A value-based kidney care company is showing what’s possible when it comes to renal treatment in the home — potentially providing a framework for home-based care providers if a variety of newly proposed payment models come to fruition.

Since getting started about three-and-a-half years ago, Vienna, Virginia-based Somatus Inc. has served 3,000 patients, doing more than 25,000 dialysis treatments total, according to CEO and co-founder Ikenna Okezie.

“If kidneys fail … dialysis can’t fully replace the kidney unless it’s dialyzing 24 hours per day,” Okezie told Home Health Care News. “Doing dialysis in the home gives you more time on dialysis than thrice weekly, three or four hours per treatment. … It’s far better for most patients to do it in the home.”

Somatus treats patients with chronic kidney disease (CKD) and end-stage renal disease (ESRD). In January, it entered into a pilot with BlueCross BlueShield of Tennessee to serve 400 ESRD patients at home in a total cost-of-care population health agreement.

For the pilot, Somatus went at-risk to manage the cost and quality of life for patients, sending nurses, community health workers, renal dietitians and renal social workers into their homes directly. Eligible beneficiaries also receive customized support and care plans, which include things like home dialysis modality education, medication management, behavioral health services and more.

“We fill in the gaps that exist and the white spaces in the care of patients between physician visits or hospital visits,” Okezie said. “Next year, we’re scaling our care model and technology platform to reach patients with CKD and ESRD across quite a few states.”

So far, the pilot has yielded “amazing” results, Okezie said. While he couldn’t share specifics, Okezie did provide some color.

“I can tell you that in four months, we’ve closed a significant number of gaps in quality of care and exceeded the savings seen by the very innovative … model in its first performance year,” he said. “So we’ve had significant impact.”

Another factor that would have significant impact on in-home renal care: newly proposed payment models for certain kidney-related conditions, most of which are covered by Medicare.

The recently proposed overhaul would incentivize doctors and kidney care centers to treat patients earlier for conditions that often lead to kidney-related health issues. Plus, it would likely provide the financial model needed for wider adoption of home dialysis.

“For us, it’s exciting in that nephrologists and transplant centers … are now motivated economically to reduce disease progression in CKD, to increase the number of patients and the percentage of their patients who get transplants and to increase the percentage of patients who have home dialysis, if they really do need dialysis at all,” Okezie said.

Finally, Okezie said the proposal creates opportunities for home-based care providers, who Somatus often works with to coordinate in-home kidney care.

In addition to collaborative opportunities, Okezie says home-based care providers have the opportunity to specialize in kidney care going forward.

“Whatever home-based care providers can do to support late-stage CKD patients to help identify them, … diagnose those patients, help them get tested so that we can know who has CKD and who doesn’t — it begins there,” Okezie said. “Then spending as much time with them as possible managing care in the home specific to CKD and ESRD, I think that can go a long way.

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