Thomas Lilly 11/2/21 Thomas Lilly 11/2/21

Monogram Health Joins Innovate Kidney Care Campaign to Support Expanded Access to Home Dialysis

Initiative dedicated to providing kidney patients information to all available care options

NASHVILLE, Tenn. (November 2, 2021) — Monogram Health, a leading value-based provider of in-home nephrology, primary care, and benefit management services for individuals with chronic kidney and end-stage renal disease, announced today it is joining Innovate Kidney Care (IKC), an educational campaign advocating for people with kidney diseases to improve patient options for home dialysis training and support. Effective immediately, Monogram Health will become an IKC supporting member.

37 million Americans are affected by kidney disease and 550,000 annually are on dialysis. However, the pathway to choosing where and how to do dialysis can sometimes be difficult for patients and their loved ones. Not all patients have access to the same choices for their dialysis care. Self-dialysis, including peritoneal dialysis and home hemodialysis, is a safe and effective treatment option for patients facing permanent kidney failure—also known as End-Stage Renal Disease (ESRD) or End-Stage Kidney Disease (ESKD)—while they wait for a kidney transplant, or if they’re ineligible for a transplant.

Home dialysis offers logistical, economic, and quality of life benefits for patients experiencing kidney failure. However, despite these advantages, it is widely underutilized in the United States broadly and especially by lower-income, Black and Hispanic individuals. Through the IKC campaign, patients are becoming more aware of available options.

“Monogram Health is committed to bringing the benefits of home-based care to patients living with kidney disease,” said Mike Uchrin, CEO of Monogram Health. “Through this important campaign, we join other industry leaders in helping educate patients, families, health care providers, and policymakers on the disease and the full range of evidence-based treatment options, including home dialysis, kidney transplant, and conservative care.”

Monogram Health is an innovative value-based provider focused exclusively on treating and managing chronic kidney disease (CKD) and end-stage renal disease (ESRD) at home. The company partners with health plans to provide their members with evidence-based nephrology, primary care, and benefit management services, including complex case and disease management, utilization management, and medication therapy management. This innovative model of care has been shown to dramatically improve patient outcomes and quality of life while reducing costs for the health care system.

Innovate Kidney Care’s diverse group of industry organizations aims to advocate for the Centers for Medicare & Medicaid Services (CMS) to modernize the ESRD Conditions for Coverage and related guidance in order to achieve the quadruple aim of better patient outcomes, improved patient experience, improved health care practitioner experience and lower costs of care.

“Innovate Kidney Care is dedicated to accelerating patients’ access to home dialysis,” said Tonya Saffer, spokesperson for Innovate Kidney Care. “With Monogram Health adding its support, we can increase momentum and support for our efforts to modernize the Medicare End-Stage Renal Disease Conditions for Coverage and empower patient choice in the management of their care, regardless of race, ethnicity, or income.”

Founding members of IKC include the American Society of Nephrology (ASN), Anthem, Inc., Cricket Health, CVS Kidney Care, Home Dialyzors United (HDU), Intermountain Healthcare, the National Kidney Foundation (NKF), Outset Medical, Inc. and Strive Health.

To learn more about Innovate Kidney Care, visit innovatekidneycare.com.

About Monogram Health

Monogram Health is a leading value-based provider of in-home nephrology, primary care, and benefit management services for individuals with chronic kidney and end-stage renal disease. The company deploys an innovative in-home care delivery model and technology-driven array of evidence-based clinical services, including complex case and disease management, utilization management, and medication therapy management to transform the way health care is delivered for those with kidney disease. This innovative model of care has been shown to dramatically improve patient outcomes and quality of life while reducing medical costs across the health care continuum. Based in Nashville, Tennessee, and privately held by Frist Cressey Ventures, Norwest Venture Partners, and TPG Capital,Monogram Health has numerous value-based partnerships with leading health plans to care for patients across 20 states and all insurance products. To learn more about Monogram Health, please visithere.

Contact information:
Kyle Cooksey
SVP, Marketing and Communications
Monogram Health
kyle.cooksey@monogramhealth.com
615.510.6492

Thomas Lilly 10/26/21 Thomas Lilly 10/26/21

Monogram Health signs Health Equity Pledge to leverage data in addressing disparities

Monogram Healthjoins approximately 40 cross-sector health care organizations committing to collecting, stratifying, and reviewing data about race, ethnicity, language and sex across top metrics and sharing that information to inform best practices.

NASHVILLE, Tenn. (October 26, 2021) — Monogram Health, a leading value-based provider of in-home nephrology, primary care, and benefit management services for individuals with chronic kidney and end-stage renal disease, announced today it has joined more than 40 health care organizations in signing a Health Equity Pledge focused on improving data collection and developing best practices to address health disparities.

COVID-19 and the social injustice crises of 2020-2021 shined a new light on the systemic disparities in the U.S. health care system. Some disparities – such as with maternal and infant health – have been understood within the industry. But startling new research published last month found that Black children experience higher complication rates than White children after having their appendix removed, an indication that such inequities are more widespread than previously believed.

A dearth of data hinders a more comprehensive understanding. Recognizing that fact, a Health Evolution Forum work group has been convening across the past year to agree on a consistent set of measures and approach to collecting, stratifying, and analyzing disparities data. Already, approximately 40 leading organizations have signed the corresponding Health Equity Pledge, committing to collect data about race, ethnicity, language and sex (REaLS) and then share what they learn to develop best practices that are ultimately disseminated broadly across the industry.

“Harnessing the power of data, while engaging patients in their communities and homes, will be vital in eliminating disparities and achieving greater equity in the delivery of care,” said Mike Uchrin, CEO of Monogram Health. “For kidney disease patients, historic biases in algorithms used to measure kidney function have negatively impacted timely access to patient care. Monogram Health is pleased to join this effort to help reverse systemic biases and improve outcomes across the health care system.”

Going forward, the Health Evolution Forum will convene executive leadership and subject matter experts to develop real-world solutions around:

· Increasing collection of voluntarily self-reported (gold standard) race, ethnicity, language, and sex data

· Strengthening industry partnerships to dismantle collection and stratification barriers, including with large employers

· Driving more consistent adoption of data standards and definitions for improved stratification and review

“A concerted commitment to such collection and stratification for all key quality and performance metrics is critical to understanding and, most important, redressing disparities,” said Richard Schwartz, President, Health Evolution. “We are pleased to serve as a learning lab for this important endeavor and welcome other industry leaders to join in.”

Learn more and endorse the Health Equity Pledge.

Per results from a preliminary 2021 survey conducted by the Health Evolution Forum, the vast majority of responding organizations are collecting some patient/member data on race and ethnicity, but sizeable shortfalls remain in these collection efforts. Fewer organizations are tracking data at all on language and sex and only 30% regularly review the disparities data they do collect. And none of the respondents stratified these data for all or nearly all (greater than 90%) of their business lines.

“Too few organizations are actually analyzing disparities data internally, developing dashboards, embedding it into clinical workflows, and making it public,” says Laurie Zephyrin, MD, who is a Forum Fellow, and Vice President, Advancing Health Equity, at The Commonwealth Fund.

These substantial gaps limit awareness and ability to implement equity-focused interventions and establish accountability mechanisms that strategically address health disparities.

To reduce variation in the ways data is applied to advance equity, Forum Fellows and other organizations pledge to, in the next three years:

1. Collect REaLS data for at least 50% of the organization’s patient, member, or customer population

2. Stratify and regularly review these collected data by the top-priority quality or access metric for 90% of major business lines and/or departments/divisions of adequate size

3. Participate in the Health Evolution Health Equity Learning Lab by sharing stratified data for select measures to facilitate anonymized benchmarking and to identify best practices for reducing disparities

“It was important for us to figure out how to address this issue in ways that could resonate with everybody in our health care system, because our health care system doesn’t exist outside the void of the social polarization in our country,” said Mark Smith, MD, a Forum Fellow and Founding President & Former CEO, California Health Care Foundation. “Equity is not separate from quality…it is part of quality. One doesn’t have to necessarily agree with my definition of social justice or yours to have equity as a professional aspiration and goal to which we hold ourselves and our institutions accountable.”

Organizations that have signed on to the Pledge to date:

Health plans: Blue Cross and Blue Shield of North Carolina, Blue Cross Blue Shield Association, GuideWell & Florida Blue, North Carolina Department of Health and Human Services, SCAN Health Plan

Health care providers: AIRnyc, Cancer Treatment Centers of America, Cityblock Health, Eleanor Health, Everside Health, Galileo, Gillette Children's Specialty Healthcare, Harvard Medical Faculty Physicians at Beth Israel Deaconess Medical Center, Hazel Health, John Muir Health, Link Primary Care, Marshfield Clinic Health System, Monogram Health, Nemours Children's Health System, Northwell Health, Oak Street Health, Rebalanced-Life Wellness Association, Spectrum Health, SUN Behavioral Health, Thomas Jefferson University and Jefferson Health, University of Arkansas for Medical Sciences, University of California Health, VillageMD

Other organizations and individuals: ARCHANGELS, Accountable Care Learning Collaborative, Bloom Standard | Newborn Foundation, Capital Rx, Change Healthcare, eMed, Health Level Seven, Inc., Mark Smith - Founding President & Former CEO of California Health Care Foundation, Newtopia, Primary.Health, Socially Determined

The Health Evolution Forum is underwritten by Change Healthcare.

