3 Kidney-Care Giants to Merge

WALTHAM & CAMBRIDGE, Mass. (March 22, 2022)—Fresenius Medical Care, a provider of products and services for individuals with kidney diseases, InterWell Health, a physician organization driving innovation in the kidney care industry, and Cricket Health, a provider of value-based kidney care with an industry-leading patient engagement and data platform, announced that they have entered into a definitive agreement to create an independent new company. The transformative deal brings together InterWell Health’s strong network of more than 1,600 nephrologists, Cricket Health’s technology-enabled care model and patient engagement platform and the expertise in value-based kidney care contracting of Fresenius Health Partners, the value based care division of Fresenius Medical Care North America, to create an innovative, stand-alone entity poised to transform kidney care.

The new organization is valued at $2.4 billion and will operate under the InterWell Health brand. With a total addressable market of $170 billion, more than $6 billion of medical costs under management and more 100,000 covered lives, the new company will accelerate growth in the mid- and late-stage chronic kidney disease value-based care population and will build upon a strong foundation of success to accelerate the transformation of kidney care. By 2025, the company expects to engage and manage the care of more than 270,000 Americans living with kidney disease, increasing its medical costs under management to $11 billion.

The new company expects to set the standard in value-based kidney care, with the goal of improving patients’ lives and reducing costs to public and private payers, health systems and all others that take risk for this vulnerable, complex and costly patient population. The new InterWell Health will drive the health care industry to increase transparency and accountability and will be uniquely positioned to lead the way in transforming kidney care with its focus on covered lives, medical costs under management, and clinical and patient-reported outcomes. By holding itself to the highest standards, the new InterWell Health expects to improve patients’ quality of life through reduced hospital admissions and readmissions, slower disease progression, increased transplant referrals and rates, accelerated transition to home dialysis and improved health equity.

“The new InterWell Health will bring together physicians, care management teams, and providers to ensure we show up as one team and provide the best possible experience for the patients who entrust us with their care,” said Bill Valle, CEO of care delivery for Fresenius Medical Care in a press release. “Cricket Health’s predictive analytics and patient engagement platform combined with the physician-led clinical approach of InterWell Health and Fresenius Health Partners’ experience and expertise in value-based care will position the organization for accelerated growth.”

The company will benefit from the integration of Cricket Health’s StageSmart machine learning and predictive glomerular filtration rate (GFR) model (known as pGFRTM). This transformative technology will enable the combined entity to identify and risk stratify patients prior to kidney failure with 96% accuracy, helping slow disease progression and giving patients the time necessary to choose a treatment option that is right for them. Through Cricket’s proprietary web-based patient engagement platform, the new company will be able to grow its operations across the U.S., providing patients with a deeply immersive and transformative experience with their care teams. The predictive analytics model and patient engagement platform meet the highest standards for information security, having earned Certified status by HITRUST1.

“At Cricket Health, our mission is to help our patients live their best lives. This combination advances our ability to do just that,” said Cricket Health CEO, Robert Sepucha in a press release. “Each patient’s situation and needs are unique, and the new organization will offer groundbreaking solutions from machine learning to highly personalized engagement that keep patients healthy, at home, and out of the hospital.”

InterWell Health was formed in 2019 as a partnership with nephrologists dedicated to driving value and innovation for chronic kidney patients in the U.S. This high-performing physician network provides individualized care to patients across the full spectrum of kidney disease—before and after kidney failure—including comprehensive 24/7 patient support service and access to the National Committee for Quality Assurance-accredited KidneyCare:365 CKD program. The new entity will expand the support physicians need to elevate the way they practice medicine. By closely aligning workflows and providing the data, education, and care management resources necessary to succeed in a value-based world, the new InterWell Health will work with practices to develop and implement care models specific to their community, as well as help them contract with national payers.

“The big beneficiaries here are patients, through the strengthened relationships created with their physicians. Recognizing that nephrologists are the constant in an otherwise fragmented care delivery system, our goal is to further enhance the support to physician practices, giving them even greater opportunities to focus on what matters most—patient care,” said co-Chief Medical Officer of InterWell Health, Dr. George Hart. “Patients will be empowered to identify issues and better manage their disease progression well before the onset of kidney failure.”

The new InterWell Health will be separate from Fresenius Medical Care, with the benefit of the company’s experience, expertise, resource, and services. With the financial and strategic support of leading investors, including: Valtruis, a WCAS company; Oak HC/FT; Cigna Ventures; and Blue Shield of California, the new company will have the financial flexibility to make further investments to strategically grow and explore adjacent value-based care opportunities.

The management team for the new InterWell Health will include Robert Sepucha, chief executive officer; David Pollack, president and chief operating officer; and George Hart, M.D., chief medical officer.

Approvals
The transaction has been approved by the Supervisory Board of Fresenius Medical Care Management AG, the InterWell Health Board of Directors, and the Cricket Health Board of Directors. The closing of the transaction is subject to regulatory review. Depending on the progress of such review, the company currently anticipates the transaction could close in the second half of 2022.

Advisors
Piper Sandler & Co. served as financial advisor and Cleary Gottlieb Steen & Hamilton LLP served as legal counsel to Fresenius Medical Care. Ernst & Young Capital Advisors, LLC served as financial advisor and Goodwin Procter LLP served as legal counsel to InterWell Health. Barclays served as financial advisor and Perkins Coie LLP served as legal counsel to Cricket Health. Ropes & Gray served as legal counsel to Valtruis and WCAS.

Visit fmcna.com, interwellhealth.com and crickethealth.com for more information.