Humana, Monogram’s value-based association goals to enhance kidney care

More than one in seven U.S. adults live with chronic kidney disease, accounting for 37 million people, according to the Centers for Disease Control and Prevention. It is especially common in those aged 65 years or older. 

A recent agreement between Humana and Nashville-based Monogram Health aims to help those adults manage this chronic condition. Monogram Health is an in-home provider of nephrology, primary care and benefit management services for patients with chronic kidney and end-stage renal disease.

The value-based partnership is for Humana Medicare Advantage HMO and PPO plan members with chronic kidney disease, who are living in Tennessee, Alabama, Mississippi and Louisiana. These members can access Monogram’s specialized care resources, such as in-home primary and specialty care visits, medication management, dialysis and social services.

In addition to treating kidney disease, Monogram’s clinical staff also treats patients’ existing comorbidities, said Michael Uchrin, CEO and cofounder of the company.

“Individuals with kidney disease have a very high prevalence of cardiovascular disease, hypertension, diabetes,” Uchrin said in an interview. “As we approach treating an individual’s kidney disease, we also treat all of their other conditions to ensure an appropriate evidence-based treatment plan.”

Providing this care in patients’ homes makes all the difference, Uchrin added. It helps reach underserved populations that may have struggled to receive kidney care in the past.

“We go into underserved communities where they’ve struggled in terms of transportation … It really enables us to truly transform the patient experience and remove barriers, many of which are social determinant barriers to accessing care,” Uchrin said.

Humana and Monogram have had a relationship since 2019. But the new partnership is transitioning to an entirely value-based model in which Monogram is paid based on the quality of care rather than quantity. By doing this, Humana hopes to improve health outcomes for the patients it serves, said Carl Daley, senior vice president of retail strategy and operations for the insurer. The companies did not provide additional information on what specific outcomes are in place to gauge the success of the program. 

“Millions of Americans have chronic kidney disease and that number continues to grow,” Daley said in an interview. “We felt it was essential to create access to evidence-based medicine, especially kidney care, and other services for our members.”

Uchrin said he has three major goals in working with Humana. The first is increasing access to care for chronic kidney disease, which is largely asymptomatic. Second, he hopes to ensure adherence to evidence-based care. Lastly, he wants to improve the patient experience for receiving care.

“We need to come up to the 21st century here in terms of patient experience and in a world where you have Amazon, you have UberEats, where goods and services are received and delivered to individuals’ homes for the most part,” he said. “Why is healthcare any different and especially for the sickest and most vulnerable among us?”

Other value-based kidney care providers include Strive Health and Somatus.

Photo: Kiwis, Getty Images

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