Anthem Selects Somatus To Deliver Personalized, Value-Based Kidney Care

By OPEN MINDS Circle

On November 3, 2021, Somatus, which provides a value-based kidney care management model, announced it entered a long-term, multi-year partnership with Anthem, Inc. Somatus began providing its program to members of Anthem’s affiliated Medicare Advantage plans as of November, 1, 2021. Starting January 1, 2022, the program will be provided to Anthem’s end-stage kidney disease (ESKD) Chronic Special Needs Plans. The program will be for individuals with chronic kidney disease (CKD) stages 3, 4, and 5, and those with ESKD. In addition to this partnership, Anthem made a strategic investment in Somatus. Neither company has disclosed the risk-sharing model in their value-based contract.

The partnership expands the Somatus footprint into 34 states, and raises the number of “kidney care” lives under management to more than 150,000. Somatus currently partners with 10 national and regional health plans, several dozen hospitals and health systems, and more than 19,000 primary care provider organizations, nephrologists, and other specialists.

Anthem is using its Health OS to facilitate bi-directional data exchange to transmit data with Somatus. This data exchange facility will transmit timely alerts on member admission and discharge to optimize care, simplify coordination with Anthem care management personnel, and enhance the consumer and provider organization experience. Anthem’s Health OS is a comprehensive, cloud based, payor and provider organization-agnostic platform that connects siloed health data and disparate technologies. Anthem is a large health benefits company. Through its affiliated companies, Anthem serves more than 177 million people, including more than 45 million people enrolled in an Anthem affiliate.

After an eligible member enrolls in the Somatus program, the member is paired with a local Somatus care team that provides holistic care management; education about CKD, treatment options and diet; and help transitioning from hospital to home. The care team includes a nurse care manager, a community health worker, a renal pharmacist, a renal dietitian, and a social worker (who assists with transportation, food or other issues that impair the member’s compliance with treatment). The goal is to improve care management for the member’s kidney disease and other comorbid health conditions. Somatus is a vertically integrated organization that provides clinical services and care management. The goal is to delay or prevent disease progression, improve quality and care coordination, and increase the use of home dialysis modalities and rates of kidney transplantation.

For more information, contact:

• Leslie Porras, Corporate Communications, Anthem, Inc., 5800 Northampton Boulevard, Norfolk, Virginia 23502; 757-459-8031; Email: leslie.porras@anthem.com; Website: https://www.antheminc.com/
• Marissa Lawson, Vice President, Marketing and Communications, Somatus, 1861 International Drive, Suite 600, McLean, Virginia 22102; 571-992-0600; Email: info@somatus.com; Website: https://somatus.com/