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Toward population management in an integrated care model.

Franklin W Maddux¹, Stephen McMurray, Allen R Nissenson

¹Fresnius Medical Care, Waltham, Massachusetts, USA.

Clinical Journal of the American Society of Nephrology : CJASN

|March 30, 2013

Summary

Accountable care organizations (ACOs) are key to high-quality, cost-effective renal care. The nephrology community can leverage experience with integrated care programs to manage ESRD populations effectively.

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Area of Science:

Health Services Research
Nephrology
Health Policy

Background:

The Patient Protection and Affordable Care Act of 2010 promotes accountable care organizations (ACOs) for quality care and cost management.
The nephrology community faces challenges integrating care for the End-Stage Renal Disease (ESRD) population due to comorbidities.
The nephrology field has prior experience with ACO-like integrated care models.

Purpose of the Study:

To outline strategies for the nephrology community to implement integrated renal care within the ACO framework.
To emphasize population management and coordinated delivery of services for ESRD patients.

Main Methods:

Review of existing ACO models and their applicability to renal care.
Analysis of past programs like the ESRD Management Demonstration Project and ESRD Prospective Payment System.
Identification of key elements for successful clinical integration initiatives.

Main Results:

Integrated renal care delivery is achievable, as demonstrated by previous ESRD programs.
These programs showed potential for improved clinical outcomes and cost savings.
Key components for future integration include performance-based payments and health IT.

Conclusions:

The nephrology community is well-positioned to lead integrated renal care delivery.
Successful integration requires performance-based payment models, health IT, and best practices.
Continuous quality improvement and iterative evaluation are essential for sustained success.