Taking advantage of recent changes in federal law, the Medicare Advantage plan is working with healthcare providers to control the cost of kidney care.
Regence announced on Tuesday that it is working with Strive Health to provide comprehensive kidney care to 16,000 Regence Advantage and commercial insurance plan members in Oregon, Washington, Idaho, and Utah.
until 2021, Medical insurance beneficiaries with end-stage renal disease cannot get medical insurance Preferential plans, except in limited circumstances. The 21st Century Cure Act changed this. Now, all beneficiaries with end-stage renal disease can participate in such programs.
The MA plan needs to limit out-of-pocket expenses, while the original medical insurance does not. This is a boon for members suffering from complex chronic diseases, because medical expenses will quickly get out of control. But managing this care and controlling the associated costs is a challenge, and the MA program has been scrambling to find ways to do both.
The partnership between Regence and Strive Health in Portland, Oregon provides members with everything from home care to virtual clinical services, as well as access to the Strive Health Kidney Care Center in Medford, Oregon. Support on-site and family dialysis.
Management of chronic diseases, such as kidney disease also needs to go Beyond conventional maintenance treatment. For example, Strive Health combines predictive analysis that relies on artificial intelligence to predict possible complications, while adopting a team-based approach to prevent and stop disease progression.
Marion Crouch, Regence’s chief medical officer and senior vice president of healthcare solutions, said in a statement: “People with kidney disease need a more people-oriented holistic approach. information Regarding the announcement of the partnership. “Strive Health’s comprehensive and proactive approach to healthcare will help us achieve our goal of providing our members and customers with better, simpler and more affordable healthcare services.”
In pursuit of health Aim to take A technologically advanced and hands-on approach to improve results and reduce costs. This includes paying attention to fundamentals, such as ensuring that the patient’s attending physician, kidney care specialist, or the coordination of care between the nephrologist and other specialists is good.
This Denver-based company is not the only kidney care provider working with health plans to provide a value-based care model to deal with chronic kidney disease. Others include Somatus and Cricket Health.
Policy changes related to the Cure Act, which allow end-stage renal disease patients to obtain medical insurance advantages, are expected to be Increase enrollment by 83,000 Over six years in this group. This will only bring greater cost pressures to private insurance companies that provide MA plans.
Most end-stage renal disease patients must undergo dialysis multiple times a week, and they are more likely to have other chronic diseases, from diabetes to heart disease.One learn Written by researchers from the University of Southern California and published in JAMA Internal Medicine last year, they found that for patients with end-stage renal disease, their average monthly total expenditure on all health care services is 33 times Patients without kidney disease (US$14,399 vs. US$435).
The heavy cost burden and related medical needs of patients with kidney disease require Advantage plan sponsors and healthcare providers to continuously innovate to ensure that members receive the care they need at a controllable price.
“Kidney disease requires a new and comprehensive approach that is patient-centric,” Strive Health CEO Chris Riopelle said when announcing the partnership with Regence. “Regence and Strive Health will provide transformative care to address the clinical and social determinants of kidney disease in a way that controls long-term healthcare costs.”
