TY - JOUR
AU - J. A. Vassalotti
AU - R. DeVinney
AU - S. Lukasik
AU - S. McNaney
AU - E. Montgomery
AU - C. Voss
AU - D. Winn
A1 - 
AB - OBJECTIVES: To execute a chronic kidney disease (CKD) intervention to assess feasibility and preliminary outcomes for a health plan. STUDY DESIGN: This CKD quality improvement study was incorporated into an existing CareFirst primary care patient-centered medical home cohort with a pre- and postintervention assessment from July 1, 2015, to June 30, 2017. METHODS: The study targeted the population at risk for CKD with diabetes and/or hypertension by implementing a care plan according to the stratification by estimated glomerular filtration rate (eGFR) and urinary albumin-creatinine ratio (uACR) or CKD heat map class. RESULTS: The population included 7420 individuals (51.8% female) with a mean age of 55.9 years; 19.1% had diabetes only, 42.2% had hypertension only, and 38.2% had both conditions. Overall, there was no change in eGFR testing among risk groups (84.8%), but a small significant increase in uACR testing occurred (from 31.3% to 33.0%; P = .0020). Reductions in admissions per 1000 patients were from 362.5 to 249.0 for class 3, 311.7 to 219.2 for class 4, and 590.9 to 323.5 for class 5. Lastly, there were reductions in 30-day readmissions per 1000 patients, from 51.9 to 13.7 for class 4 and 45.5 to 0 for class 5. Although there were increases in many of the per-member per-month costs assessed pre- versus post intervention, net savings in medical costs were $276.80 and $480.79 for CKD classes 3 and 5, respectively. CONCLUSIONS: This scalable CKD intervention demonstrated feasibility. For advanced CKD, decreased hospitalization and a reduction in several important costs were observed. These preliminary results support the stratification of laboratory data for CKD population health innovation in commercial health plans.
AD - National Kidney Foundation, 30 E 33rd St, New York, NY 10016. Email: joseph.vassalotti@mssm.edu.
BT - The American Journal of Managed Care
C5 - Financing & Sustainability; Medical Home
CP - 11
CY - United States
IS - 11
JF - The American Journal of Managed Care
M1 - Journal Article
N2 - OBJECTIVES: To execute a chronic kidney disease (CKD) intervention to assess feasibility and preliminary outcomes for a health plan. STUDY DESIGN: This CKD quality improvement study was incorporated into an existing CareFirst primary care patient-centered medical home cohort with a pre- and postintervention assessment from July 1, 2015, to June 30, 2017. METHODS: The study targeted the population at risk for CKD with diabetes and/or hypertension by implementing a care plan according to the stratification by estimated glomerular filtration rate (eGFR) and urinary albumin-creatinine ratio (uACR) or CKD heat map class. RESULTS: The population included 7420 individuals (51.8% female) with a mean age of 55.9 years; 19.1% had diabetes only, 42.2% had hypertension only, and 38.2% had both conditions. Overall, there was no change in eGFR testing among risk groups (84.8%), but a small significant increase in uACR testing occurred (from 31.3% to 33.0%; P = .0020). Reductions in admissions per 1000 patients were from 362.5 to 249.0 for class 3, 311.7 to 219.2 for class 4, and 590.9 to 323.5 for class 5. Lastly, there were reductions in 30-day readmissions per 1000 patients, from 51.9 to 13.7 for class 4 and 45.5 to 0 for class 5. Although there were increases in many of the per-member per-month costs assessed pre- versus post intervention, net savings in medical costs were $276.80 and $480.79 for CKD classes 3 and 5, respectively. CONCLUSIONS: This scalable CKD intervention demonstrated feasibility. For advanced CKD, decreased hospitalization and a reduction in several important costs were observed. These preliminary results support the stratification of laboratory data for CKD population health innovation in commercial health plans.
PP - United States
PY - 2019
SN - 1936-2692; 1088-0224
SP - e326
EP - e333
EP - 
T1 - CKD quality improvement intervention with PCMH integration: health plan results
T2 - The American Journal of Managed Care
TI - CKD quality improvement intervention with PCMH integration: health plan results
U1 - Financing & Sustainability; Medical Home
U2 - 31747237
VL - 25
VO - 1936-2692; 1088-0224
Y1 - 2019
Y2 - Nov 1
ER -