Understanding Integrated CKD and ESRD Programs

Patients with Chronic Kidney Disease (CKD) and End-Stage Renal Disease (ESRD) are continuously faced with increasing costs and demanding treatment plans that make treatment an overwhelming experience. This becomes more difficult when a patient has to deal with different physicians from different facilities who do not have the means to communicate with each other concerning a patient effectively.

The transition from one healthcare to another is costly for kidney patients and may result in poor health outcomes. The progression of patients from the advanced CKD stage to ESKD is also linked to clinical instability and prolonged hospitalization. The move from one health facility to another as a patient seeks medical attention for different conditions also presents a risk of delayed treatment in a situation requiring immediate attention. These challenges present the need for coordinated care to help improve patient care quality.

Luckily, the introduction of integrated care that offers a holistic approach by considering various factors that make up treatment plans for kidney care is a promising solution. The integrated care model is based on value-based care where a healthcare provider is paid as per the patient outcome rather than how many services were administered. It also involves addressing a patient’s healthcare needs in one place and offering a better patient experience as it saves them from the logistics burden and offers coordinated care.

The integrated care is a welcome move considering that patients with advanced CKD also experience co-morbid (additional conditions) diseases, such as diabetes and cardiovascular diseases, that require treatment, adding to an already mentally and physically stressful treatment plan. Each disease requires a patient to visit different doctors and even have several care plans. The needs for End-Stage Renal Disease (ESRD) patients are even more complex as they also require frequent dialysis treatments to sustain life.

However, with integrated care, disease management becomes convenient. A good example of an integrated program for patients with kidney failure is the ESRD Seamless Care Organization (ESCO), a model whereby Medicare assigns a patient to an ESCO based on facilities where they go for dialysis. ESCO takes responsibility for all treatment costs for an ESRD patient. The ESCOs are part of the Comprehensive ESRD Care Model established to develop better ways to improve the care given to patients under Medicare.

Aside from ensuring reduced cost for healthcare costs, integrated kidney care serves to educate the patients on treatment options and other related information, helps avoid unnecessary hospitalization, and helps to lower the rate of unplanned dialysis starts. This has been made possible through actionable data analytics that physicians can use to make better-informed decisions when handling patients.

Since an integrated care model addresses the needs of the kidney patients in one location and reduces the logistics burden, a patient will receive quick care and hence better health outcome. Through integrated care, it is possible to maintain continuity and consistency in-inpatient medical records making it possible to track patient treatment and progress, which improves the overall patient experience.

Whereas traditional fee-based services may lead to prolonged treatments as physicians seek to maximize payments, integrated care focuses on the outcome of a service. Thus, combining integrated care with value-based care contributes to innovative solutions specific to different patient needs.

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