Blue Cross Blue Shield consortium picks Cricket Health as preferred kidney care provider

Kidney care startup Cricket Health just got a healthy vote of confidence from a consortium of Blue Cross Blue Shield (BCBS) plans.

Consortium Health, a collaboration of 21 independently licensed BCBS plans, selected the San Francisco-based tech-enabled kidney care provider as its "preferred partner." The collaboration means Consortium member plans will be able to offer Cricket's care model for chronic kidney disease and end-stage renal disease to their national accounts representing about 25 million members.

“By working with Consortium, together we can help large national employers covered by its partner plans access better kidney care that drives better health outcomes and reduced costs for their millions of employees across the country,” said Arvind Rajan, CEO and co-founder of Cricket Health, in a statement.

BCBS plans serve 27 million national account members, with nearly 25 million of those members from Consortium’s 21 member plans, company officials said.

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Cricket Health has sought to differentiate itself in the market by focusing on early detection and preventive care to slow disease progression and prolong kidney function. While the company was not yet profitable when it spoke to FierceHealthcare earlier this year, executives expect to become so in the next few years by saving payers money through better managing patients by keeping them out of the hospital and dialysis centers as long as possible. 

Over the next few years, the company said it expects to begin ramping up its activities, scaling its workforce to about 100 people and deploying its first commercial programs for both payers and health systems around the country. 

The collaboration comes several months after Cricket raised a $24 million series A funding round led by Oak HC/FT. 

The company also recently added Carmen Peralta as its chief medical officer, Geoff Clapp as chief product officer and former Fresenius Medical Care executive Robert Sepucha as chief administrative officer. Cricket Health also brought on Sam Mankiewicz as chief technology officer.

Rajan has estimated Cricket Health is chasing a market worth well over $100 billion. An estimate published last year by KBV Research projects the global dialysis market is growing at an annual rate of 5.3% and will reach $124 billion by 2023.

Kidney care has also been receiving increased attention from federal officials such as Department of Health and Human Services Secretary Alex Azar, who has said the Trump administration is rethinking payment models for both in-home dialysis and transplantation. Medicare spent $79 billion in 2016 on people with kidney disease and $34 billion on people with end-stage renal disease, for a total of $113 billion—the equivalent of more than 1 in 5 dollars spent in the program.  

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The industry has also gotten increased interest from established healthcare players like CVS Health.

Of course, dialysis giants such as DaVita have questioned how novel the efforts of kidney care newcomers are, with new CEO Javier Rodriguez recently telling FierceHealthcare his company has been leading the way in integrated care and home care efforts.

"One of the ironies of the whole thing is DaVita has been talking about integrated care for over 15 to 20 years," he said. "It's been a passion of ours, we've been pursuing it. We are very excited the time has come and people are focused on this now because we are poised and ready to go."