A study published in the November issue of The American Journal of Managed Care® provides evidence from an intervention for chronic kidney disease (CKD), explained lead author Joseph Vassalotti, MD, clinical professor at Icahn School of Medicine at Mount Sinai and chief medical officer of the National Kidney Foundation.
A study published in the November issue of The American Journal of Managed Care® (AJMC®) provides evidence from an intervention for chronic kidney disease (CKD), explained lead author Joseph Vassalotti, MD, clinical professor at Icahn School of Medicine at Mount Sinai and chief medical officer of the National Kidney Foundation.
Transcript
What were the findings of your recent AJMC® study on a health plan’s CKD intervention?
The study showed a population health, simple, scalable intervention for chronic kidney disease among people with diabetes and/or hypertension, showed reduction in hospitalizations and readmission and selected cost containment. So we’re really excited that this short-term 2-year study with a pre- and post design showed benefits in chronic kidney disease population health intervention.
Which aspects of the intervention do you think had the greatest effect on outcomes?
The study was designed to incorporate both the blood and urine testing for kidney disease, the estimated GFR [glomerular filtration rate] and the urine albumin-to-creatinine ratio tests, so those are tests of kidney function and kidney damage, and by defining kidney disease according to those tests and stratifying the risk at 5 different levels, we were able to employ a population health that was scaled to the severity of disease in a patient-centered medical home with CareFirst Blue Cross Blue Shield in Maryland.
Why was the intervention successful? So certainly the risk stratification informing the interventions is probably the most important aspect of the study to emphasize. It wasn’t just the kidney function, it was the kidney function by the estimated GFR with the urine albumin-to-creatinine ratio together, and a layered intervention that increased as the severity of the disease increased. The other important aspect of the study was that we did increase the use of medical nutrition therapy for the patients with chronic kidney disease, which is impactful.
And then we allocated the nephrology services in a way that was more consistent with the heat map class, or the severity of the disease. For example, the patients with class 5 on the heat map which are the most severe at risk for adverse events, in the preintervention year, 63% of the patients saw a nephrologist, and the ones that saw a nephrologist saw a nephrologist quarterly. In the postintervention year, 83% of the patients with CKD class 5 saw a nephrologist, and they saw a nephrologist, on average, monthly. So we had intensification of nephrology services for the patients with the most advanced disease, and we didn’t have any increase in nephrology services for patients with lower classes or lower severity of CKD. So, we allocated a finite resource, nephrology services, according to the risk stratification.
ATS 2024: Bridging the Past, Present, and Future of Respiratory Care
May 16th 2024The application of artificial intelligence in medicine is anticipated as a highlight of ATS 2024, with sessions exploring its applications in research, radiological interpretation, and pediatric pulmonology.
Read More
The Importance of Examining and Preventing Atrial Fibrillation
August 29th 2023At this year’s American Society for Preventive Cardiology Congress on CVD Prevention, Emelia J. Benjamin, MD, ScM, delivered the Honorary Fellow Award Lecture, “The Imperative to Focus on the Prevention of Atrial Fibrillation,” as the recipient of this year’s Honorary Fellow of the American Society for Preventive Cardiology award.
Listen
Looking Back on ISPOR 2024: Hot Policy Topics, Welcome Focus on Employers, and More
May 10th 2024Kimberly Westrich, MA, chief strategy officer of the National Pharmaceutical Council, reflects on the most valuable learnings from the 2024 meeting of ISPOR—The Professional Society for Health Economics and Outcomes Research, including lively discussions of the Inflation Reduction Act and workshops on value assessment.
Read More
Promoting Equity in Public Health: Policy, Investment, and Community Engagement Solutions
June 28th 2022On this episode of Managed Care Cast, we speak with Georges C. Benjamin, MD, executive director of the American Public Health Association, on the core takeaways of his keynote session at AHIP 2022 on public health policy and other solutions to promote equitable health and well-being.
Listen
Posters Characterize DMD Caregiver Experiences, Impact of Gene Therapy on Caregiving Demands
May 10th 2024Posters presented at the ISPOR—The Professional Society for Health Economics and Outcomes Research meeting explored Duchenne muscular dystrophy (DMD) caregiver experiences and gene therapy’s impact on work opportunities for caregivers.
Read More
A Focus on Women: AUA Best Posters Highlight Female Athletes, Prenatal Care, and Women in Urology
May 9th 2024Three posters from the American Urological Association (AUA) 2024 Annual Meeting focused on urinary incontinence in female athletes, prenatal care for fetuses with spina bifida in California, and the experiences of women residents at the Brady Urological Institute.
Read More