The end-stage renal disease program. Experience with a chronic disease capitated health plan

The ESRD program has demonstrated the potential for a capitated, disease-oriented, total care method of patient support. Given both the increasing age and complexity of the patient population, not only has the cost per patient decreased over the life of the program, but the standardized mortality rates have also declined. Technology has bridged the gap and made the relative cost per treatment more affordable and science has developed medications and techniques that have enhanced both patient comfort and longevity. As more complex patients enter the fold of the ESRD program, an increased awareness of enhanced coordination of care needs to be recognized.