Kidney care provider Monogram Health has entered into a new value-based care agreement for most Humana Medicare Advantage HMO and PPO plan members in four states who live with chronic kidney disease. It also recently signed a deal with Point32Health, the parent company of Tufts Health Plan and Harvard Pilgrim Health Care.
Nashville-based Monogram says it 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 healthcare system.
The agreement is designed to help improve quality of life for the members who have chronic kidney disease in Tennessee, Alabama, Mississippi and Louisiana. The members can now access Monogram’s specialized resources, which include in-home primary and specialty care visits, medication management, dialysis and transplant coordination, palliative care, and social services.
“With millions of Americans living with chronic kidney disease and the number continuing to grow, Humana is committed to increasing access to evidence-based, multi-specialty kidney care to ensure our members have the services they need without having to leave home,” said Carl Daley, Humana senior vice president of retail strategy and operations, in a statement. “Building on our existing relationship with Monogram is an important way we can provide the highest levels of support and access to care for our members.”
Humana continues to grow its value-based care portfolio. As of June 30, 2022, Humana has more than 3.2 million individual Medicare Advantage and commercial members who are cared for by 75,600 primary care providers in more than 1,000 value-based relationships across 46 states and Puerto Rico. Humana’s total Medicare Advantage membership is approximately 5.1 million members, which includes members affiliated with providers in value-based and standard Medicare Advantage settings.
"This important step forward strengthens our already impactful relationship with Humana, allowing us to continue our mission-driven work of transforming care for people with chronic conditions,” said Monogram CEO Mike Uchrin, in a statement. “We’re proud Monogram can now bring even more value to Humana and the members they serve.”
Through the new collaboration with Canton, Mass.-based Point32Health, Monogram Health will assume full financial risk for Point32Health’s members with kidney disease, delivering in-home specialty care services promoting better patient outcomes while improving affordability.
“Point32Health is committed to delivering innovative services, tailored care management and support to the members we serve,” said Cain Hayes, president and CEO of Point32Health, in a statement. “Working with Monogram Health, we will ensure our commercial members receive best-in-class kidney care with the goal of slowing disease progression and providing our members and provider community access to specialty care for better health outcomes.”
The collaboration also includes a research component between Monogram and the Harvard Pilgrim Health Care Institute’s Department of Population Medicine, a collaboration between Harvard Pilgrim Health Care and Harvard Medical School focused on innovative teaching and research to address healthcare issues.
