Here's why Humana helped a kidney disease management startup raise $160 million

Tech-enabled kidney disease management startup Monogram Health scored $160 million in Series B funding from investors including massive health insurer Humana.

What it does: Monogram Health teams up with insurers to give members affected with chronic kidney disease (CKD) and end-stage renal disease AI-enabled services to manage their condition, including remote patient monitoring devices, a platform connecting patients to a personalized care team, and algorithms to identify early cases of CKD and risk for disease progression.

Humana’s interest in Monogram Health was likely driven by the potential for high ROI in the form of earlier intervention and avoidable hospital admissions:

• Treating CKD costs the US billions every year, so tools that can stave them off will be need-to-have for insurers on the hook for a large chunk of the costs. In 2018, the US spent nearly $82 billion treating Medicare beneficiaries with CKD. Startups like Monogram Health say their AI-powered platforms can help shrink hospital readmission rates for CKD patients down to 18% (compared with the national average of 35%)—which could go a long way toward trimming the US’ high healthcare spending on CKD, the majority of which consists of hospital stays due to CKD complications.
• Insurance incumbents struggle to introduce their own AI-powered tools—so they’ll be eyeing companies like Monogram with ready-to-deploy tools as potential partners or acquisition targets. About two-thirds of payer execs say a lack of requisite expertise (like cloud engineering and software architecture) is a challenge to their digital transformation strategies, according to a May Deloitte survey of 35 tech leaders at US health plans. Startups like Monogram Health already have the necessary tech to tackle insurers’ problems: For example, months prior to investing in Monogram Health, Humana inked a partnership with the company to help slow CKD disease progression in patients residing in Louisiana and Mississippi—states where there’s a higher prevalence of the condition.

Most CKD cases go untreated until the final stages—which is why big names in healthcare are betting on tech that helps detect CKD earlier when it's less costly to manage.

• Many patients don’t realize they have CKD until it’s in advanced stages—AI-powered disease management tools are effective in early detection and slowing disease progression. CKD usually progresses before symptoms begin to appear, which makes it difficult to detect. However, tech like Monogram’s Health’s can help slow the disease and reduce complications that arise in later-stage progression: Monogram Health’s competitor, Strive Health, says it can predict CKD progression with 95% accuracy, for instance.
• And Monogram Health isn’t the only tech-enabled CKD management startup that’s caught the attention of big-name investors. In March, Alphabet and large health system Ascension backed Strive Health’s $140 million investment round to scale its business, a startup which works with primary care docs and nephrologists to provide predictive analytics, telehealth services, and home dialysis options for CKD patients.