Cigna, Blue Shield of California back Cricket Health's $83.5M funding round

Startup Cricket Health scored $83.5 million in fresh capital to fuel its growth as it sees growing demand for its personalized approach to kidney care.

The series B funding round was led by Valtruis, which is focused on investing in companies with value-based and health-at-home models. Existing investors Oak HC/FT and Cigna Ventures as well as K2 HealthVentures also participated, and the round included a strategic investment from Blue Shield of California.

The company plans to use the financing to drive rapid expansion of its services, executives said in a press release.

San Francisco-based Cricket Health has raised a total of more than $120 million in equity and debt financing to date.

"Kidney disease has been a tremendous problem for our health care system due to its complexity, high cost of care, and the lack of early diagnosis intervention. Cricket Health's approach of marrying cutting edge analytics with dedicated care teams supported by a digital health platform is achieving outstanding clinical outcomes," said Tracy Bahl, managing partner at Valtruis.

Cricket Health developed a predictive analytics model to risk-stratify patients and identify those with chronic kidney disease in stage 3b and beyond with 96% accuracy. Identified patients are then assigned a care team that includes a nurse, a pharmacist, a social worker, a dietitian and a trained patient peer mentor.

Patients can connect with the care team over the phone or virtually, with the goal of slowing the progression of their disease and supporting them in accessing needed services. 

If patients do progress to end-stage kidney disease, Cricket Health's evidence-based approach increases transplant referrals, increases utilization of home dialysis and reduces unnecessary hospitalizations, company executives said.

RELATED: Cricket Health launching platform targeting Medicare Advantage plans

"Changing the way kidney disease is identified and managed is how we are able to deliver better clinical results," said Robert Sepucha, Cricket Health CEO, in a statement. "By identifying patients earlier and delivering the care they need, we are helping more Americans than ever stay healthy, at home, and out of the hospital. With new partners Welsh Carson and Blue Shield of California, and existing partners Oak HC/FT, Cigna, and K2 Health Ventures, we will be able to continue to expand our innovative model of kidney care across the country."

The company recently launched a program targeting Medicare Advantage plans to assist them in managing care for patients with end-stage renal disease.

Cricket Health has developed a track record of improving clinical outcomes for people with kidney disease, which in turn results in lower costs for health plan partners. In both Texas and California, across commercial and Medicare Advantage health plan partnerships, Cricket Health has shown marked improvements in key clinical measures for its populations living with kidney disease, including more than 50% fewer hospital admissions than the status quo.

The company also reports that 77% of patients starting dialysis do so in an outpatient setting, compared to the status quo of 40%, and 45% of patients who need dialysis are initiating at home, compared to the status quo of 11%.

Cigna reports that since May 2020, the health plan has seen more than a 50% reduction in hospitalizations and an increase in patient autonomy in a customer's transition to dialysis.

"In our partnership with Cricket, we've been able to bring even more affordability, predictability and simplicity to our customers with kidney disease," said Tom Richards, senior vice president and global lead, strategy and business development at Cigna, in a statement.

Blue Shield of California teamed up with Cricket Health in 2020 to offer coordinated care to members with late-stage and end-stage renal disease.

The long-term collaboration is part of Blue Shield's Health Reimagined initiative, which includes a slew of pilot programs targeting the unique needs of members in four communities across the state.

"Cricket Health's virtual platform has helped connect patients with clinical and peer support, making them feel more educated about their health and involved in their care plans, allowing them to live their best lives," said Susan Fleischman, M.D., interim chief medical officer of Blue Shield of California, in a statement.

RELATED: CVS, Anthem, Intermountain form coalition to push for regulatory changes for home dialysis

The company is among several startups, along with industry heavyweights, chasing a lucrative home-based kidney care market. 

Startups that focus on modernizing chronic kidney disease and end-stage renal disease management are attracting big investments. Alphabet’s independent growth fund CapitalG backed Strive Health’s $140 million series B funding round. Strive Health aims to slow the progression of kidney disease with an approach that combines advanced technology with high-touch patient care.

Tech-enabled kidney disease management company Monogram Health scored a $160 million series B funding round backed by Humana. The funding round was led by TPG Capital, the private equity platform of global alternative asset firm TPG, and included participation from existing investors Frist Cressey Ventures and Norwest Venture Partners as well as other notable national and regional strategic investors. 

Reforming kidney care was a key health priority at the Department of Health and Human Services and the Centers for Medicare & Medicaid Services under President Donald Trump. The Trump administration issued a new rule boosting end-stage renal disease patients' access to home dialysis by allowing certain new equipment and supplies to qualify for an additional Medicare payment. The administration also launched a set of new payment models aimed at boosting the use of home dialysis and transplantation as alternatives to clinic dialysis.