The End-Stage Renal Disease Demonstration Project was conducted between 2006 and 2010 by the Centers for Medicare & Medicaid Services o test the impact of expanded integrated care approaches applied to the Medicare ESRD patient population.
The Arbor Research Collaborative for Health abstracts and the evaluation report of the ESRD DM Demonstration Project and additional information on our integrated care program can be viewed at our Fresenius Health Partners company website www.kidneytel.com.
“The demonstration project yielded important data and results regarding approaches that the kidney provider community can apply to improve the care and outcomes for kidney patients”
The first three years of the demonstration (2006 through 2008) were evaluated and the case-mix adjusted results indicate the following for Fresenius patients enrolled in the demonstration:
- A significantly larger percentage of patients in the FMC program survived to the one-year and two-year time points.
- Patient survival at the one-year time point for FMC was 90.7 percent vs. 85.4 percent for the comparison group. Patient survival at the two-year time point for FMC was 80.1 percent vs. 73.9 percent for the comparison group. This equates to mortality improvement for FMC versus the comparison group of 36.3 percent at the one-year time point (9.3 percent vs. 14.6 percent) and 23.8 percent at the two-year time point (19.9% percent vs. 26.1 percent).
- A significantly lower percentage of patients in the FMC program were hospitalized for the first time by one year and two years.
- Improvement for FMC versus the comparison group in first hospitalizations for “all causes” at one year of 13.6 percent (51.1 percent vs. 59.1 percent) and at two years 20.5 percent (60.5 percent vs. 76.1 percent).
- A significantly lower percentage of patients in the FMC program were hospitalized for cardiovascular disease for the first time by one year and two years.
- Improvement for FMC versus the comparison group in first hospitalizations for “cardiovascular disease” at one year of 14.1 percent (50 percent vs. 58.2 percent) and at two years 20.7 percent (59.7 percent vs. 75.2 percent).
“Our main objective in the ESRD DM Demonstration Project was to implement a model of care that was patient-centered, one that could improve the more comprehensive patient quality outcomes of improved survival and reduced hospitalization. We are very pleased to have achieved our objectives in this Demonstration Project to advance care models for the benefit of people with kidney disease,” commented Robert Farrell, President, Fresenius Health Partners, Integrated Care Management Division, Fresenius Medical Care North America.
The Fresenius Health Partners program provided a holistic care approach utilizing an integrated care “health home” concept that actively expanded the management of the various co-morbidities such as congestive heart failure, cardiac disease, nutritional status, infection risks, vascular access and psychosocial needs that impact kidney patients.
The program achieved this expanded patient care by adding personal nurse care managers to work with patients and their providers on these non-dialysis focus areas and by deploying a unique home telehealth monitoring device technology (KidneyTel) and care plan pathways platform, which provided interactive daily contact with patients to collect symptomatic and biometric data, and provide support, education and coordination to patients and their providers.
“The demonstration project yielded important data and results regarding approaches that the kidney provider community can apply to improve the care and outcomes for kidney patients,” said Rice Powell, Fresenius Medical Care North America CEO, deputy chairman management board. “We applaud CMS for its foresight in conducting this initiative. We look forward to working with our nephrologist partners and the CMS Innovation Center to build upon an expanded care approach for kidney patients. We believe that Accountable Care Organizations and patient-centered medical/health homes are very well-suited models for improving care and outcomes for patients with kidney disease.”
