Fresenius Medical Care Sees US Plans for Kidney Disease as Positive
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For Fresenius Medical Care North America (FMCNA), improving health outcomes for patients with renal disease extends far beyond the four walls of our dialysis centers. FMCNA has built an integrated network of people, technology, and resources to deliver patient-centered care in a manner that improves health outcomes and reduces medical costs.
Fresenius Health Partners (FHP) was organized by FMCNA to lead its transformational initiatives in designing and delivering value based care programs for renal disease. FHP now has almost fifty thousand renal patients enrolled in its value based care programs with governmental and private insurance payors, giving FHP a scale and experience unmatched by any other provider of care to renal patients. Combining FMCNA's expertise and one hundred-plus years of experience as the world's leading innovator in kidney care and dialysis products and services with FHP's centralized and in-market care coordination resources, we are at the forefront of renal care management.
Through our high-touch approach, we help renal patients live life to the fullest while managing the rising cost of care.
Today, FHP's payor programs deliver targeted, real-time care coordination services to a health plan's commercial and Medicare Advantage members with chronic kidney disease (CKD) and/or ESRD. These programs improve member health outcomes while reducing the health plan's financial risk for this challenging population. Current FHP clients include Aetna/Coventry, Cigna, and Humana.
ABOUT OUR PAYOR PROGRAMS
As a long-time leader in the development and successful application of value based models of care for chronic needs populations, Fresenius Health Partners focuses on quality to help drive improved health outcomes while reducing the total cost of care.
We place patients at the center of an integrated care team. As part of one of the nation's largest providers of dialysis services, we are uniquely positioned to leverage our advanced analytics—using both clinical data and in-person interactions—to identify health risks and create informed individualized care plans.
Fresenius Health Partners coordinates care for renal patients through a unique value based care model. Unlike most traditional care management programs, our distinct model of care is tailored to suit the needs of the populations we serve through:
NEPHROLOGIST-LED CARE TEAMS
We put the experts at the head of our care team to lead health decisions resulting in better health outcomes.
REAL-TIME MONITORING AND PREDICTIVE RISK MODELING
We monitor clinical data from our dialysis centers in real time while applying predictive risk models to our patient care database to identify early signals of impending hospitalization allowing for timely interventions to reduce the incidence of avoidable inpatient admissions.
24/7 CARE NAVIGATION SUPPORT
Our Care Navigation Unit (CNU), a dedicated team of nurses and care coordinators, provides both remote telephonic and in-market face-to-face interactions with patients, families and caregivers to address the medical, psychosocial, and logistical challenges faced by the CKD/ESRD patients enrolled in our value based care programs. Working as part of the integrated care team, the CNU helps remove barriers to patient care by providing patients with support around transportation, referrals and appointments, palliative care, and behavioral health. Patients also have 24/7 access to the CNU to answer their questions and get the help they need.
Preemptive and time-of-need interventions are dual-focused to provide solutions for immediate needs while addressing underlying, long-term issues that can impact health outcomes. We are constantly measuring and fine-tuning our interventions based upon well-established metrics to optimize their impact on our patients and their contribution to our program objectives.
FOCUS ON CARE TRANSITIONS—BOTH AT TIME OF ADMISSION AND AT DISCHARGE
With technology-enabled early identification of patients presenting to the emergency room, the CNU is able to engage hospital staff and the patient care team to coordinate outpatient treatment options, reducing avoidable hospital admissions. Our programs engage with our patients' nephrologists to assist with transition of care plans upon discharge to reduce readmission rates, which are much higher with the ESRD population than the general population.
Improving quality of life extends beyond dialysis, so we have built an integrated network of people, technology, and resources focused on delivering the right care to patients.
BILL VALLE, CEO, FRESENIUS MEDICAL CARE NORTH AMERICA
With a one hundred-plus-year history as care innovators, we're never satisfied with the status quo when it comes to patient care. Using our Clinical Innovations Lab, we can vet, pilot, and optimize interventions for our high-risk patient population. Using a robust data platform, we determine which interventions are most likely to create value where value = quality/cost. These interventions are then piloted and, if successful, scaled for our patient populations.
The transition from late stage CKD to ESRD is often marked by fragmented care, leaving patients vulnerable and resulting in a total cost of care during the first ninety days of dialysis that is 45 percent higher than that of the prevalent dialysis population. To address this critical period of care, Fresenius Health Partners offers a comprehensive Transition Management Program. Through the analysis of claims and lab data, we identify later stage CKD patients (Stages 3b, 4, and 5) most likely to progress to ESRD and then: