Bending the Cost Curve in End-Stage Kidney Disease (ESKD) with Former HHS Deputy Secretary, Eric Hargan and Alio CEO, David Kuraguntla

Webinar Recap & Summary


On 12 July, 2022, Alio sponsored an AHIP webinar, Bending the Cost Curve in End-Stage Kidney Disease (ESKD), covering the scope and scale of the ESKD challenge, shifts in the healthcare landscape that have contributed to forward momentum, and solutions for a brighter future where ESKD is better managed and a lower cost.


At present there are more than 37 million people in the United States living with Chronic Kidney Disease (CKD). It’s not only an under-diagnosed disease but also one which progresses quickly. According to the US Renal Data System and University of Penn Medicine at least 2.3% or 21,000 people progress from CKD to ESKD every year. Simply put, with 37 million Americans already living with CKD, and almost 150,000 new patients starting dialysis each year, it’s a costly challenge that’s rapidly increasing in prevalence without commensurate evolution in infrastructure which would allow us to manage dialysis patients effectively at scale.


Former Deputy Secretary Hargan called out some of the significant shifts that have happened in the policy and disease management space that have led to forward momentum in rethinking how we address the disease. During the webinar he shared six critical shifts that have propelled the evolution in ESKD management:

  • AAKHI Executive Order – mandating increased home dialysis and RPM, with a goal of 80% of new ESRD patients in 2025 receiving dialysis at home or a transplant
  • CMS established ESKD Treatment Choice model – with payment codes to encourage home dialysis and better patient-centered care
    • High demand in Medicare Advantage plans – for devices that improve patient outcomes and business economics ~50% of patients now in Value-Based Care
    • KidneyX launch: a public private partnership (PPP) between HHS & ASN focused on accelerating innovation in the prevention, diagnosis, and treatment of kidney diseases
    • HHS hosted its first Innovation & Investment Summit – the event included top investors & innovators in the US. A main topic was incentivizing innovation in the kidney space.
  • Updates on remote patient monitoring (RPM) & telemedicine coding and reimbursement – opening pathways for reimbursement provides improved access to innovative solutions for dialysis patients and clinicians.


Former Deputy Secretary Hargan noted the last three shifts were primarily focused around driving and fostering innovation in kidney care. The launch of Kidney X in particular drew significant attention to the need for more entrepreneurs and funding in the ESKD space. Forward-thinking and patient-centric solutions like Alio have emerged and thrived with this type of PPP support. The increasingly high number of avoidable hospitalizations for patients on dialysis only further reinforced that intermittent monitoring is not enough to enable and empower patients to live their healthiest lives.


David Kuraguntla, Alio CEO and Co-founder, shared information on the power of remote patient monitoring solutions and their ability to better serve dialysis patients, focusing on the importance of purpose built technology that fits seamlessly into the patient’s life. Off the shelf smart watches or health and fitness trackers are not sufficient to manage and monitor the complex care needs of a dialysis patient. Kuraguntla shared additional details about the key metrics the Alio SmartPatch is able to monitor while relaying data to care teams which enable timely interventions before adverse health events can occur.


Alio has already received FDA clearance for basic vitals and Kuraguntla shared information about upcoming metrics and clearances that Alio intends to pursue including noninvasive monitoring of hemoglobin, hematocrit, and potassium. Receiving these clearances would be a significant improvement – both in speed and accuracy –  to the status quo which is a monthly in-clinic blood draw.


If you were unable to join yesterday’s webinar, you may find a link to watch the event at