Nephrologists, Cardiologists Work to Reduce Readmissions


By Kasia Michalik

John Wigneswaran, MD, vice president of market development and clinical strategy at Fresenius Medical Care North America (FMCNA)  has participated in a new program since early 2012 that has been put together for hospitals to lower the increasing problem of patient readmission.

UFComplete (Ultrafiltration Complete)  was developed and brought together cardiologists, nephrologists and hospitalists to work as a team to prevent patients from returning after being released from a hospital.

"The main problem is that congestive  heart failure, which is the disease we are laser focused upon, is the number one reason for people being readmitted to the hospital," Wigneswaran said. "It's the largest Medicare expense at $32-50 billion yearly and hospitals and clinicians are being penalized for poor outcomes."

An average readmission rate across the U.S. is at about 25 percent.  

"It's a very significant market that could be well served if you have a therapy that may help  reduce readmissions  and optimize coordinated care with heart failure  providers —this could be very beneficial," Wigneswaran said.

Physicians get indirectly penalized through the hospital. The Value Based Purchasing Program makes hospitals lose money if there is no improvement in outcomes seen.

So how and why would a nephrologist get involved in this with a cardiologist? About one-third of patients that cardiologists see are patients who are on diuretics, or water pills. 

"Those are the patients that may require a medical device to remove fluid and the nephrologist is essentially providing that service to the cardiologist, hospitalist or whoever is responsible for seeing the heart failure patient," Wigneswaran said.

When a hospital chooses to participate in the UFComplete program, Fresenius trains nurses, the physicians of the patients, which usually tend to be cardiologists and hospitalists, in what patients should be involved, how the program works, and the benefits of it.

Patients have to fit a specific criteria to be chosen for this program.

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