About Health Evolution

Health Evolution engages chief executives, presidents, founders, board chairs, policymakers and other top industry leaders. We do this by convening in-person and virtual gatherings, publishing insights and analyzing information that helps industry leaders accelerate progress, develop opportunities and shape new strategies. Health Evolution supports executives seeking to create a high quality and efficient health care system based on prevention, affordability, access, equity and outcomes for people and their communities. The Health Evolution Forum is a peer-to-peer collaboration among leaders across health care sectors focused on driving near-term impact at a critical juncture for health care. The Forum consists of Fellows participating in three Roundtables—New Models of Care Delivery, Next Generation IT in Health Care, and Community Health and Advancing Health Equity—that leverage the deep expertise of Fellows to accelerate American health care’s transformation into a more equitable and effective marketplace amid the COVID-19 pandemic, severe economic challenges, and the health disparities highlighted by them.

Contact information:
Lesley Bristol
Manager, Forum
Health Evolution
lesleyb@healthevolution.com
415.694.5666

About Monogram Health

Monogram Health is a leading value-based provider of in-home nephrology, primary care, and benefit management services for individuals with chronic kidney and end-stage renal disease. The company deploys an innovative in-home care delivery model and technology-driven array of evidence-based clinical services, including complex case and disease management, utilization management, and medication therapy management to transform the way health care is delivered for those with kidney disease. This innovative model of care has been shown to dramatically improve patient outcomes and quality of life while reducing medical costs across the health care continuum. Based in Nashville, Tennessee, and privately held by Frist Cressey Ventures, Norwest Venture Partners, and TPG Capital, Monogram Health has numerous value-based partnerships with leading health plans to care for patients across 20 states and all insurance products. To learn more about Monogram Health, please visit here.

Contact information:
Kyle Cooksey
SVP, Marketing and Communications
Monogram Health
kyle.cooksey@monogramhealth.com
615.510.6492

Thomas Lilly 8/10/21 Thomas Lilly 8/10/21

Monogram Health Expands Leadership Team, Names General Counsel

NASHVILLE, Tenn. (August 10, 2021) — Monogram Health today announced Shawn L. Verner, J.D., has joined its leadership team as general counsel and chief compliance officer. Verner brings two decades of experience in health care law, policy, and compliance to the rapidly growing kidney disease benefit management and care delivery company.

“As Monogram Health continues its rapid expansion, Shawn’s experience navigating complex legal and regulatory matters for fast-growing health care and technology companies will be critical in helping us realize our goals,” said Monogram Health CEO Michael Uchrin. “His breadth of understanding of the health care industry and the role of technology will bring an important perspective to our growing leadership team.”

A native of Nashville, Verner most recently served as general counsel and chief compliance officer at Shearwater Health, where he led a global team of attorneys and staff on corporate, regulatory and compliance, employment, and immigration matters. He previously served as vice president and assistant general counsel for health care technology company Change Healthcare, Inc., where he managed legal, compliance, and risk management functions for provider services, software, and analytics.

Verner earned a Juris Doctor (J.D.) and a Master of Business Administration (M.B.A) at the University of Tennessee in Knoxville and an undergraduate degree from Vanderbilt University.

About Monogram Health

Monogram Health is a leading kidney disease benefit management and care delivery company. It provides an innovative renal care model and data-driven array of clinical managed services, including complex case and disease management, utilization management, and medication therapy management to transform the delivery of care received by patients living with chronic kidney and end-stage renal disease. Partnering with health plans, physician practices, dialysis providers, and clinically integrated health systems, Monogram Health provides patients with exceptional at-home individualized clinical managed services and nephrology care delivery. Through the use of next generation artificial intelligence, evidence-based criteria, and personalized care planning, Monogram Health’s model seeks to delay the progression of the disease, promote a seamless transition to dialysis, palliative care and/or pre-emptive kidney transplant, and optimize health outcomes for patients with end-stage renal disease. Based in Nashville, Tennessee, and privately held by Frist Cressey Ventures, Norwest Venture Partners, and TPG Capital, Monogram Health currently operates its renal disease benefit management programs and in-home nephrology clinic across 20 states in the U.S. and has built a national network of nephrologists that includes hundreds of leading kidney care specialists. To learn more about Monogram Health, please visit here.

Media Contact:

Susanne Powelson, susanne@lovell.com, 615.440.6846

Thomas Lilly 6/8/21 Thomas Lilly 6/8/21

Monogram Health Closes $160M Series B Funding to Fuel Acceleration of Next Generation Kidney Care Model

Funding advances leading kidney disease benefit management and care delivery company’s mission to transform kidney care in the U.S.

Company welcomes TPG as lead investor of the round; Todd Sisitsky joins board of directors

NASHVILLE, Tenn. (June 8, 2021) — Monogram Health, a benefit management and care delivery company transforming care for individuals with chronic kidney and end-stage renal disease, today announced that it has closed a $160 million Series B funding round led by TPG Capital, the private equity platform of global alternative asset firm TPG. The funding round also includes existing investors Frist Cressey Ventures and Norwest Venture Partners, as well as Humana Inc. and other notable national and regional strategic investors.

The investment will be used to fuel the company’s continued rapid expansion as the leading solution for improved kidney care in the U.S. In conjunction with the investment, Todd Sisitsky, co-managing partner of TPG Capital who co-leads the platform’s healthcare franchise, has joined the Monogram Health Board of Directors.

“Welcoming TPG Capital alongside noted national and regional strategic investors further validates our industry leading kidney model of care,” said Senator Bill Frist, M.D., Monogram Health’s board chairman. “We look forward to working with the TPG team as Monogram further solidifies its role as the preeminent leader in personalized, compassionate, and evidence-based kidney care for patients.”

Based in Nashville, Tennessee, Monogram is focused exclusively on managing chronic kidney disease (CKD) and end-stage renal disease (ESRD) at home. The company partners with health plans to provide their members with an evidence-based renal care model of clinical managed services, including complex case and disease management, utilization management, and medication therapy management, to improve patient outcomes and quality of life while dramatically reducing costs for the health care system.

“Monogram is transforming one of the most complex and underserved areas of healthcare,” said Sisitsky. “As someone who has supported a family member through end‐stage renal disease, I witnessed first‐hand the challenges and deficiencies that Monogram is addressing. I couldn’t be more optimistic about the future of the company and the lives it’s changing every day.” Kendall Garrison, Partner at TPG Capital, continued, “Monogram’s integrated care model combines data-driven solutions and in-home specialist care to deliver better outcomes for patients at a lower total cost. We’re excited to partner with Senator Frist, Mike, and the rest of Monogram’s industry-leading team to support the company’s next phase of growth.”

More than 10 percent of the U.S. adult population suffers from CKD today, though many cases go untreated until their final stages due to the shortcomings of existing care models. Leveraging the company’s technology and managed services platform, Monogram’s clinical team of nurses, nephrologists, dieticians, pharmacists, and social workers partner closely with a patient’s entire care network to help them understand their condition, slow disease progression, and manage their unique care needs.

“Despite more than 20 percent of all Medicare spending going toward Americans with kidney disease, the population continues to grow and experience often dismal health outcomes and quality of life,” said Monogram Health CEO Mike Uchrin. “Our model of care dramatically improves health outcomes and reduces spending by delivering the care and services these individuals truly need and want, right in their own homes. One by one, our patient successes are adding up to significant value for our partners and driving accelerated demand for our services.”

Monogram currently operates its renal disease clinical managed services to manage benefits across 20 states in the U.S. and has built a national network of nephrologists that includes hundreds of leading kidney care specialists. In April it opened an operations center in Arizona to support its growth in Western states.

About Monogram Health

Monogram Health is a leading kidney disease focused benefit management and care delivery company. It provides an innovative renal care model and data-driven array of clinical managed services, including complex case and disease management, utilization management, and medication therapy management to transform the delivery of care received by patients living with chronic kidney and end-stage renal disease. Partnering with health plans, physician practices, dialysis providers, and clinically integrated health systems, Monogram Health provides patients with exceptional at-home individualized clinical managed services and nephrology care delivery. Through the use of next generation artificial intelligence, evidence-based criteria, and personalized care planning, Monogram Health’s model seeks to delay the progression of the disease, promote a seamless transition to dialysis, palliative care and/or pre-emptive kidney transplant, and optimize health outcomes for patients with end-stage renal disease. Based in Nashville, Tenn. and privately held by Frist Cressey Ventures, Norwest Venture Partners, and TPG Capital, Monogram Health currently operates its renal disease benefit management programs and in-home nephrology clinic across 20 states in the U.S. and has built a national network of nephrologists that includes hundreds of leading kidney care specialists. To learn more about Monogram Health, please visit here.

About TPG

TPG is a leading global alternative asset firm founded in 1992 with more than $91 billion of assets under management and offices in Beijing, Fort Worth, Hong Kong, London, Luxembourg, Melbourne, Mumbai, New York, San Francisco, Seoul, Singapore, and Washington D.C. TPG's investment platforms are across a wide range of asset classes, including private equity, growth equity, impact investing, real estate, secondaries, and public equity. TPG aims to build dynamic products and options for its investors while also instituting discipline and operational excellence across the investment strategy and performance of its portfolio. For more information, visit www.tpg.com or @TPG on Twitter.

Media Contacts:
Monogram Health - Susanne Powelson, susanne@lovell.com, 615.440.6846
TPG Capital - Luke Barrett and Courtney Power, media@tpg.com, 415.743.1550

Thomas Lilly 4/20/21 Thomas Lilly 4/20/21

There’s no place like home

By Shaminder Gupta, MD, Nephrologist, Monogram Health Corporate Medical Director

(Originally published in Kidney Citizen, Issue number 13)

End Stage Renal Disease (ESRD) is a life changing diagnosis and impacts both the patient and the family. While waiting for renal transplantation, renal replacement therapy (RRT) is required to sustain life. RRT, also known as dialysis, can be provided either in-center or at home. Home therapies can either be via peritoneum (PD) or via fistula (HHD).

Patients are concerned about their own abilities to provide this life sustaining therapy on their own. This is natural and should be anticipated as a barrier. Most of us, including medical professionals, would also share these apprehensions. Success at home depends on the initial attitude of the patient who is being asked to consider the therapy and depends on how it is delivered initially to the patient.

Common questions include: Is there enough space in my house? What about my partner? What if I have pets? Will it disturb my own family dynamics?

It is natural to have these questions about home dialysis. Space is always a concern, but the reality is that a small amount of private space is needed. This space has to be dedicated to home dialysis and be kept clean and free of pets. Pets are not a deal breaker. They simply have to be kept away from areas where home dialysis is performed. For PD patients, this is usually the bedroom. For HHD patients, the supply bags have to kept in an area away from possible intrusion.

The most important question usually relates to life partners. Life partners are invested in the health of the patient and they usually are also very supportive of any care plan that improves outcomes and quality of life. Patients do not want to burden others with their own health issues; however, it has been my experience that home dialysis improves patient outcomes and this both directly and indirectly affect the partner in a positive way. There is a happier partner, no travel requirements, more time at home together and a more positive attitude towards the treatment plan.

Peritoneal dialysis is very difficult to describe in words to a patient. It is also more daunting when a video is watched about the process. I have found that direct interaction between a perspective patient and an established patient is the most effective way to educate the patient holistically. The established patients had the same questions as the perspective patients and can fully attest to the nature of the treatment, both positive and negative. PD patients often have positive experiences, and this is conveyed at this meeting. The approach also illustrates how patients teaching patients should be utilized in education. PD patients share their experiences and most importantly, showcase the freedom they have in controlling their own destiny and journey. This is powerful and impactful.

The barriers the patient was anticipating soon become less of a concern as they witness another patient sharing their positive experience. The only absolute hurdles to PD are the inability to avoid water, pet/hygiene issues where a room cannot be isolated in a home. Partners are not necessary. The hurdle of bringing healthcare to the home environment is often overblown as family members tend to be very supportive of home-based therapies. It also allows for the family member to remain at home/work and not have the burden of transporting their loved one to dialysis 3x/week or dealing with the post dialysis fatigue and increased hospitalizations associated with in center HD.

HHD patients have similar concerns. They also have additional concerns about self cannulation. This can be overcome by continual support of the patient and care partner. Introduction to other patients who do HHD is imperative in success of this model. Self- cannulation fear abates with strong support of the patient. Family members teaching other family members creates powerful bonds between them and creates bonds between the patient and HHD nurses. The positive experiences of HHD patients when shared with perspective patients helps alleviate the natural fears patients have. Self-care builds confidence in patients and this translates into positive attitudes and improved outcomes.

Home dialysis also better prepares patients for transplantation. Labs are better and patient engagement translates into better transplant candidacy. Learning to do home dialysis is similar to learning to drive. When learning to drive, it is an overwhelming task, yet most people learn to do it. There are many buttons, sensors, radars, and complex decision making. After a few months of practice, operating the vehicle becomes routine. The key is support for the new driver through supervision and gradual autonomy. Home dialysis proficiency is similar. When given the proper support and timeline, patients can master the therapy and then learn to teach others. Home dialysis nurses and staff provide the support needed to learn and provide the individualized attention necessary to be successful for both the patient and their caregivers.

Thomas Lilly 4/12/21 Thomas Lilly 4/12/21

Monogram Health Appoints Former CMS Administrator Seema Verma to Board of Directors

Policy leader joins Monogram to help accelerate transformation of care for kidney disease patients

NASHVILLE, Tenn. — April 12, 2021 — Monogram Health today announced the appointment of Seema Verma, MPH, to its board of directors. Verma, former administrator for the Centers for Medicare and Medicaid Services (CMS), joins the board as Monogram continues to expand its national footprint to transform care for kidney disease patients across the U.S.

“We are delighted to welcome Seema Verma to our board as an independent director. Her recent work at CMS to improve kidney disease patients’ access to high-quality, coordinated care aligns directly with our company’s purpose and brings an invaluable perspective to our board,” said Sen. Bill Frist, M.D., Monogram Health’s board chairman. “Seema shares our deep commitment to detecting and slowing progression of kidney disease, improving quality of life and empowering patients to make informed choices about their renal care.”

A leading expert on health policy and value-based care, Verma was the longest-tenured administrator of CMS in modern history. She oversaw a budget of more than $1.3 trillion and health insurance programs for more than 140 million Americans. Verma also served on the White House COVID-19 Task Force, where she led efforts to drive telehealth and remote care across the health care system while creating flexibility for health providers to augment the health care workforce, expand services and testing, and ensure access to vaccines and therapeutics. Modern Healthcare ranked Verma as The Most Influential Person in Healthcare in 2019 and one of the Top 25 Women Leaders in Healthcare.

“Traditional models for paying for kidney disease care have failed to innovate and put patients first,” said Verma. “More must be done to improve outcomes and quality of life for patients with this devasting disease, including encouraging transplants and home-based dialysis. Monogram Health is tackling the challenge head-on with a data-driven, evidence-based model focused solely on caring for patients at home. I look forward to supporting this important work to bring meaningful change and a better life for patients with kidney disease.”

As part of her work at CMS, Verma launched the Kidney Care Choices (KCC) Model in 2020. The program seeks to improve the lives of beneficiaries suffering from kidney disease, expand their treatment options, and reduce their healthcare costs. The KCC Model is just one example of Verma’s leadership at CMS that drove innovation to strengthen kidney health. Additionally, Verma spearheaded efforts to introduce transparency and competition into the organ procurement process in order to increase the supply of lifesaving organs available for transplant.

In 2019, Verma received the President’s Medal from the American Society of Nephrology (ASN) for her work on the Advancing American Kidney Health initiative that promotes ASN’s mission to prevent, treat, and cure kidney diseases throughout the world by educating health professionals and scientists, advancing research and innovation, communicating new knowledge, and advocating for the highest quality care for patients.

Monogram Health is an innovative company focused exclusively on managing chronic kidney disease (CKD) and end-stage renal disease (ESRD) at home. The company partners with health plans to provide their members with an evidence-based renal care model and data-driven array of care management services, including complex case and disease management, utilization management and medication therapy management.

Monogram also deploys in-home renal care through its virtual Kidney Care Clinic, which provides in-home and virtual visits conducted by a team of kidney-focused physicians, nurse practitioners and other clinicians. The clinic’s telehealth capabilities enable greater access to specialists for all kidney disease patients, including those living in remote or rural areas.

According to the U.S. Department of Health and Human Services (HHS), 20 percent — or $114 billion — of traditional Medicare expenditures go toward Americans with kidney disease, a growing population that now totals more than 30 million.

About Seema Verma

At CMS, Seema Verma was the architect of CMS’s strategic vision, implementing over 16 tactical initiatives aimed at transforming the American healthcare system to lower costs, improve quality, and increase access. During her tenure, Verma led federal government efforts to infuse market competition, empower consumers, and unleash innovation producing historic reforms. She also drove efforts to require price and quality transparency while ensuring consumers have ownership over their portable medical records.

Verma’s historic “Patients Over Paperwork” initiative reduced regulatory burden and saved the healthcare system billions of dollars. Verma also worked to accelerate value-based care transformation and address the social determinants of health by advancing new payment models throughout CMS programs, including models for drug pricing that resulted in lower insulin prices. Under her leadership, premiums dropped in Medicare Advantage, Part D, and the insurance exchanges. In response to COVID-19, she led industry-changing efforts to drive telehealth and remote care across the healthcare system while creating flexibility for health providers to augment the health care workforce, expand services and testing, and ensure access to vaccines and therapeutics.

Prior to CMS, Verma was the founder and CEO of a health policy consulting firm helping states and private industry on a range of healthcare issues. Verma received her BS in life sciences from the University of Maryland and her Master of Public Health (MPH) with a concentration in health policy and management from Johns Hopkins University.

About Monogram Health

Monogram Health is a leading kidney-disease focused benefit management and care delivery company. It provides an innovative renal care model and data-driven array of clinical managed services, including complex case and disease management, utilization management and medication therapy management to transform the delivery of care received by patients living with chronic kidney and end-stage renal disease. Partnering with health plans, physician practices, dialysis providers and clinically integrated health systems, Monogram Health provides patients with exceptional at-home individualized clinical managed services and Nephrology care delivery. Through the use of next generation artificial intelligence, evidence-based criteria and personalized care planning, Monogram Health’s model seeks to delay the progression of the disease, promote a seamless transition to dialysis, palliative care and/or pre-emptive kidney transplant and optimize health outcomes for patients with end-stage renal disease. Based in Nashville, Tenn. and privately held by Frist Cressey Ventures and Norwest Venture Partners, Monogram Health currently operates its renal disease benefit management programs and care delivery across 20 states in the U.S. and has built a national network of nephrologists that includes hundreds of leading kidney care specialists. To learn more about Monogram Health, please visit here.

