Highmark Ventures, GuideWell back Healthmap's $35M round to scale up kidney care

Two major Blues plans—GuideWell and Highmark Ventures—are backing kidney population health management company Healthmap Solutions.

The company, founded in 2016, raised $35 million to fuel explosive growth over the past few years, going from 60 employees in the summer of 2020 and expecting to reach more than 500 by the end of this year. By then, Healthmap will have more than 150,000 members under contract across commercial, Medicare and Medicaid lines of business, according to the company.

Healthmap will also continue to fund R&D initiatives that provide innovative solutions to improve chronic kidney disease.

Previous investors Windrose, DCHP, Shulman Ventures and management also participated in the funding round. The company has raised $125 million to date, according to Crunchbase.

Healthmap leverages advanced technology, predictive analytics and clinical expertise to detect kidney disease early and recommends clinically proven interventions to delay or slow disease progression. The company's care navigation team works with patients and providers including primary care, nephrologists, cardiologists, endocrinologists and dialysis providers to deliver personalized whole-person care, according to executives.

The company's approach is to proactively plan care transitions and optimize renal replacement therapy, with a focus on in-home dialysis treatment and transplant. The aim is to improve care, outcomes and experience for patient while also lowering total medical costs for health plans and provider groups.

GuideWell is the parent of Florida Blue and Triple-S Management, the Blue Cross Blue Shield plans of Florida and Puerto Rico, while Highmark and its Blue-branded affiliates cover members in Pennsylvania, Delaware, West Virginia and New York.

The Blue-affiliated plans ramped up investment in the startup to highlight a growing public health imperative and to more effectively identify and care for the 40 million people living with kidney disease in the U.S.

“Caring for members who have kidney disease is complex and costly,” said Eric Reimer, Healthmap chief executive officer in a statement. “For this reason, Healthmap has built a kidney health management solution to be used with our clients to deliver clinical, financial and operational excellence.”

More than one in seven adults, or about 15% of U.S. adults or 37 million people, are estimated to have chronic kidney disease, according to data from the U.S. Centers for Disease Control and Prevention. But as many as nine in 10 adults with CKD do not know they have the condition.

In the U.S., treatment of chronic kidney disease is likely to exceed $48 billion per year. Treatment for kidney failure consumes 6.7% of the total Medicare budget to care for less than 1% of the covered population, the National Kidney Foundation reported.

Health plans and health systems across the country are searching for a kidney solution partner because of the massive size and scale of the problem, which has been accelerated in recent years by the federal CURES Act and the “Advancing American Kidney Health Initiative” Executive Order, Reimer said.

Healthmap has been ramping up its partnerships with health plans to tackle kidney care. In 2020, Regence BlueShield teamed up with Healthmap to improve outcomes for members with chronic kidney disease in Oregon, Utah, Idaho and Washington.

Humana also collaborated with the company to offer a new care coordination program for Medicare Advantage and commercial members in Florida with kidney disease.

GuideWell and Highmark are both customers of Healthmap and conducted a comprehensive review of the kidney management market before selecting Healthmap as a partner. Based on the results of those partnerships, both organizations decided to invest in Healthmap. 

“This partnership draws on natural synergies between Highmark and Healthmap, as we are both committed to revolutionizing healthcare delivery in the U.S.," said Saurabh Tripathi, Highmark Health’s chief financial officer in a statement.

"Our goal is to improve kidney care and reduce costs with new approaches to care. We are excited to work with Healthmap’s proprietary artificial intelligence to build individualized care plans at scale and partner with our network providers to enable them to be more effective and efficient in caring for these complex patients," Tripathi said.

"After a year as a Healthmap client, we’ve developed a high level of confidence in their executive team and experienced first-hand, Healthmap’s early execution and ability to deliver on patient engagement, providing positive impact on clinical outcomes," said Florida Blue Medicare President Kathy Feeny. “Healthmap’s unique approach to kidney disease management engages with earlier stage kidney disease members and proactively partners with our provider network, helping us to make a measurable difference for our kidney disease members.” 

Healthmap is among several startups that along with industry heavyweights like DaVita are chasing a lucrative kidney care market. 

Startups that focus on modernizing chronic kidney disease and end-stage renal disease management are attracting big investments including Strive Health, Cricket Health, Monogram Health and Somatus, which recently scored $325 million in a series E funding, boosting its valuation to more than $2.5 billion.

Three big players in kidney care—Fresenius Health Partners, Cricket Health and InterWell Health—plan to form a new value-based care company focused on services for the earlier stages of kidney disease.