NASHVILLE, Tenn., June 25,
2024 /PRNewswire/ -- Evergreen Nephrology is
proud to announce the publication of a pivotal study in The
American Journal of Managed Care (AJMC), introducing a new
category for chronic kidney disease (CKD) management called "CKD
3-Plus." This groundbreaking research highlights the importance of
earlier nephrology intervention and expands access to
value-based-care (VBC) models for individuals living with kidney
disease.
Significance of the Research
CKD affects approximately 15% of adults in the United States, and its prevalence is
expected to rise as the population ages and risk factors like
diabetes continue to expand. Nephrology intervention often begins
at CKD stage 4, if not later. However, this research identifies a
subset of CKD stage 3 patients, termed "CKD 3-Plus," who exhibit
disease progression and healthcare costs similar to those in later
stages of CKD.
Representing approximately 35% of Original Medicare
beneficiaries with CKD stage 3, the CKD 3-Plus category represents
a significant expansion of the population who would benefit from
nephrology intervention. As a value-based-care provider, Evergreen
knows engaging people earlier in their disease progression provides
the best opportunity to slow disease progression and improve health
outcomes.
Key Findings:
- Identification of High-Risk Patients: The study
identified that Medicare beneficiaries with CKD stage 3 and at
least one of seven selected comorbidities (CKD 3-plus) represented
35.4% of all CKD stage 3 patients. This cohort had cost and
utilization patterns more akin to CKD stages 4 and 5, with
significantly higher medical costs and rates of disease
progression, suggesting they may benefit from the services commonly
available only to people with more advanced stages of kidney
disease.
- Cost and Utilization Patterns: CKD 3-plus patients
incurred medical costs averaging $3,877 per member per month (PMPM), compared to
$1,145 PMPM for other CKD stage 3
patients. They also had five times the amount of acute inpatient
medical costs and admissions compared to their counterparts without
the selected comorbidities, presenting an opportunity to reduce
costs for both patients and the healthcare system broadly.
- Disease Progression: The CKD 3-plus cohort had a higher
likelihood of progressing to end-stage kidney disease (ESKD) or
death, with 40.4% experiencing such progression during the study
period, compared to only 9.1% of other CKD stage 3 patients,
demonstrating the need for kidney-focused interventions to provide
them the best opportunity to receive a transplant or begin dialysis
outside of a hospital, ideally with home dialysis.
Expanding Access to Value-Based-Care Models
The findings underscore the necessity of including CKD 3-plus
patients in VBC models, such as the Comprehensive Kidney Care
Contracting (CKCC) model from the Center for Medicare and Medicaid
Innovation, in addition to Medicare Advantage plans.
By identifying and managing high-risk patients earlier,
value-based enablers like Evergreen and their associated
nephrologists can improve outcomes, drive more home dialysis, and
increase the number of transplants, ultimately reducing healthcare
expenditures.
Ultimately value-based models improve the lives of Evergreen
patients like John. "For the first time in 50 years I was able to
really share my experience with CKD and have someone listen," John
explained. "I have a sense of hope for the first time in a long
time that there's someone who cares."
Collaboration with AJMC
The authors extend their gratitude to The American Journal of
Managed Care and its expert reviewers for their collaboration
in bringing this crucial research to publication.
About Evergreen Nephrology
Evergreen Nephrology takes a patient-centric approach to kidney
care. In collaboration with our nephrologist partners, along with
Medicare and health insurance companies in value-based
arrangements, Evergreen fosters a holistic-care experience for
individuals living with kidney disease by empowering them through
shared decision-making to take an active role in their own health.
With over 750 provider partners serving patients across 24 states,
Evergreen is making personalized, physician-led care the national
standard for kidney care. Learn more about our efforts to advance
value-based care and personalized treatment for kidney disease at
EvergreenNephrology.com
The American Journal of Managed Care
The American Journal of Managed Care (AJMC) is a peer-reviewed,
multidisciplinary journal dedicated to advancing healthcare
delivery and outcomes through comprehensive coverage of the latest
research and trends in managed care. Since its inception in 1995,
AJMC has been a leading source of cutting-edge information for
healthcare professionals, policymakers, and researchers. The
journal publishes original research, reviews, and commentary on
topics including healthcare policy, clinical care, and economic
outcomes, with a strong emphasis on value-based care and
patient-centered management. AJMC is committed to fostering the
exchange of knowledge and best practices to improve the quality and
efficiency of healthcare delivery.
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SOURCE Evergreen Nephrology