Health IT

Population health business aimed at IBD patients SonarMD is hunting for a CEO

Chicago-based gastroenterologist Larry Kosinski of the Illinois Gastroenterology Group is excited by the prospects for SonarMD, the population health company he founded and for which he serves as Chief Medical Officer. 

Chicago-based gastroenterologist Larry Kosinski of the Illinois Gastroenterology Group is excited by the prospects for SonarMD, the population health company he founded and for which he serves as Chief Medical Officer. He led the development of the clinical decision support and patient engagement tools that evolved from a project he embarked on with IGG and Blue Cross Blue Shield of Illinois to reduce costs associated with complications from Inflammatory Bowel diseases such as Crohn’s disease. Now the company is poised for expansion.

Last year the Physician-Focused Payment Model Technical Advisory Committee (PTAC) recommended SonarMD’s proposal for limited-scale testing of its intensive medical home alternative payment model for Project Sonar, the first specialty APM for patients with Crohn’s disease and ulcerative colitis, as part of MACRA. It is still awaiting approval by the Centers for Medicare and Medicaid Services. The company is also on the hunt for a CEO, Kosinski noted in a phone interview.

Here’s how Project Sonar would work under the proposed APM. Patients would participate in an enrollment visit with a nurse care manager, be contacted (pinged) at least once per month on their smartphone or another device and submit self-assessment data. Responses to the questions are coded into a symptom or “Sonar Score.” A nurse care manager calls the patient if a score is poor, and enters information about the patient’s status into electronic health records—  contacting a physician when necessary.

The nurse care manager would follow up if the data indicated a potential health problem that required intervention. If necessary, the nurse would contact a specialist physician. The model uses a communications platform, electronic health records, clinical algorithms, clinical decision support tools, and predictive analytics to support these activities, according to the HHS website for the assistant secretary for planning and evaluation.

The model calls for practices to receive a supplemental per-member, per-month care management payment for each attributed/enrolled patient, and a shared savings payment at the end of each study period.

SonarMD also has been working with pharma companies. A collaboration with drug developer Allergan will apply Sonar’s technology to patients with irritable bowel syndrome with diarrhea. The goal is to improve diagnosis and effective use of treatment options to manage IBS-D in clinical practice. The collaboration was spotlighted at the Eye for Pharma conference in Philadelphia last week.

Takeda Pharmaceutical has also funded studies of Project Sonar. A two-year study of 183 Crohn’s disease patients enrolled in Project Sonar compared with 273 Crohn’s disease patients in a control group showed that reductions in emergency department visits and hospitalization costs led to cost savings of more than $10 per member, per month for the Project Sonar patients.

Through SonarMD, which is backed by Arboretum Ventures and Blue Cross Blue Shield Venture Partners, Kosinski is trying to change the way doctors in his field make money by making practices less dependent on procedures such as colonoscopies and other tests, which account for a sizeable portion of revenue. Crohn’s disease and ulcerative colitis can be expensive conditions to treat as they are associated with high morbidity, with complications such as bowel obstructions and fistulas that require hospitalization. Instead, Kosinki, IGG, and Blue Cross Blue Shield of Illinois have developed a business that seeks to improve disease management and support the shift to value-based care.

A key component in the development of SonarMD was data. In response to a query to Blue Cross Blue Shield of Illinois, he acquired claims data on 21,000 patients with inflammatory bowel disease, an autoimmune disease, over a two-year period from all over the state. As he poured through the data, Kosinski found a connection between patients with the condition who were hospitalized and lack of contact with a physician for more than 30 days. The data also revealed that the insurer’s average IBD spend is $22,000 per commercial patient, per year for Crohn’s disease, much of it spent on inpatient treatment and complications of this condition.

Blue Cross Blue Shield of Illinois plans to deploy the Project Sonar model at other gastroenterology practices around the state.