Fresenius Medical Care North America (FMCNA), a division of Fresenius Medical Care, has been busy forming partnerships with national insurers. FMCNA announced a partnership in March 2017 with Humana Inc. with plans for a new program to improve care and health outcomes for Humana’s members with end stage renal disease (ESRD). In February 2017, FMCNA announced a partnership with Cigna in a national program to lower the cost and improve quality of care for people with ESRD who are undergoing dialysis.
Under the program with Humana, FMCNA will implement its proprietary care coordination model. Each patient will be supported by a collaborative team of local nephrologists and clinicians working in partnership with the Care Navigation Unit (CNU), FMCNA’s group of specialized nurses and service coordinators who provide 24/7 care coordination services. By focusing on the physical and emotional needs of each patient, the CNU aims to foresee issues before they arise and to help patients, their families, and their providers respond as conditions change.
“Through this partnership, we will positively impact the overall medical care of Humana’s ESRD members who receive treatment within our dialysis centers, and it’s our responsibility to ensure they can access the care they need, when they need it,” said William McKinney, president of FMCNA’s Integrated Care Group.
In the new Cigna partnership, FMCNA will continue to be paid for the kidney dialysis services it provides to its Cigna patients, while its affiliate, Fresenius Health Partners, will assume separate responsibility for providing management of medical costs and improving patient outcomes.
Implementing its proprietary care coordination model for this purpose, FMCNA may be eligible for additional reimbursement if it achieves such goals, the company noted in an announcement. The dialysis clinics must maintain or improve their star ratings within parameters set by the Centers for Medicare & Medicaid Services (CMS) in its Dialysis Facility Compare (DFC) quality rating. Cigna will evaluate outcomes for a number of quality measures that correlate directly to the total cost of care and overall patient experience.
One of the program’s goals is to reduce emergency room use and hospital admission for dialysis by keeping patients healthier and providing them with additional access to dialysis at Fresenius Kidney Care outpatient facilities as needed, Fresenius announced.