Thomas Lilly 4/6/21 Thomas Lilly 4/6/21

Monogram Health Opens Operations Hub in Arizona

Tempe Location Supports Delivery of Kidney Care Services Across U.S.

TEMPE, Ariz. (April 6, 2021) — Monogram Health, a managed services company transforming care for individuals with chronic kidney and end-stage renal disease, has opened an operations hub in Tempe, Arizona, to support its growing patient base in the Western U.S. and nationwide. The operations hub launches with an initial team of more than 50 individuals who provide call center support for Monogram’s network of nurse care managers and field clinicians providing in-home care for health plan members in Western states.

“Monogram’s recent growth has dramatically increased our patient base and clinician workforce west of the Mississippi,” said Katrina Cope, vice president of enterprise programs with Monogram Health. “Our new operations hub ensures we have the right resources in the right location to deliver seamless support to our clients and caregivers throughout the country.”

So far this year, Monogram has announced a new partnership with California-based SCAN Health Plan, as well as expanded agreements with both Cigna and Humana that bring the company’s unique, in-home kidney care model to 13 additional states. The recent partnerships add to the company’s existing client base, including Banner University Health Plans in Arizona. Monogram now operates its kidney-focused managed services and virtual kidney clinic across 20 states.

Monogram’s initial plans called for filling more than 50 positions in Tempe by the end of the year. However, due to Monogram’s recent growth, the company needed to expand the hub’s capabilities and accelerate hiring to scale operations in proportion to its expanding health plan customer base. The company expects ongoing growth in the market and continues to seek qualified individuals interested in making a difference in the lives of patients with kidney disease.

“One of the reasons we chose Tempe is its reputation for outstanding call center talent, especially diverse and multilingual professionals,” said Yashica Sullivan, director of outreach and enrollment with Monogram Health. “Our field employees in this part of the country reflect the demographics of the communities they serve, so having a multilingual team — especially native Spanish speakers — ensures the clear and consistent communication that underlie high quality results.”

Monogram’s Operations Hub is located in the Papago Spectrum building at 1225 W. Washington Street at the corner of Washington Street and Priest Drive in Tempe. A listing of open positions is available at monogramhealth.com/joinourteam.

“Monogram disrupts historic approaches to kidney care with an AI-enabled, in-home model of evidence-based care that offers better outcomes, better quality of life and lower costs,” said Monogram Health Chief Operating Officer Chris Chi. “We expect our teams in both Nashville and Tempe to continue to grow as we raise awareness of the value Monogram delivers to patients and families, health plans and the overall health care system.”

About Monogram Health

Thomas Lilly 3/24/21 Thomas Lilly 3/24/21

Solo nephrology practices can succeed at directing patients home

Original article published via helio.com on 11/12/2020, found here

Article by Shaminder Gupta, MD, 11/12/2020

There has been a great deal of focus recently in getting more patients interested in home dialysis.

The timing of this approach is important: HHS has issued a directive to the kidney community to have 80% of patients either starting home dialysis or in possession of a functioning transplant by 2025.

Shaminder Gupta

That goal is ambitious. Currently, 10% to 12% of patients in the United States are dialyzing at home. Yet a significant increase is not impossible, and the results are worth the challenge.

Home dialysis is patient-directed and fosters independence and self-worth. It allows the patient to remain productive in the workforce or in family units at home, leading to better patient satisfaction. Patients on home dialysis also use fewer resources overall, require fewer medications and have fewer hospitalizations, reducing the overall cost of care.

In my solo practice in south Louisiana, we have demonstrated how to grow the home dialysis population to nearly 40%. Our program is rooted in the belief that most patients can learn how to care for themselves. Physician bias often leads to patients being denied the chance to succeed; with the right approach, we can make significant gains.

Low-key start

I began my program in 2008 with one nurse and one patient who had expressed interest in home dialysis. As our program grew, we had victories but also failures — not from picking the wrong patients, but from following the wrong approaches.

Many patients doubt their own ability to care for themselves and are apprehensive about making decisions regarding a dialysis modality. As we gained more patients and expanded our program, my nurses and I learned the key to effective care was approaching all patients with confidence in their ability to take control of their treatment and encouraging them to try. We did not promise success, but we did promise opportunity — and our method has shown real and important results.

Direct approach

Our approach is methodical and direct. Beginning when a patient reaches a GFR of 20 mL/min/1.73 m2, I offer options education. I have the patient come to the clinic for a tour, which is scheduled on our home dialysis clinic days, and allow the patient to engage directly with another patient who is already doing home dialysis. These “patient ambassadors” humanize home dialysis by discussing the details of their therapy, as well as their experiences with the more personal challenges of home dialysis, like sleep, intimacy and partner engagement.

At the conclusion of this meeting, patients also see the dialysis floor and learn how in-center dialysis is structured.

This personal and reassuring approach helps patients reflect on their choices, demystifying the experience and taking some of the fear out of the process. During the nearly 10 years I have used this technique, more than 90% of my patients have chosen home dialysis.

Of course, not every home dialysis patient is a new patient. We also approach our current in-center population each month, engaging patients who would be well-served by home dialysis, as well as those facing new circumstances that could influence new choices, from access complications, improvement in the home situation, fears about communicable diseases or general health. In southern Louisiana, as we grapple with hurricane threats for 6 months each year, home dialysis can be a safer and more comfortable option. With the added threat of COVID-19, home options have taken on a greater importance and have found a more willing audience.

Opportunities for growth

Going forward, I anticipate the use of home dialysis will grow. Our current high-risk population is younger and will likely develop end-stage kidney disease at an earlier age. They are more tech-savvy and more apt to expect health care on demand. These characteristics are likely to make home dialysis the first option for our future patients. As clinicians, it is our responsibility to prepare for that future.

We must change our own attitudes about these therapies and stop being paternalistic. We must be open minded and recognize most patients are candidates for home dialysis. Nearly all of us would choose home care for ourselves or a family member. Our patients deserve the same approach.

For more information

Shaminder Gupta, MD, is the immediate past president of the National Kidney Foundation of Louisiana and the leader of its home dialysis task force. He also serves as the section chief of nephrology at Leonard J. Chabert Medical Center in Houma, Louisiana. He can be reached at shaminder.gupta@monogramhealth.com.

Thomas Lilly 3/8/21 Thomas Lilly 3/8/21

Monogram Health and Cigna Launch National Kidney Benefit Management Program

Program Now Covers 18 States Where Cigna Individual MA Customers Live

NASHVILLE, Tenn. — March 10, 2021 — Monogram Health announced today that it has expanded its in-home kidney benefit management program to Cigna Medicare Advantage customers in 11 new states, providing convenient, personalized care to help people manage chronic kidney disease (CKD) and End Stage Renal Disease (ESRD).

The program is now available to Cigna's individual MA customers in most of Florida as well as Texas, Pennsylvania, Illinois, North Carolina, South Carolina, New Jersey, Delaware, Maryland, Missouri, Kansas, and Colorado and the District of Columbia. It was previously available to individual MA customers in Arkansas, Arizona, Alabama/North Florida, Mississippi, Tennessee and Georgia.

“Monogram’s care managers provide qualifying Cigna customers across the country with in-home, personalized services that help them access the health care they need and deserve,” said Senator Bill Frist, M.D., Monogram Health’s board chairman. “Our organizations share a commitment to evidence-based renal care and improved health outcomes for those people with chronic kidney disease and end- stage renal disease.”

Monogram’s benefit management staff of nurse case managers and social workers regularly visit CKD and ESRD patients in their homes. The organization’s field staff works with Monogram physicians and nurses to develop personalized care plans aimed at keeping customers with kidney disease healthy and out of the hospital. Benefit management strategies include medication therapy management, co-morbidity management and collaboration with nephrologists and primary care physicians on evidence-based renal care pathways. Care plans also focus on addressing patients’ social determinants of health.

“Working with Monogram Health, Cigna is taking a personal, individualized approach to raising the quality of care for our customers with CKD and ESRD," said Dr. Gina Conflitti, Cigna Medicare Advantage's chief medical officer. "Cigna wants our customers with kidney disease to know all of their care options. We will work to help them receive evidence-based treatment that maximizes their health and quality of life."

According to the U.S. Department of Health and Human Services (HHS), 20 percent – or $114 billion – of traditional Medicare expenditures go toward Americans with kidney disease, a growing population that now totals more than 30 million. Improved outcomes, including reduced mortality rates after dialysis starts and increased use of home therapies, remain a priority for HHS and other governmental health care programs. Additionally, the 21st Century Cures Act allows previously ineligible Medicare beneficiaries with ESRD to enroll in a Medicare Advantage (MA) plan.

According to the U.S. Renal Data Systems, there are 746,557 Americans with ESRD, a number which grows by about 20,000 a year.

About Monogram Health

Guest User 2/19/21 Guest User 2/19/21

Monogram Health secures $8.1 million debt round, inks deal with Scan Group

Senator Bill Frist is the Nashville Business Journal's 2017 Health Care Heroes Lifetime Achievement honoree, NATHAN MORGAN | FOR THE NASHVILLE BUSINESS JOURNAL

By Joel Stinnett – Reporter, Nashville Business Journal

Published via Nashville Business Journal, on 02/19/2021

One of Nashville’s newest health care companies has secured funding from one of the nations largest not-for-profit health plans.

Monogram Health has received a strategic investment from Scan Group, who’s holdings include Scan Health Plan (stylized: SCAN Health Plan), according to a news release. Terms of the deal were not disclosed.

According to an filing made Thursday with the U.S. Securities and Exchange Commission, however, Monogram raised $8.1 million of a possible $10.1 million round of debt funding at the end of January.

It’s not clear if the two deals are connected and Mongram did not immediately comment on the SEC filing.

The investment comes less than a year after Mongram closed on a $7 million round of funding led by Frist Cressey Ventures and Norwest Venture Partners, which brought the company’s lifetime cash raised at the time to $12 million.

Founded in January 2019 by Michael Uchrin and Frist Cressey co-founder Sen. Bill Frist, the kidney disease management company works with health insurance plans, such as Humana Medicare Advantage and Commercial, to care for chronic kidney disease patients inside their homes across 20 states. Depending on the stage of the patient’s disease, Monogram works to either stabilize a patient’s disease progression, prepare the patient for dialysis or transplant or improve treatment results for patients already on dialysis.

Scan is a not-for-profit Medicare Advantage plan, with more than 220,000 members in California, according to the release. The plan’s investment in Monogram marks the first time Scan has invested in an outside entity.

In May, Uchrin told the NBJ that Monogram was preparing for a period of rapid growth in part because of the enactment of the 21st Century Cures Act, which allows Medicare beneficiaries with end-stage renal disease to enroll in 2021 Medicare Advantage plans through private insurers for the first time.

“We are pleased to partner with Scan to offer advanced solutions that expand access to evidence-based therapies and proactive planning,” Frist, Monogram’s chairman, said in the release. “By leveraging the power of Medicare Advantage plans to provide better care to older adults at a lower cost, both of our organizations will work together to ensure that people with kidney disease can take greater control of their health and quality of life.”

In addition to the funding, Scan and Monogram have signed a strategic agreement to “to work together to improve care for older adults with kidney disease, according to the release.”

Mike Uchrin, Monogram Co-founder and CEO

"The Covid-19 pandemic has put a spotlight on the home as a safe health care setting for dialysis and other kidney-related care," Uchrin said in the release. "Monogram’s solutions empower vulnerable patients with renal disease to be treated in the comfort and safety of their own homes. This innovative approach to managing kidney care delivery is improving health outcomes for a population that drastically needs and deserves better care."

Guest User 2/15/21 Guest User 2/15/21

SCAN Group Makes Strategic Investment in Monogram Health

Healthcare non-profit makes first-ever outside investment in Nashville-based company that’s transforming care for patients with chronic kidney and end-stage renal disease

LONG BEACH, Calif., Feb. 16, 2021—SCAN Group, whose holdings include SCAN Health Plan, one of the nation’s largest not-for-profit Medicare Advantage plans, has made a strategic investment in Monogram Health. Monogram Health is a leading kidney care management company providing at-home care and data-driven solutions for patients living with chronic kidney and end-stage renal disease.

The investment marks the first time SCAN, which focuses on healthcare for older adults, has made an investment in an outside entity. SCAN Group made the investment as part of its larger diversification strategy, through which it will build and invest in new companies to support healthier aging. After inking the deal, SCAN and Monogram also signed a strategic agreement formalizing the two entities’ intent to work together to improve care for older adults with kidney disease.

“This strategic partnership marks an important new chapter for SCAN and a valuable investment in the health of America’s seniors,” said Dr. Sachin Jain, president and CEO of SCAN Group and SCAN Health Plan. “SCAN recognizes the tremendous challenges faced by the growing population of patients experiencing chronic kidney and end-stage renal disease, and we believe Monogram Health is doing the right work at the right time to serve this patient population.”

Approximately 31 million Americans are living with chronic kidney disease and end-stage renal disease, according to the United States Renal Data System. Of those, more than 26 million are over age 65.

Monogram Health partners with health plans, physician practices, dialysis providers and clinically integrated health systems to develop personalized care plans that keep patients independent and at home. Because of Monogram’s unique, in-home care model, the readmission rate for its patients is half the national average.

"We pride ourselves on working with and building innovative companies that are truly transforming the delivery of healthcare,” said Dr. Jain. “We share Monogram’s vision of making kidney care more accessible to more people, lowering the cost of care, and at the same time improving both quality of life and health outcomes.” Jain noted that about 90% of Monogram patients are enrolled in Medicare Advantage plans, SCAN’s traditional focus and the area in which it has developed a record of expertise.

“We are pleased to partner with SCAN to offer advanced solutions that expand access to evidence-based therapies and proactive planning,” said former U.S. Sen. Bill Frist, M.D., co-founder of Frist Cressey Ventures and Monogram Health’s board chairman. “By leveraging the power of Medicare Advantage plans to provide better care to older adults at a lower cost, both of our organizations will work together to ensure that people with kidney disease can take greater control of their health and quality of life.”

"The COVID-19 pandemic has put a spotlight on the home as a safe healthcare setting for dialysis and other kidney-related care," said Michael Uchrin, Monogram Health’s CEO and co-founder. "Monogram’s solutions empower vulnerable patients with renal disease to be treated in the comfort and safety of their own homes. This innovative approach to managing kidney care delivery is improving health outcomes for a population that drastically needs and deserves better care."

About SCAN Group

SCAN Group is a mission-driven organization that is tackling some of the biggest issues in health care for older adults. The core of SCAN Group is SCAN Health Plan, one of the nation’s foremost not-for-profit Medicare Advantage plans, serving more than 220,000 members in California. Independence at Home, a SCAN community service, provides vitally needed services and support to seniors and their caregivers regardless of plan membership. SCAN Group also invests in new companies to support healthier aging, offers education programs, community funding, volunteer opportunities, and other community services in support of its mission—keeping seniors healthy and independent. To learn more, visit scanhealthplan.com or follow us on Twitter @scanhealthplan.

About Monogram Health

SCAN Health Plan Media Contact:

Seffrah Orlando, sorlando@scanhealthplan.com 562.533.0641

Monogram Health Media Contact:

Sophie Moore, sophie@lovell.com

678.977.8647

Guest User 2/9/21 Guest User 2/9/21

Monogram Health Launches In-home and Virtual Kidney Clinic

New clinic expands access to care for growing population of patients with kidney disease

NASHVILLE, Tenn. February 9, 2021 -- Monogram Health today announced the launch of the Monogram Kidney Care Clinic, which will provide industry-leading access to patients facing kidney disease. The clinic allows those with kidney disease to receive preventive renal care as early as possible and allows for ready access to renal specialists for those with urgent kidney-related needs.

Currently operating in 10 states, the Monogram Kidney Care Clinic serves a growing national cohort of high-risk chronic kidney disease (CKD) and end-stage renal disease (ESRD) members enrolled in Medicare Advantage and managed Medicaid plans, following enactment of the 21st Century Cures Act. The clinic provides access to patients through in-home and virtual visits conducted by its team of kidney-focused physicians, nurse practitioners and other clinicians. The clinic’s telehealth capabilities will enable greater access for all kidney disease patients, including those living in remote or rural areas without local renal specialists.

“The Monogram Kidney Clinic complements our managed care services, by increasing access to nephrology services for those who need it,” said Chris Booker, a partner at Frist Cressey Ventures and co-founder of Monogram Health. “The clinic helps ease a national shortage in renal services, leading to more preventive medicine and greater access to urgent care for those with CKD and ESRD. By providing upstream care to patients dealing with early onset of kidney disease, we are taking on one of the toughest challenges in healthcare. As our board chairman, former U.S. Senate Majority Leader, and heart surgeon Bill Frist has said, ‘Healthcare, in its simplest of forms, is people helping people.’ That’s the mission of the clinic.”

Early nephrologist engagement helps patients to understand kidney disease, delay its progress and engage in early planning for renal replacement therapy or conservative care. The Monogram Kidney Clinic will collaborate with nephrology practices across the country that are part of the Monogram Health nephrology care management network, acting as a supplementary access point to those patients already seen by a care management network nephrologist. “Our care managers serve as extensions of our partner nephrologists’ practices. Our clinic will do the same for those for practices that are working with Monogram to promote evidence-based care management,” said Kyle Cooksey, Monogram Kidney Care’s Senior Vice President and Administrative Officer.

“Our services are designed for kidney disease patients who are too sick for a standard primary care physician but are earlier in the progression of kidney disease than the average patient who first sees a nephrologist,” Cooksey said. “We also offer an urgent point of care for those with CKD and ESRD who are already under the care of a nephrologist. Our approach was developed by our team of industry leading nephrologists to harness the potential of our evidence-based dialysis criteria, best-in-class order sets and specialty services. But our biggest drivers are compassion and personalized kidney care.”

According to industry data, 30% of patients who experience kidney failure have never seen a nephrologist and 43% of CKD stage IV patients are unaware of their disease progression. Today, the prevalence of kidney disease is 1.5 times higher in Hispanic populations, and African Americans represent the highest affected group with 3.7 times the national average.

“Our focus is on improved health outcomes. We apply evidence-based criteria and use this to guide patients to the right care pathway. We promote planned dialysis starts, increase the use of home dialysis modalities and decrease unnecessary hospitalizations,” said Dr. Shaminder Gupta, Monogram Kidney Care’s Chief Medical Officer. “The COVID-19 pandemic has heightened the need for high-quality, in-home access to kidney health services. Monogram Kidney Care Clinic provides it.”

Monogram Kidney Care Clinic’s services are used by health plans across the country that serve Medicare, Medicare Advantage, Medicaid, and Commercial members. The clinic expects to be operating in a total of 20 states within the first half of 2021 and to serve thousands of health plan members. Based on national trends, the company estimates at least 50 percent of those members will not have seen a nephrologist in at least 12 months, making them ideal patients for engagement through Monogram Kidney Clinic.

To learn more about Monogram Kidney Care, please visit monogramhealth.com/care-clinic.

About Monogram Health

Monogram Health is a leading kidney-disease focused benefit management and care delivery company. It provides an innovative renal care model and data-driven array of clinical managed services, including complex case and disease management, utilization management and medication therapy management to transform the delivery of care received by patients living with chronic kidney and end-stage renal disease. Partnering with health plans, physician practices, dialysis providers and clinically integrated health systems, Monogram Health provides patients with exceptional at-home individualized clinical managed services and Nephrology care delivery. Through the use of next generation artificial intelligence, evidence-based criteria and personalized care planning, Monogram Health’s model seeks to delay the progression of the disease, promote a seamless transition to dialysis, palliative care and/or pre-emptive kidney transplant and optimize health outcomes for patients with end-stage renal disease. Based in Nashville, Tenn. and privately held by Frist Cressey Ventures and Norwest Venture Partners, Monogram Health currently operates its renal disease benefit management programs and care delivery across 20 states in the U.S. and has built a national network of nephrologists that includes hundreds of leading kidney care specialists. To learn more about Monogram Health, please visit here.

Dr. Shaminder Gupta (L), Monogram Kidney Care’s CMO, and resident nephrologist and Kyle Cooksey (R), Monogram Kidney Care’s SVP and Administrative Officer — **Dr. Shaminder Gupta** (L), Monogram Kidney Care’s CMO, and resident nephrologist and **Kyle Cooksey** (R), Monogram Kidney Care’s SVP and Administrative Officer

Thomas Lilly 1/25/21 Thomas Lilly 1/25/21

Monogram Health Announces Availability of Kidney Disease Care Coordination Services for Humana Members in Tennessee and Alabama

Broadened Collaboration Now Includes Four States

NASHVILLE, Tenn. — January 26, 2021 — Monogram Health announced today that it is expanding its collaboration with leading health and wellness company Humana Inc. (NYSE: HUM). Through an agreement now in effect, Monogram is providing care coordination services in Alabama and Tennessee for eligible Humana Medicare Advantage and Commercial health plan members with chronic kidney disease (CKD) or End Stage Renal Disease (ESRD). This is in addition to providing such services as previously contracted with Humana in two other states, Louisiana and Mississippi.

“It’s an honor to serve Humana members suffering from kidney disease. We are grateful to offer our services to them in Tennessee and Alabama,” said Sen. Bill Frist, M.D., Monogram Health’s board chairman. “Monogram shares Humana’s commitment to early detection of kidney disease, the slowing of its progression and empowering patients to make informed choices about their renal care.”

Monogram nurse case managers and social workers regularly visit CKD and ESRD patients in their homes, whether in urban or rural communities. The organization’s field staff work with Monogram physicians and nurses, and the patient’s primary care physician and nephrologist, to develop personalized care plans to keep patients as healthy as possible. These plans focus on care coordination strategies, such as medication and treatment compliance and monitoring of comorbidities. The goal is to treat patients more holistically, providing patient education about treatment options such as home dialysis, utilizing evidence-based care pathways, and taking into account social determinants of health.

“We are pleased to help Humana in its efforts to offer members evidence-based therapies and proactive planning,” said Monogram Chief Executive Officer Mike Uchrin. “It’s important that people with kidney disease have the chance to take greater control of their health and quality of life by using our program resources.”

About Monogram Health

Thomas Lilly 1/21/21 Thomas Lilly 1/21/21

Clinicians should personalize their approach to the management of kidney disease

Original article published via helio.com on 01/21/2020, found here

Article by Raymond Hakim, MD, 01/21/2021

As nephrologists know, the decline in kidney function is almost always a “silent disease,” and even patients who experience fatigue and low energy often attribute these symptoms to “getting old,” rather than as signs of illness.

When I practiced nephrology at Vanderbilt Medical Center, I was always surprised at the number of patients who presented to the chronic kidney disease clinic with comments such as, “I didn’t know I had kidney disease” or “I am still able to urinate, so why is my primary care physician referring me to a kidney disease clinic?”

These types of comments point to specific areas of needed improvement in kidney care, namely the need for earlier, proactive education of patients with CKD to encourage a greater awareness of the disease among these patients and the provision of evidence-based care to slow down progression of CKD. It is also important to educate them on their treatment options and optimize the care they may be receiving as patients with end-stage kidney disease.

Data from the 2020 Annual Data Report from the United States Renal Data System confirm that, of patients initiating dialysis for ESKD, more than 80% “crash” into dialysis during a hospital admission and end up initiating dialysis with a central venous catheter and all its acute and chronic complications, including high risk of infection and hospitalization.

Prior nephrology care

Even patients who have been followed by a nephrologist prior to ESKD often do not know all their treatment options, such as transplantation, home dialysis and, importantly, conservative care as an alternative to in-center dialysis.

These “crashes” into in-center dialysis not only impact the patient’s health adversely, resulting in multiple hospitalization episodes and high mortality, but also result in high cost of care, whether the patient has private insurance, Medicare or Medicaid.

Rather than “crashing“ into dialysis, patients with kidney disease should be empowered with knowledge and educated on ways they can slow down progression of their disease, learn about their treatment options if and when they progress to ESKD and help them prepare for whatever option they choose.

Alternative care models

A couple of years ago. I received a call from U.S. Senator Bill Frist, MD, who was my colleague when he worked at Vanderbilt as a heart transplant surgeon. We discussed this lack of knowledge among patients about their kidney disease, lack of awareness of non-dialytic or dialytic treatment options and lack of planning for evidence-based ESKD treatment pathways.

After a few meetings, he asked me to join a startup kidney care company, Monogram Health, that he founded. We shared the vision of raising awareness and knowledge of kidney disease in as many patients with CKD as possible and working with the nephrology community to raise the quality of care and patient satisfaction for patients with CKD and ESKD, resulting in better patient outcomes and cost efficiency in this expensive segment of health care.

Our model of care is simple: engage and talk with patients where they are most comfortable and relaxed – at home. We have done our in-home visits, using appropriate protections, even during the COVID-19 pandemic, because most patients prefer face-to-face interactions with medical personnel.

Raymond Hakim

Our interactions and educational program for patients follow three broad pathways that are complementary.

CKDelay focuses on patients with eGFR from 40 mL/min/1.73 m2 to less than 20 mL/min/1.73 m2.
ACT! is our advanced care transition program which focuses on educating patients with eGFR of less than 20 mL/min/1.73 m2 but who have not yet made an informed decision for their ESKD treatment options, including conservative kidney care, transplant or dialysis.
ECO or the ESKD care-optimization program is aimed at patients with eGFR less than 15 mL/min/1.73 m2 who have or have begun to experience kidney failure and for whom compliance with the right evidence-based treatment plan is critical.

CKDelay educates patients about lifestyle changes that can slow down progression of their illness, such as the following:

compliance with prescribed medication;
avoidance of OTC nephrotoxic medications;
diets that are rich in vegetables and fruits and low in sodium and protein; and
monitoring and recording their BP daily and if they have diabetes, monitor and record their blood sugar at least a few times daily to help their physician adjust their diabetes medication accordingly.

If the patient’s eGFR is 20 mL/min/ 1.73 m2 or less, in addition to the CKDelay education, the discussion focuses on their therapeutic options if and when they reach kidney failure.

The therapeutic options discussed are inclusive and consist of dialysis (with emphasis on home dialysis, transplantation preferably from a living related donor, which is an option that is also discussed with the patient’s next of kin) or conservative therapy for patients who are at an older age (> 75 years) or have multiple comorbidities that may significantly reduce their well-being and the quality of their lifestyle if they are initiated on dialysis.

Timely access placement

For those patients who elect dialysis as a modality choice, we discuss with them the need to prepare and initiate a timely access placement (AV fistula for those who elect hemodialysis and a PD catheter for those who elect the PD option), with emphasis on early placement of an AV fistula because they often require surgical revisions before the fistula matures and because placement of AV fistulas has been associated with improvement in eGFR.

For patients in our ECO program – those who have experienced kidney failure – we ensure they comply with an evidence-based pathway, be it conservative kidney care, transplant or post-transplant care. For those already on in-center dialysis, we emphasize the need for treatment compliance (and help with transportation issues if needed) and again, discuss the advantages of home dialysis if clinically appropriate.

This strong emphasis on home-based dialytic therapies has been reinforced by my colleague, Shaminder Gupta, MD, currently the medical director of Monogram Health, whose work was recently highlighted in an article in this publication.

