex, growing, expensive challenges.

What’s Next

Looking ahead, the growth of Medicare Advantage (MA) plans and the trillion-dollar opportunity across value-based care indicate a transformative shift in the healthcare landscape already underway.⁸

To arrive at a $1 trillion enterprise value estimate, McKinsey estimates 160 million total lives will have to be in value-based care. This follows CMMI’s ambitious 2021 goal of shifting 100 percent of Medicare beneficiaries into an accountable-care relationship by 2030.⁹

Kidney care is just one part of this larger trend, and it has room to run. This point was well articulated on a Private Equity panel at this week’s Nashville Healthcare Sessions (s/o to RC360 CEO Joseph Cashia for sharing):

We are in the 2nd inning of what will inevitably be an extra inning ball game.

We have come a long way in the last 4 years since the Advancing American Kidney Health initiative (AAKH). There’s “no turning back” on value-based care for ESKD, and I’m here for it.

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What are your thoughts on this Signal? Go to Part 2 to find my VB kidney care reference table. If you’re building something in this [space], I’d love to meet you. Leave a comment or connect with me on LinkedIn.

1. Kidney-care company Monogram Health receives $375M investment (Mobihealthnews)

2. Strive Health clinches $166M from CVS Health Ventures and NEA to fuel growth (Fierce Healthcare, 2023)

3. Calculation: Assumes $22,000 per patient x 375K patients under management

4. CVS-backed Oak Street, Strive Health form kidney care partnership (Modern Healthcare)

5. Humana cuts 13-state kidney disease management deal with Interwell Health (Fierce Healthcare)

6. Healthmap raises $100M to scale value-based kidney care management for payers, providers (Fierce Healthcare)

7. Increasing adoption of at-home dialysis (Optum)

8. Investing in the new era of value-based care (McKinsey)

9. Ibid.