Blue Cross Blue Shield of Arizona (AZ Blue) is partnering with Monogram Health to provide in-home, evidence-based care and benefit management services for patients living with chronic kidney and end-stage kidney disease. Through this value-based care partnership, AZ Blue will use Monogram's network of in-home providers and support services to improve the care of their members.
Monogram is a provider of in-home nephrology, primary care, and benefit management services. It partners with health plans to provide their members with an evidence-based renal care model of clinical managed services, including complex case and disease management, utilization management, and medication therapy management, to improve patient outcomes and quality of life while dramatically reducing costs for the healthcare system.
As part of this collaboration, Monogram Health will assume full financial risk for BCBSAZ's Health Choice Pathway D-SNP (Dual Eligible Special Needs Plans) Product members with kidney disease. This partnership will give this population across eight counties in Arizona access to Monogram's suite of specialized clinical and support services including evidence-based clinical pathways and protocols, in-home specialty care, complex case and disease management, and comprehensive medication therapy management.
"Through our value-based risk platform, we are transforming the way care is delivered to highest cost and most complex kidney patients," said Aashish Shah, M.D., chief growth officer of Monogram Health, in a statement. "We're excited to partner with Blue Cross Blue Shield of Arizona, home to our operations hub, to extend our reach to vulnerable populations who deserve best-in-class care so they can enjoy healthier, happier, and more fulfilling lives."
Prior to joining Monogram last year, Shah served as corporate vice president for strategy and product innovation for payer contracting and alignment at Nashville-based HCA Healthcare.
"We're proud to embark on this value-based care journey with Monogram Health to provide improved patient experiences, achieve better health outcomes and reduce variability in care," said Shawn Nau, general manager, Medicaid Segment at Blue Cross Blue Shield of Arizona, in a statement. "We are firmly committed to delivering innovative services, personalized care management and support to the members we serve across Arizona. By combining AZ Blue's high-value, cost-effective product with Monogram's innovative, evidence-based approach to in-home care delivery, we'll be able to dramatically improve the quality of life for our members navigating complex chronic and end stage kidney disease.”
Based in Nashville and privately held by Frist Cressey Ventures, Norwest Venture Partners, and TPG Capital, Monogram Health has numerous value-based partnerships with health plans, integrated delivery systems, and risk-bearing entities to care for patients across 35 states and all insurance products.