Southern California Kidney Consultants is collaborating with Strive Health to improve outcomes and chronic care management for Medicare patients living with kidney disease.
Higher quality, cost-effective kidney care is the goal of a joint entity formed between the largest nephrology group in Orange County, California, and a Denver-based technology company.
The joint venture between Southern California Kidney Consultants (SCKC) and Strive Health is targeted at Medicare beneficiaries in Southern California, whereby each partner shares in the financial benefits, management, and governance of risk contracts with Medicare and Medicare Advantage plans and Independent Physician Associations (IPAs), aimed at improving outcomes and reducing costs.
The partnership includes 21 providers, based mostly in Orange County, who serve 5,000 patients with chronic kidney disease (CKD) and end-stage kidney disease (ESKD). Leveraging Strive's platform, SCKC aims to prevent the progression of kidney disease.
Centers for Disease Control and Prevention (CDC) estimates show that kidney disease impacts 37 million adults, or 15% of the US adult population, including more than 38% of those over 65 years old. Kidney disease is responsible for $410 billion of unmanaged annual medical spend, demonstrating the need for payment models that are based on outcomes.
"We know that our dedication to value-based models will make our practice a leader in the community," says nephrologist Nirav Gandhi MD, one of SCKC's partner/owners. "We evaluated several partners to help us on our journey and are confident that Strive offers the strongest vision, capabilities and team in value-based kidney care.”
Nirav Gandhi, MD, owner/partner, Southern California Kidney Consultants. Photo credit SCKC.
The new SCKC/Strive entity contracts with Medicare, Medicare Advantage plans, and IPAs to take risk on the outcomes and costs of their kidney patient populations. Strive will supply SCKC with access to data and technology resources, administrative support, management expertise, and an interdisciplinary clinical care team including nurse practitioners, dietitians, pharmacists, care coordinators, and licensed clinical social workers. These team members act as an extension of the nephrologist’s office and help manage comorbidities, such as diabetes, that can impact a patient’s overall health.
"For so long, the investments in this space have been really focused on treating people with kidney failure once their kidneys fail," says Ben Kuhn, senior vice president of partnerships and growth at Strive Health. "A big focus of Strive and this partnership is on getting upstream, intervening with patients who have chronic kidney disease, helping to prevent and delay the progression of their kidney disease to avoid kidney failure. That's obviously in the interest of the patients, the providers, and also in the interest of the payers."
For SCKC, the partnership is intended to break a vicious cycle of patients failing to follow-up with their care providers or keep in touch in a timely fashion, which can lead to adverse health outcomes and even death.
"We get referrals of patients who have anywhere from mild to moderate to severe kidney disease that are sent to us in the office," Gandhi says. "What happens is sometimes these patients, whether it's insurance-related or they get lost to follow-up, or they just have a hard time for socioeconomic reasons, or various other reasons, they are not able to follow up or necessarily adhere to the treatments and everything that's necessary to try to delay progression of their kidney disease. They may end up suddenly crashing into the hospital ER, where they present and they're in advanced kidney failure."
In deliberating whether to partner with Strive, SCKC's partner/owners did due diligence, Gandhi says.
"Anytime you have a bunch of doctors who have a little bit of intelligence and ego, we're all going to have some opinions," he says. "We've been working on something like this for over 18 months and Strive is not the only company we spoke to. We had presentations with other companies. We even spoke to some of the large dialysis organizations, to figure out who we think would partner best with us to do what we wanted to do."
Competitive approaches varied from technology companies trying to do healthcare to healthcare companies trying to do analytics.
"We thought Strive was kind of both," Gandhi says.
SCKC will use Strive’s technology platform, which gathers data from hundreds of sources, to gain a holistic view of the patient’s experience. That information can help paint a picture about the risk of hospitalization or progression of disease, helping nephrologists better tailor care to a patient's specific needs.
"We’re giving leading nephrology groups the ability to intervene earlier based on data, which enhances the patient experience and makes expensive treatments less necessary," Kuhn says. "SCKC has leaned into these innovations, and the group and their patients are well-positioned to succeed in the future of kidney care."
The SCKC/Strive partnership also fits in with the Comprehensive Kidney Care Contracting Program launched in 2021 by the Centers for Medicare & Medicare Services' (CMS) Innovation Center, whereby nephrologists can take on value-based care incentives for Medicare patients they are already seeing.
"We were not going to join somebody where we're not heavily involved in decision-making, because we still think we know what we're doing better than anybody else when it comes to taking care of these patients," Gandhi says.
Strive manages more than 56,000 patients with CKD and ESKD through partnerships with nephrologists and other care arrangements with payers and providers. Earlier in 2022, the company signed a nephrologist-led partnership with the nation’s largest nephrology group, Nephrology Associates of Northern Illinois and Indiana (NANI).
“We were not going to join somebody where we're not heavily involved in decision making, because we still think we know what we're doing better than anybody else when it comes to taking care of these patient.”
— Nirav Gandhi MD, owner/partner, Southern California Kidney Consultants
Scott Mace is a contributing writer for HealthLeaders.
Southern California Kidney Consultants will use a technology platform supplied by Strive Health to manage care for roughly 5,000 patients through 21 providers.
The platform will enable providers to better manage care for patients living with chronic kidney disease (CKD) and end-stage kidney disease (ESKD), coordinating follow-ups and reducing the risk of adverse health outcomes.
The partnership also fits neatly into the Comprehensive Kidney Care Contracting Program launched in 2021 by the Centers for Medicare & Medicare Services' (CMS) Innovation Center.