Multidisciplinary care team

While most of these discussions with patients are performed by experienced nurses in the locality where patients live, social workers who can provide the patient with emotional support, particularly those with evident depression or denial of their health status and, for those who need it, help with transportation to medical entities or help them apply for external financial support.

When appropriate, patients with CKD (eGFR <30 mL/min/1.73 m2) who are not followed by a nephrologist are referred to the nephrology practice engaged with Monogram Health, to receive their nephrology-specific care. Monogram Health does not have a financial relationship related to the provision of dialysis. Monogram Health neither owns any dialysis facility nor benefits from any dialysis referral.

Our model of care is simple. Equally important, it is effective. We have been able to engage with more than 70% of patients referred or identified by a health plan as having CKD and doubled the rate (to more than 40%) of patients who initiate planned dialysis, with 28% initiating home dialysis (two to three times higher than the national average), resulting in a significant decline in hospitalizations and re-hospitalizations.

More than 20% of patients choose conservative therapy after they (and their next of kin) are educated on the risks and benefits of dialysis as a therapeutic option.

With all these positive patient outcomes, our “at-risk” payment model is performing well, confirming the principle of “doing well by doing good.”

For more information:

Raymond Hakim, MD, PhD, is an adjunct clinical professor at Vanderbilt University School of Medicine and Chief Medical Officer for Monogram Health.

Raymond Hakim, MD, Monogram Health Chief Medical Officer — Raymond Hakim, MD, Monogram Health
Chief Medical Officer

Anthony DeCosta 12/1/20 Anthony DeCosta 12/1/20

Monogram Health Receives HITRUST CSF® Certification

Kidney care management organization meets rigorous data security criteria

NASHVILLE, Tenn. – December 1, 2020 – Monogram Health announced today that the organization has received HITRUST CSF® Certification, following a review of the company’s systems and controls for protecting electronic health records and other sensitive data.

“Strong information security controls are critical to population health management,” said Chris Chi, Monogram Health’s Chief Operating Officer. “Our company’s health plan clients and plan members entrust us with their data. HITRUST certification underscores our commitment to patient privacy and data security.”

Monogram uses its advanced, proprietary artificial intelligence systems to identify the potential care needs of patients with kidney disease. Monogram’s care team – made up of physicians, nurse care managers and social workers – partners with nephrologists to ensure medication and treatment compliance and adherence to evidence-based care pathways. The specialized care team also assesses health drivers, such as appropriate nutrition, exercise, and other social determinants of health, through regular visits with patients in their homes.

The HITRUST CSF® Certified Assurance Program verifies that the organization's development, security, and compliance protocols meet key regulations and industry-defined requirements for data security and appropriate risk management. The certification encompasses HIPAA and numerous other federal and state regulations and standards for protecting sensitive patient data. Certification of Monogram Health’s cybersecurity effectiveness involved an end-to-end review of the company’s information technology systems, including its electronic care management system, software tools, cloud and data storage environments, servers, hardware, user workstations and encryption protocols.

"HITRUST is the industry gold standard for information security,” said David Hoffmann, Monogram Health’s Vice President of Information Technology. “Achieving HITRUST certification gives our clients peace of mind about their data and our safeguards to protect it.”

About Monogram Health

Media Contact:
Monogram Health
Sheila Biggs
312.837.3458
sbiggs@jarrardinc.com

Anthony DeCosta 10/20/20 Anthony DeCosta 10/20/20

Monogram Health Announces NCQA Population Health Program Accreditation

Monogram Health demonstrates commitment to quality and population health-based care model through receipt of NCQA accreditation

NASHVILLE, Tenn. – October 20, 2020 – Monogram Health announced today that the organization has received Population Health Program accreditation from NCQA, in furtherance of part of the company’s value-based kidney benefit management services. Achieving NCQA accreditation underscores Monogram Health’s dedication to population health management, improved outcomes, and continuous quality improvement for health plan members suffering from chronic kidney disease and end stage renal disease. NCQA issued the accreditation following a detailed review of the company’s operational processes, clinical benefit management policies and other practices.

“Achieving NCQA accreditation is a testament to the quality work Monogram Health does each day to serve the needs of our members, providers, and health plan clients,” said Dr. Raymond Hakim, Monogram’s Chief Medical Officer. “By leveraging our in-home care model, evidence-based clinical criteria and advanced analytics, we are able to drive improved outcomes and reduce unnecessary costs.”

Monogram uses its advanced, proprietary artificial intelligence systems to identify the potential care needs of patients with kidney disease. Monogram’s care team – made up of nurse care managers and social workers – partners with nephrologists to ensure medication and treatment compliance and adherence to evidence-based care pathways. The specialized care team also assesses health drivers, such as appropriate nutrition, exercise and other social determinants of health, through regular visits with patients in their homes.

NCQA is an independent, not-for-profit organization dedicated to assessing and reporting on the quality of managed care plans, managed behavioral healthcare organizations, preferred provider organizations, new health plans, physician organizations, credentials verification organizations, disease management programs and other health-related programs.

“The Population Health Management programs moves us in greater alignment with the increased focus on person-centered population health management,” said Margaret E. O’Kane, President, NCQA. “Not only does it add value to existing quality improvement efforts, it also demonstrates an organization’s highest level of commitment to improving the quality of care that meets people’s needs.”

About Monogram Health
Monogram Health is a leading kidney-disease focused benefit management and care delivery company. It provides an innovative renal care model and data-driven array of clinical managed services, including complex case and disease management, utilization management and medication therapy management to transform the delivery of care received by patients living with chronic kidney and end-stage renal disease. Partnering with health plans, physician practices, dialysis providers and clinically integrated health systems, Monogram Health provides patients with exceptional at-home individualized clinical managed services and Nephrology care delivery. Through the use of next generation artificial intelligence, evidence-based criteria and personalized care planning, Monogram Health’s model seeks to delay the progression of the disease, promote a seamless transition to dialysis, palliative care and/or pre-emptive kidney transplant and optimize health outcomes for patients with end-stage renal disease. Based in Nashville, Tenn. and privately held by Frist Cressey Ventures and Norwest Venture Partners, Monogram Health currently operates its renal disease benefit management programs and care delivery across 20 states in the U.S. and has built a national network of nephrologists that includes hundreds of leading kidney care specialists. To learn more about Monogram Health, please visit here.

About NCQA
NCQA is a private, nonprofit organization dedicated to improving health care quality. NCQA accredits and certifies a wide range of health care organizations. It also recognizes clinicians and practices in key areas of performance. NCQA’s Healthcare Effectiveness Data and Information Set (HEDIS®) is the most widely used performance measurement tool in health care. NCQA’s website (ncqa.org) contains information to help consumers, employers and others make more informed health care choices. NCQA can be found online at ncqa.org, on Twitter@ncqa, on Facebook at facebook.com/NCQA.org and on LinkedIn at linkedin.com/company/ncqa.

Anthony DeCosta 6/16/20 Anthony DeCosta 6/16/20

Monogram Health and Banner – University Health Plans Announce Innovative Kidney Care Partnership

Through combined expertise, organizations will further improve the quality of life for patients living with chronic kidney disease in Arizona

NASHVILLE, Tenn. and PHOENIX – June 16, 2020 – Monogram Health and Banner—University Health Plans (B – UHP), a division of Banner Health, announced today an agreement that will improve the coordination of vital care for B – UHP members living with chronic kidney disease (CKD) and end-stage renal disease (ESRD).

“We’re excited to partner with Monogram to transform the delivery and management of kidney care,” said Banner University Health Plans. “Together, we have the unique opportunity to improve the lives of those suffering from kidney failure, increase access to their clinical care team and more deeply engage patients in their treatment plans.”

Banner University Health Plans noted that the partnership with Monogram emphasizes home-based benefit management and home dialysis therapies, in order to improve outcomes and lessen the risk of communicable disease transmission. “COVID-19 has put a spotlight on home-based care and the ability to treat kidney disease outside of the dialysis clinic environment.”

The Monogram-B – UHP partnership is designed to delay the progression of CKD, improve the timeline of care for those at risk of kidney failure, as well as elevate the quality of life for patients and leverage the benefits of in-home therapies for those with ESRD. Members of B – UHP’s Medicare Advantage DSNP, Complete Care and Long-Term Care health plans with late-stage CKD or ESRD will now have the option of receiving Monogram’s services. In addition to receiving regular home benefit management visits, these patients will have 24/7 access to Monogram’s support team, who help manage care with the patient’s nephrologists and dialysis providers and promote adherence to treatment plans through education and coaching.

“Partnering with an esteemed organization such as B – UHP is an honor,” said Senator Bill Frist, M.D., Monogram Health’s board chairman. “Through innovative and collaborative partnerships like this, we’re able to improve patient outcomes by addressing the unique needs of those who suffer from kidney disease. We believe that higher quality of care means that patients receive the right care at the right time, ultimately lowering costs, and we look forward to bringing our model to more patients.”

Monogram uses advanced artificial intelligence to identify the potential care needs of patients with kidney disease. Monogram’s care team – made up of nurse care managers and social workers – partners with nephrologists to ensure medication and treatment compliance. The specialized care team also assesses health drivers, such as appropriate nutrition, exercise and other social determinants of health through regular visits with patients in their homes. Through the partnership with B – UHP, Monogram will use advance payment models that reward nephrology practices for delivering high-quality, costefficient care.

