By OPEN MINDS Circle
Hospitalizations over six months were about 25% lower among Medicare Advantage members with chronic kidney disease (CKD) who were enrolled in a value-based kidney care management program offered by Cricket Health. Among enrollees on dialysis, hospitalization rates were 37% lower over six months.
Because hospitalizations were lower, health plan per member per month (PMPM) spending for Cricket Health enrollees with CKD at stage 3B dropped by 17%. Health plan PMPM spending dropped by 27% for enrollees with CKD at stage 4 or greater.
Cricket Health launched its value-based kidney care program for Medicare Advantage plans on March 31, 2021. The reported outcomes are based on an analysis of six months of data. The findings were issued in a press release.
The value-based kidney care offering is specifically designed for Medicare Advantage plans, helping them provide care management services for plan members with late-stage CKD and end-stage kidney disease (ESKD).
The program uses a data analytics model to identify and risk-stratify plan members diagnosed with or at-risk for kidney disease. For these members, Cricket Health provides a multidisciplinary care team that includes a nurse, pharmacist, social worker, dietitian, and trained patient peer mentor who provide support to the member. The Cricket Health care team coordinates with the Medicare Advantage plan’s existing provider organization network. Cricket Health charges the health plan a care management fee that it keeps only if it meets pre-specified population health outcomes. These outcomes include: increase in home dialysis starts, reduction in avoidable inpatient admissions, and lower total cost of care. Consumer engagement benchmarks and targets are embedded in the contracts through performance guarantees. Cricket Health believes that with its program, health plans may be able to reduce dialysis costs by 25% to 50%, and increase the transplant referral rate.
Cricket Health currently manages care for about 10,000 people with kidney disease who are enrolled in commercial or Medicare Advantage plans. It currently provides the program for Cigna members in California and for members of Blue Shield of California.
For more information, contact: Jen Miller, Public Relations, Crosscut Strategies for Cricket Health, 251 Kearny Street, Floor 7, San Francisco, California 94108; 888-780-0253; Email: jen@crosscutstrategies.com; Website: https://www.crickethealth.com/