Fresenius Teams with Insurer to Slow Progression of Chronic Kidney Disease

In 2011, Fresenius successfully concluded a 5-year pilot project that showed costs could be lowered with an integrated provider program focusing on patients with chronic kidney disease (CKD). By capturing patients earlier in the course of CKD, the provider of dialysis services and products was able to show noteworthy savings in the project sponsored by the Centers for Medicare & Medicaid Services (CMS).

Now Fresenius and Aetna are bringing the same program to a wider group of patients, beginning in the Northeast and phasing it in to more regions over time.

The CMS pilot project brought in health care costs 12 percent below the Medicare Advantage and 4 percent below Medicare fee-for-service benchmarks for this population, and the hope is that this will continue in the new collaboration. The 1-year and 2-year survival rates were also higher in the groups receiving additional monitoring and care, from California to Connecticut.

Health indicators improved, too. Patients in the program prospered, with clinical measures showing a 24 percent improvement in the mortality rate and a 20 percent reduction in all-cause hospitalization in comparison with national benchmarks.

The new care program is structured to enhance coordination of care among specialists, primary care providers, and nurses. Together, they identify members at risk and improve clinical management in earlier stages of kidney disease to help slow the progression to kidney failure.

The program’s success relies on daily measures from patients coming in through a wireless communication system that lets the care team members identify, make suggestions, or even remotely intervene to prevent complications versus national benchmarks. Other features of the program include expanded management of the various comorbidities such as congestive heart failure and cardiac disease, with particular attention to nutritional status, infection risks, vascular access, and psychosocial needs that affect kidney patients.

The pilot program achieved this expanded patient care by adding personal nurse care managers to work with patients and their care providers on these nondialysis focus areas.

Peter Sauer, president at Fresenius Health Partners, said the collaboration with Aetna fits well with the company’s focus and expertise in comprehensive renal therapy management. “As rates of diabetes, obesity, and heart disease climb and threaten to dramatically increase the incident rates for renal disease, we want to assist payers, doctors, and patients by providing the highest quality and most cost-effective care now,” Sauer said. The hope is that the program will work on a large scale to slow the progression of CKD in patients by catching evidence of the disease early and by “facilitating gentler, less costly transitions to dialysis or pretransplant care,” according to a story about the program launch on the Medical Express site.

“If dialysis becomes necessary, we want to help members begin dialysis with the lowest risk for complications,” said Roger London, MD, Aetna’s Northeast Region medical director. “We believe the model will improve our members’ quality of life by helping them and their doctors better manage the conditions contributing to or resulting from chronic kidney disease.”

March 2012 (Vol. 4, Number 3)