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Every day thousands of Medicare and Medicaid beneficiaries with end-stage kidney disease (ESKD) report for dialysis and are often greeted with an unfriendly and depersonalized experience. A patient once likened his dialysis experience to incarceration saying the dialysis center felt like jail. Research shows many dialysis patients are unhappy with the ESKD treatment experience, yet, since its inception, the dialysis industry is largely unchanged in its approach to care delivery. What if the kidney care experience could be transformed to one that is less onerous and more patient-centered? Fortunately, companies like Somatus are emerging and promise to offer better experiences and health outcomes for patients with ESKD. The Somatus tagline is “Revolutionizing kidney care” and their vision is to become a leader in the ESKD space by improving the kidney care, dialysis experiences and health outcomes for patients with chronic kidney disease.
Somatus, a value-based kidney care company offering holistic care to ESKD patients, was founded in 2016 by Dr. Ikenna Okezie, a physician entrepreneur and Aspen Health Innovator Fellow with a Harvard MBA. A recent conversation with Okezie highlights a critical need to offer more patient-focused kidney care solutions and why it’s a perfect time to revolutionize the kidney care industry.
Somatus Founder, Dr. Ikenna Okezie
Okezie says, “We want the kidney care industry to change and we aim to be world’s best provider of integrated care for patients with kidney disease.” He also says their mission involves keeping patients healthy. Okezie’s passion for improving the kidney care journey originated from his experience working in traditional dialysis settings. Most dialysis is embedded in health care systems that too often lack the infrastructure or operational support to provide holistic care and education to ESKD patients. Throughout his work in the kidney care industry, he encountered a recurring and troubling theme across discussions and interactions with nurses, social workers and dialysis patients—that many patients were uneducated about their disease and more importantly their treatment options. He discovered, despite being a more patient friendly solution, most patients were not offered home dialysis as a treatment option nor were they educated about transplantation as an alternative to dialysis.
Okezie also noticed the negative impact on kidney morbidity when care is shifted to nephrologists-kidney specialists. Nephrologists may assume responsibility for most of a patient’s health care but often neglect non kidney-related primary care needs. This coupled with scarce focus on health literacy and kidney care education, patient engagement declines further exacerbating kidney disease. Given this, Okezie recognized opportunities to better educate patients about their disease and the health care associated with it.
Somatus distinguishes its brand and care model from traditional kidney care incumbents in a few ways. First, their primary goal is to preserve kidney function which benefits patients by delaying time to dialysis, maximizing the time horizon for kidney transplantation and at times, obviating the need for dialysis.
Second, health education is a cornerstone of their care model. All patients are educated about dialysis including transplantation as an alternative to lifelong dialysis. Their tailored approach to kidney education is unique. Okezie says, “Learning is personal. [That’s why] we find the right person on our team, it may be a nurse, a tech, a dietitian or the nephrologist, to communicate information to the patient.” By educating 99% of patients, Somatus exceeds the national average for patient kidney education by nearly 70%.
Third, Somatus assumes responsibility for coordination of all medical and social care which streamlines the health experience and reduces patient care navigation burden. These efforts are augmented by Somatus’ own technology platform that triangulates risk, clinical and financial data to facilitate early identification of and intervention for clinical and social needs.
Finally, to maximize patient convenience, the company preferentially and disproportionately dialyzes more patients at home. Compared to a 9.7% national average, 35% of Somatus patients are dialyzed at home. As for why companies don’t provide more home dialysis access, Okezie cited a recent GAO report suggesting large dialysis organizations that have built physical spaces for in-center dialysis have a financial disincentive to increase home dialysis. The report also suggests Medicare payment policies might constrain shifts toward increased delivery of home dialysis. Despite this, Somatus is first committed to patient outcomes and convenience. Their near term goal is to increase home dialysis to 50%. In addition, they have established education and support systems to ensure patient confidence and success in managing home dialysis.
Okezie says the inclusion of inpatient dialysis as a service was a strategic decision because when hospitalized, patients are a captive and often a more receptive audience which creates unique opportunities for the Somatus team to intervene early. During inpatient stays the team can establish trust and implement state-of-art education and support services which ultimately reduces care gaps, impacts care and health outcomes long term. This early intervention also improves patient perceptions about kidney care. Okezie is on to something. According to the US Renal Data System (USRDS), of all patients with dialysis who initiated dialysis in the previous 12 months, 40% had not seen a nephrologist which represents a staggering unmet need for people newly-diagnosed with ESKD.
Further, to address these gaps Somatus is intentional about hiring dialysis nurses trained to educate and administer both home and traditional in-center hemodialysis. They also proactively seek collaboration with nephrologists to support and provide education for patients at risk of disengaging from care, missing dialysis or whose social circumstances make it challenging to adhere to lifestyle requirements for ESKD management.
So, what will it take to revolutionize kidney care? Okezie says, “It will take a committed team that can withstand the heat from competition while trying to disrupt multi-billion dollar kidney care incumbents along with customers progressive enough and willing to take a chance on new care models and early stage companies like Somatus. We will need to consistently demonstrate our ability to improve kidney care-related outcomes by addressing care gaps and providing holistic management of ESKD patients.”
Somatus is just beginning but if their performance thus far including reduction in hospital readmissions and average hospital stays to 6.5 days vs. 11 days nationally are indications, a revolution is definitely on the way.
