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Strive Health: At-Home & Virtual Value-Based Kidney Care

The Driver:

Strive Health, a provider of technology-enabled value-based at-home and virtual kidney care, recently raised $166M in Series C funding in a round led by NEA and included participation from CVS Health Ventures, CapitalG, Echo Health Ventures, Town Hall Ventures, Ascension Ventures, and Redpoint. This brings the company’s total funding to $386M since its founding. According to the company the funding will be used to expand partnerships with Medicare Advantage and commercial payers, as well as expanding into new and existing markets.

Key Takeaways:

  • More than 1 in 7 adults in the U.S. (15% of the adult population) have kidney disease and approximately 90% of those with kidney disease don't know they have it (National Kidney Foundation)

  • Strive is currently responsible for $2.5B of medical spending and has realized a 20% reduction in the total cost of kidney care and a 42% reduction in hospitalizations (Strive Health)

  • Approximately 34M people have early undiagnosed, early-stage (stage 1-3) kidney disease accounting for over 50% of the cost of kidney disease (U.S. Renal Data System)

  • McKinsey estimates that between 15-25% of dialysis spending could be shifted to the home accounting for about $5B in savings.

The Story:

Strive Health was co-founded by CEO Chris Riopelle and Bob Badal, both for (from?) DaVita. As noted by the Denver Business Journal, Riopelle and Badal realized that only a small percentage of those with chronic kidney disease, about 10%, are aware of it and have been diagnosed. [In fact] about 80% of patients start on dialysis by crashing into it: getting so sick that they end up in the hospital, and learning there that their kidneys have shut down and they need to start treatment.” Riopell and Badal realized there had to be a better way and understood that finding a way to diagnose and intervene with these patients earlier in the process could improve the experience and the quality of care. As noted on the company’s website, Riopelle wants to help those who deserve a better patient journey and is deeply committed to fundamentally changing how kidney care works for the almost 40M patients in need in America. Currently, “kidney care focuses almost entirely on ESKD and in-center dialysis, missing the primary drivers of high cost and poor outcomes. Strive is [attempting to change] the kidney care paradigm to identify patients earlier, prioritize the right care at the right time and drive better outcomes – all while lowering costs.”

The Differentiators:

Strive’s care model looks to combine technology such as Artificial Intelligence to empower caregivers to, in their words, “methodically reinvent kidney care”. According to the company, Strive’s Care Multiplier uses machine learning models that are trained on over 100 million patient records to calculate risk scores, end-stage kidney disease crash predictions, admission and readmission predictions as well as disease progression predictions. In addition, the company states that its artificial intelligence algorithms can identify patients whose kidney disease is undiagnosed thereby allowing earlier interventions.

Strive then uses this data to “form an integrated care delivery system that supports the entire patient journey from chronic kidney disease (CKD) to end-stage kidney disease (ESKD), As highlighted by MedCity News “The company provides at-home and virtual support for chronic kidney disease, end-stage kidney disease, dialysis, and kidney transplant and connects the patients with a care team, nurse practitioner, registered nurse, case manager, and care coordinator.”

Strive states that it is currently responsible for $2.5B of medical spending and has realized a 20% reduction in the total cost of kidney care, a 42% reduction in hospitalizations, and has achieved a 94% overall patient satisfaction rate. The company serves 80,000 CKD and ESRD patients in 30 states and has established partnerships with 600 nephrology providers across 10 states.

The Big Picture:

According to the National Kidney Foundation, approximately 90% of those with kidney disease don’t know they have it and Medicare costs for all people with all stages of kidney disease were $130 billion. For patients in need of a kidney transplant, this amounts to over $80K per person per year spending, much of which could have been prevented with early detection and treatment. Moreover, over 50% of the cost of untreated kidney disease is for people with early-stage disease (stage 1-3 disease) where companies like Strive Health and its competitors (Monogram, Somatus) could make a meaningful impact on the cost of care and patient quality of life. By helping to move kidney care out of facilities and improving its effectiveness. This would also have a significant financial impact as McKinsey estimates that between 15-25% of dialysis spending could be shifted to the home, amounting to about $5B in spending. Thus Strive and its competitors are significantly reducing the total cost of care. This is also propelled by regulatory moves such as the 21st Century Cures Act which now allows dialysis patients to become enrolled in Medicare Advantage plans. By combining the power of improved data and analytics with personalized care, companies like Strive may be able to change the progression of this very costly chronic disease.


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