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Kidney disease is life-altering for patients and families, complex for providers to treat, and costly for health plans to cover. It doesn’t have to be this way.
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February is American Heart Month and this year the focus is on hypertension, often referred to as high blood pressure. In the U.S., 30.3 million American adults have been diagnosed with heart disease , the leading cause of death in our country—and across the world, for men and women of all races. One of the major risk factors for developing heart disease is hypertension, a condition that affects 33.2%, of Americans aged 20+, and only one in four have the condition under control.
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The costly status quo for end-stage renal disease (ESRD) patients is to automatically send them to in-center dialysis treatment. However, in-home dialysis represents one of the greatest opportunities to improve care, outcomes, member experience, and better manage cost. Healthmap Solutions’ Kidney Health Management (KHM) program guides providers and patients to in-home dialysis treatment. We’re currently working with national, regional, and local health plan clients to increase in-home dialysis adoption among their ERSD patient populations.
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On September 18, the Centers for Medicare & Medicaid Services (CMS) announced it had “finalized the End-Stage Renal Disease (ESRD) Treatment Choices (ETC) Model, to improve or maintain the quality of care and reduce Medicare expenditures for patients with chronic kidney disease. The ETC Model delivers on the Executive Order, “Advancing American Kidney Health” and encourages an increased use of home dialysis and kidney transplants to help improve the quality of life of Medicare beneficiaries with ESRD. The ETC Model will impact approximately 30 percent of kidney care providers and will be implemented on January 1, 2021 at an estimated savings of $23 million over five and a half years”.
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For ESRD patients, in-center dialysis has been the paradigm for dialysis management.. Of the number of newly diagnosed ESRD patients, 33% may have received little to no pre-ESRD nephrology care, and often “crash” into dialysis when renal failure drives them to the ER. For the majority of these patients, who are often unaware of their disease, overwhelmed by their diagnosis, and unaware of their options, in-center dialysis became the only option and today, continues to be the modality of choice.
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The Cures Act opens the door for previously ineligible end-stage renal disease (ESRD) patients to enroll in a Medicare Advantage (MA) plan starting this fall. CMS expects an increase in the number of ESRD MA plan beneficiaries by 63%. ESRD patients are highly-complex and high-cost to care for and treat. MA plans still have time to get ready.
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An alarming trend continues: the number of people living with end-stage renal disease (ESRD) has climbed by approximately 20,000 each year over the past decade. Based on this trajectory, the number is expected to surpass 800,000 this year. This situation risks being exacerbated by the number of COVID-19 Acute Kidney Injury (AKI) survivors who developed renal failure while hospitalized and required emergency dialysis to survive. It’s well established that AKI increases the risk of developing kidney disease. In fact, 31% of people who develop AKI while hospitalized are diagnosed with kidney disease, the precursor to ESRD, within a year of being discharged.
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In June, Yale New Haven Hospital completed one of the largest kidney chain exchanges ever in the U.S, matching nine kidney donors with nine end-stage renal disease (ESRD) patients. This heartwarming story first appeared in the Hartford Courant, highlighting an important, ongoing issue as well as a kidney care innovation. Paired donor transplants, which connect the right kidney patient with the right kidney, are making an impact.
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For ESRD patients, in-center dialysis has been the paradigm for dialysis management.. Of the number of newly diagnosed ESRD patients, 33% may have received little to no pre-ESRD nephrology care, and often “crash” into dialysis when renal failure drives them to the ER. For the majority of these patients, who are often unaware of their disease, overwhelmed by their diagnosis, and unaware of their options, in-center dialysis became the only option and today, continues to be the modality of choice.
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An important news story just broke in Modern Healthcare magazine on a subject we at Healthmap Solutions have been talking about for some time
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