“Monogram’s unique approach to partnering with nephrologists and dialysis providers builds relationships between nurses and patients, leading to better health outcomes and reduced costs,” said Dr. Raymond Hakim, Monogram’s Chief Medical Officer. “Through our highly focused care delivery network, we confidently drive improved patient outcomes and take on the financial risk around total cost of care.”

The partnership with B – UHP comes as greater attention is dedicated on a national scale to the care of those suffering from kidney disease. Last July, the Executive Order on Advancing American Kidney Health was issued seeking to transform kidney care in the United States by creating provider payment models that reward kidney care specialists for achieving high-quality patient outcomes and cost efficiency. This effort is extremely important to both care quality and cost, as the Center for Disease Control reported that in 2017, approximately $120 billion was spent annually for Medicare program beneficiaries with CKD (more than $84 billion) and ESRD (an additional $36 billion).

“We are proud to be working with B – UHP and Monogram Health to strengthen our ability to further address the growing healthcare needs of Arizona residents living with chronic kidney disease and endstage renal disease,” said Jami Snyder, director of the Arizona Health Care Cost Containment System. “AHCCCS has proven to be a leader in innovation, and through Monogram Health’s pioneering care model, led by nephrologists, we can provide these patients with the essential access points of care in their own homes.”

About Banner—University Health Plans
Banner—University Health Plans (B – UHP) is a managed care organization and part of Banner Health (Banner). As the largest employer and Medicaid provider in Arizona, Banner has more than 30 years of experience in Arizona's healthcare and labor markets. As a Banner division, B – UHP is the only locally owned plan focused exclusively in Arizona and is a recognized Medicaid managed care leader. In 1985, B – UHP began as an early Medicaid contractor and has a history of successful operations in Medicaid and Medicare. B – UHP owns and operates: Banner–University Family Care (B – UFC/ACC), an AHCCCS Complete Care plan; Banner – University Family Care (B – UFC/ALTCS), an AHCCCS Long Term Care plan; and Banner – University Care Advantage (B – UCA), a Medicare Advantage Dual Special Needs Plan (DSNP). B – UHP fosters a member-centric culture, is an active community partner, and is on a mission to make health care easier so life can be better.

Anthony DeCosta 5/11/20 Anthony DeCosta 5/11/20

Nearly 40% of This Nephrologist’s ESKD Patients Dialyze at Home

By Jody A. Charnow via Renal and Urology News

Shaminder Gupta, MD, is a nephrologist who practices in Houma, Louisiana. He serves as the section chief at his hospital and also as Corporate Medical Director at Monogram Health, a renal disease care management company. He tells Renal & Urology News how he developed and manages a home dialysis program in which approximately 40% of his patients with end-stage kidney disease (ESKD) participate, far above the national average in the United States. As of December 31, 2017, only 2% of hemodialysis (HD) patients used home HD, according to the US Renal Data 2019 Annual Data Report. Another 7.1% of ESKD patients used peritoneal dialysis, which is a home dialysis modality.

How are you able to care for such a relatively high proportion of your patients receiving home dialysis?

Dr Gupta: I practice in a rural part of Louisiana. On the first pass, it may seem that home dialysis would be challenging in these patients for multiple reasons: poor socioeconomic status, large distances from patient to dialysis unit, lower education. I have found that this patient cohort is extremely resilient and capable of self-care. They are willing to learn and care for themselves, and there is a deep sense of family.

Our nurses are the key to having patients choose home options by constant encouragement and support. We do not promise patients it will be easy in the beginning, but we do promise it will be better. Once the home program matures past a critical mass, it is actually easier for the nurses as a team because of the self-care that patients do. Many patients only come in for the monthly visit and we do check-ins. The ones who need more attention can usually be managed by phone or telehealth.

What prompted you to establish a home dialysis program?

Dr. Gupta: Our part of the state is also very prone to weather events, and this makes home options very attractive. I started this program in 2008 with the idea that all patients can do home dialysis and they all should be offered home dialysis. I do not let my own biases get in the way, and I want all patients to consider home dialysis as a first option. For some, it is easy. They have support and are engaged. Others are very reluctant, but we continue to encourage and push them from early CKD stage 4 to consider this option.

How big a role does telemedicine play in your ability to manage these patients?

Dr. Gupta: For my practice, telemedicine has not been a large component. We sometimes utilize it, but most patients are stable and enjoy coming for their monthly visit. I believe the face-to-face encounter is still very important and crucial to patient success.

Reimbursement issues (ie, lack of reimbursement) have been noted as an impediment to adoption of home dialysis. Has this been a problem for you and, if so, how have you been able to manage such a large home dialysis population from a financial perspective?

Dr Gupta: Reimbursement issues can be a hurdle when first starting. The dialysis companies have to dedicate a nurse to the program, and these programs can take a few years to mature. There are some positive reimbursements in terms of training of the patients that go to the dialysis center, and there are training payments that go the physicians as well. Ultimately, the reimbursements are good and when computed in a payment for time spent, they are fair.

Do you make house calls?

Dr Gupta: I do not do house calls, but our nurses do in-home visits to assess the environments and often check on patients on their own. I would welcome the chance to do them, but have not yet.

Do you think the COVID-19 pandemic will accelerate adoption of home dialysis nationally?

Dr Gupta: COVID-19 provides a unique opportunity to further interest and choice in home dialysis options. Patients are rightfully worried about being in environments where there are chances of exposure to COVID-19 and other communicable diseases. Home dialysis eliminates this possibility, and the current COVID-19 crisis is making patients realize this. I have found that patients are much more open to listening to these options now, and I have had some patients commit to conversion to peritoneal dialysis or home hemodialysis over the past few weeks. A strategy for home dialysis growth has always been to approach patients at moments when they are feeling stress about in-center therapies, and this is one of those moments.

Anthony DeCosta 5/5/20 Anthony DeCosta 5/5/20

Monogram Health Announces Series A-1 Funding to Further Kidney Health

The new round brings the total funds raised to $12 million in the past 15 months and reflects a growing national focus on kidney disease and at-home healthcare services

NASHVILLE, Tenn. — May 5, 2020 — Monogram Health, a leading kidney disease benefit management company, announced today that it has secured $7 million in funding through the closing of a Series A-1 financing round. The round was co-led by Frist Cressey Ventures and Norwest Venture Partners. The funding represents another significant milestone for

Monogram as the company continues to grow, increase health plan partnerships and manage the care of vulnerable patients with kidney disease through in-home engagement and increased interaction during this time of heightened isolation brought forth by the COVID-19 pandemic. Monogram currently operates its kidney disease benefit management programs for thousands of patients across the U.S., including Humana Medicare Advantage and Commercial plan members in Louisiana and Mississippi. The company partners with health plans to collaborate with nephrologists and ensure high quality patient care is delivered cost effectively. Monogram’s benefit management team of nurses, social workers, nephrologists, and geriatricians develop strong and lasting relationships with patients through in-person visits to their homes, inclusive of family members and community support, as a means of improving overall health outcomes. Through these regular visits, Monogram’s specialized care teams monitor and manage patients’ kidney care delivery, such as appropriate medication compliance, as well as transitions to and adherence with renal replacement, palliative care, and other evidence-based treatment modalities.

“We pride ourselves on working with innovative companies that are truly transforming the delivery of healthcare, and we share in Monogram’s vision of making kidney care more accessible to more people, lowering the cost of care, and at the same time improving their quality of life and health outcomes,” said Senator Bill Frist, M.D., Co-Founder & Partner of Frist Cressey Ventures and Monogram Health’s board chairman. “In light of the COVID-19 pandemic, the need for high-quality, in-home kidney health services are only growing, and Monogram is at the forefront of this shift to home-based benefit management and delivery.”

Home visits and frequent interaction with Monogram team members have become even more vital in light of COVID-19. These visits have been instrumental in safeguarding high-risk patients with serious underlying health conditions against unnecessary hospitalizations, missed physician visits and the emotional impacts of being isolated in a time of social distancing. Monogram supports the delivery of care in the home and outside of clinics and healthcare facilities, minimizing the potential spread of COVID-19. 2

“The COVID-19 pandemic has put a spotlight on the home as a safe healthcare setting for dialysis and other kidney-related care,” said Casper de Clercq, General Partner, Norwest Venture Partners. “Monogram’s solution empowers the vulnerable patients with renal disease to be seen in the comfort and safety of their own homes and to choose treatment modalities that are home-based, rather than clinic-based. This innovative approach to managing kidney care delivery will help improve health outcomes for a population that drastically needs and deserves better care.”

The funding also comes as the Centers for Medicare and Medicaid Services is increasing its attention and focus on the cost and quality of kidney care for its Medicare beneficiaries. Through the 21st Century Cures Act, Medicare beneficiaries with end stage renal disease will have the option during the Annual Election Period (AEP) later this year to enroll in 2021 Medicare Advantage plans administered by private health insurers to provide coverage for their care needs.

Anthony DeCosta 5/5/20 Anthony DeCosta 5/5/20

NBJ Exclusive: Frist-founded Healthcare Startup Raises $7 million

Monogram Health is gearing up for a period of rapid growth in part because of the enactment of the 21st Century Cures Act, which will allow Medicare beneficiaries with end-stage renal disease to enroll in 2021 Medicare Advantage plans through private insurers for the first time. See the full story here.