Dr Joseph Vassalotti on How Risk Stratification Informed a Primary Care CKD Intervention

Population health screening involves risk stratification that allows interventions to be targeted to appropriate patients, as was demonstrated in a study of a chronic kidney disease (CKD) intervention published in the November issue of The American Journal of Managed Care^®, said 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 is the importance of CKD screening and detection for population health?

One of the most important things for population health screening is to not only stratify the risk, but also stratify the interventions accordingly. We stratified the interventions including things like risk factor control for diabetes, medical nutrition therapy for diabetes and hypertension, pharmacist evaluation for drug safety interactions, dose adjustment for reduced kidney function, and nephrology consultation for advanced disease, as well as preparation for kidney replacement therapy. All of those were incorporated in a stepwise fashion into the patient-centered medical home population. There was an incentive for the primary care clinician that was upside only to meet cost containment, to meet some quality improvement measures that included both diabetes and hypertension management as well as kidney disease management.