Managing Full Risk for ESRD Patients: What We Learned in Managing a Medicare Advantage C-SNP
VillageHealth®, in collaboration with a health plan partner, developed the first of our Medicare Advantage ESRD Chronic Special Needs Plans (C-SNPs) in Southern California. Under this arrangement, we have full financial risk for a population of ESRD patients receiving dialysis in San Bernardino and Riverside, California. This program started as a Medicare demonstration project in 2006 before transitioning to an ESRD C-SNP in 2011. Following eight years of investment and program evolution, we have achieved success with a nearly $8,000 per-member per-year savings, an average hospitalization rate 26 percent lower than the national average, and a top-three patient satisfaction rating across all 30 California C-SNP plans since 2013.
How Highmark Is Achieving the Triple Aim for ESRD Patients
Highmark, a large Blue Cross Blue Shield-affiliated company headquartered in Pittsburgh, recognized that achieving the Triple Aim for their renal patients, one of their most medically complex outlier populations, would be nearly impossible with a traditional care management approach. In partnership with VillageHealth, Highmark has improved ESRD patient quality of care, enhanced patient quality of life, and achieved 18 percent addressable cost savings.
To learn how VillageHealth can assist your organization in understanding and managing your renal population, email Inquiries@VillageHealth.com.
Page 'Breadcrumb' Navigation: