The Rising Tide of Home-Based Kidney Care

The healthcare industry is undergoing a fundamental transformation, with an increasing emphasis on delivering care directly to patients’ homes. This shift is particularly pronounced in the realm of kidney care, where in-home options, while currently utilized by only 14% of dialysis patients as of 2024, are gaining traction among both payers and patients. The Elara Caring deal underscores this trend, demonstrating the growing recognition of home health providers as crucial partners in expanding access to specialized kidney care.

DaVita’s involvement is particularly noteworthy. As a leading kidney care provider, their investment signifies a strategic bet on the future of in-home care. This isn’t simply a financial transaction; it’s a validation of the potential for home-based models to improve patient outcomes, reduce costs, and enhance the overall quality of life for individuals with kidney disease. Ares’ participation further solidifies this outlook, bringing substantial financial expertise and a track record of successful healthcare investments to the table.

Elara Caring’s Strategic Expansion

Elara Caring, under the leadership of CEO Ananth Mohan, has consistently expressed a commitment to growth through strategic acquisitions. Mohan previously stated that the company anticipates an increase in mergers and acquisitions, believing that smaller agencies will recognize the benefits of joining their platform. “I see [M&A] increasingly in our future,” Mohan said in July 2025. This ambition is now poised to accelerate with the backing of Ares and DaVita, enabling Elara Caring to pursue a multi-pronged strategy encompassing clinical innovation, reimbursement optimization, and aggressive expansion through M&A.

A key focus of this strategy will be the development of a specialized kidney-focused home-based care model. Leveraging Elara Caring’s clinical capabilities and DaVita’s deep expertise in kidney disease management, the program aims to reduce hospitalizations and lower the total cost of care. Steve Phillips, DaVita’s chief strategy officer, emphasized the potential impact, stating, “Strengthening access to Elara Caring’s exceptional services will help more patients maintain stability at home, avoid unnecessary hospitalizations, and ultimately experience a better quality of life.”

Beyond Dialysis: The Broader In-Home Kidney Care Landscape

While the prospect of in-home dialysis is often the first thought when discussing home-based kidney care, the opportunity extends far beyond. Patients with kidney disease frequently experience a range of co-morbidities, requiring comprehensive care that includes wound management, medication adherence support, and nutritional counseling. This is where home health providers like Elara Caring can play a critical role, offering a holistic approach to care that addresses the diverse needs of this patient population.

Several other players are also making significant strides in this space. CVS began clinical trials for a home hemodialysis system in 2019, with studies continuing into 2025. Furthermore, the U.S. Department of Health and Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS) proposed new payment models in 2019 designed to incentivize the adoption of in-home dialysis. The Improving Access to Home Dialysis Act, introduced in 2024, further demonstrates the growing bipartisan support for expanding access to home-based kidney care.

Companies like Somatus, which has raised over $500 million, and Monogram Health, with over $542 million in funding according to Tracxn, are demonstrating the viability of value-based, home-focused care models. Mike Uchrin, CEO of Monogram Health, previously highlighted the need for clinically integrated partnerships with home health companies, emphasizing the importance of skilled nursing care for managing co-morbidities like wounds. “We need clinically integrated partnerships with home health companies,” Uchrin told HHCN.

What role will regulatory scrutiny play in shaping these partnerships? The increasing consolidation within the healthcare industry, including the acquisitions of LHC Group and Amedisys by UnitedHealth Group, has drawn the attention of the Federal Trade Commission (FTC), which is probing noncompete provisions at DaVita and Fresenius. Will this increased scrutiny impact the Elara Caring/DaVita partnership, or will the benefits of expanded in-home care outweigh antitrust concerns?

Did You Know? The shift towards value-based care is a major driver of the growth in home-based kidney care, as payers increasingly seek to reward providers for improving patient outcomes and reducing costs.

Frequently Asked Questions About In-Home Kidney Care

• What is the primary benefit of in-home kidney care? In-home kidney care offers patients greater convenience, improved quality of life, and potentially better health outcomes by allowing them to receive care in the comfort of their own homes.
• How does the Elara Caring and DaVita partnership impact the future of kidney care? This partnership signals a growing trend of collaboration between home health providers and specialized kidney care companies, paving the way for more integrated and comprehensive care models.
• What percentage of dialysis patients currently receive care at home? As of 2024, approximately 14% of patients on dialysis utilize at-home options, highlighting the significant opportunity for growth in this area.
• What role does federal legislation play in expanding access to in-home dialysis? Legislation like the Improving Access to Home Dialysis Act aims to provide patients with the necessary training and support to safely dialyze at home, increasing access to this valuable care option.
• Are there concerns about antitrust implications related to the DaVita and Elara Caring deal? The increasing consolidation in the healthcare industry is attracting scrutiny from regulators like the FTC, and the Elara Caring deal may be subject to review to ensure it does not stifle competition.