Somatus Achieves 4-Star Rating for Health Plan Partner Kidney Population Through Whole-Person Clinical Quality Program
June 12, 2024
McLean, VA — Somatus, the nation’s leading and largest value-based kidney care company, made marked improvements in the overall quality of care for a client’s complex kidney care population measured across 22 CMS Medicare Advantage Star metrics in 2023 measurement year, 2024 reporting year.
Historically, quality ratings for this patient population have been in the 2-Star range due to the inherent clinical complexity of kidney disease and the disproportionate impact of kidney disease on disadvantaged populations. However, Somatus multidisciplinary in-home care teams worked closely alongside community provider partners to improve quality of care for the Somatus membership, which started at a 2.5-Star rating and ended at a 4-Star performance rating for 2023 measurement year, 2024 reporting year.
Approach
Somatus’ whole-person approach to care prioritizes preventive care and results in improvements across both traditional cardiovascular-kidney-metabolic quality metrics like blood pressure and HbA1c control outcomes, as well as colorectal and breast cancer screening, osteoporosis management, and all-cause hospital readmissions.
“Somatus’ comprehensive, integrated quality program brings together community-based in-home field teams with a centralized outreach team and a deeply experienced quality leadership team to ensure attributed patients receive timely, equitable access to evidence based preventive care that can significantly improve clinical outcomes,” said Dr. Joe Kimura, Somatus Chief Medical Officer, and primary care internist.
Advancing Health Equity
Additionally, Somatus’ clinical model focuses on promoting health equity and addressing the longstanding disparities in outcomes among patients with kidney disease. According to the National Institute of Diabetes and Digestive and Kidney Diseases, Black individuals are nearly four times more likely to develop end stage kidney disease (ESKD), and Hispanic and Native American individuals are more than twice as likely to develop ESKD compared with White individuals. [1]
Somatus community-based care teams work purposefully to engage patients in their care and promote patient-centered, compassionate, and culturally sensitive care aimed at improving outcomes for patients, with a focus on improving access to early and appropriate nephrology care, effective disease delaying medications, and support for kidney transplant and home dialysis.
Compared with national averages, Black individuals engaged with the Somatus care model have 63% higher rates of nephrologist specialist care, and 4.1x higher rates of kidney disease delaying medication use. Hispanic individuals engaged with the Somatus care model have 65% higher rates of nephrologist specialist care and 3.2x higher rates of disease delaying medication use.
“By focusing on multidisciplinary, patient-centered care, the Somatus clinical solution is effective at helping patients delay the progression of kidney disease, ultimately promoting higher quality of life and more healthy days at home,” explained Dr. Bassem Mikhael, Somatus Deputy Chief Medical Officer and practicing nephrologist.
[1] https://www.niddk.nih.gov/health-information/health-statistics/kidney-disease
Result = More Lives, Better Lived.®
Pairing these proven quality outcomes with Somatus’ demonstrated impact on total cost of care through reductions in clinically avoidable inpatient utilization, Somatus enables high-value care for patients with complex chronic conditions. Building on the clinical quality foundation achieved through serving hundreds of thousands of individuals living with kidney disease since 2017, in 2024 Somatus expanded its home-based integrated care program to contract for individuals with congestive heart failure (CHF), even in the absence of kidney disease.
“We are excited by the results we are achieving, and what it means for the patients we serve,” said Dr. Kimura. “And we look forward to bring more quality based solutions to all of our valued health plan and payer partners.”
About Somatus
Somatus partners with nephrology, cardiology, and primary care groups, leading health plans, and health systems to provide integrated care for patients with, or at risk of developing, kidney and heart disease. As the market leader in value-based kidney care, Somatus’ fully integrated clinical services and AI-driven technologies delay or prevent disease progression, improve quality and care coordination, and increase the use of home dialysis modalities and rates of kidney transplantation. In 2024, Somatus expanded its program to contract for individuals with congestive heart failure. The company is headquartered in McLean, Virginia and founded by a team of world-class healthcare operators, successful entrepreneurs, and leading clinicians. For more information, please visit www.somatus.com.
Somatus Contact
Lara Smith
AVP, Communications
571-634-2526
[email protected]
