Companion Benefit Alternatives

Providers

Renal Case Management

Helping members get support for end-stage renal disease

Members with end-stage renal disease (ESRD) require prolonged, intensive, costly treatment involving dialysis or kidney transplant.

According to the National Institute of Diabetes and Digestive Kidney Diseases (NIDDK), more than 661,000 Americans have kidney failure; roughly 70 percent are on dialysis, with the remaining 30 percent requiring a kidney transplant. According to the United States Renal Data System 2016 Annual Data Report, on average, ESRD patients are admitted to the hospital nearly twice a year, and about 30 percent have an unplanned re-hospitalization within the 30 days following discharge.

Program overview

The Renal Case Management (RCM) program uses a proactive, member-centered strategy focused on intensive education, care coordination and member empowerment across the health care delivery system and throughout the life cycle of the disease.

Each member is paired with a personal case manager to coordinate care and improve use of the medical management tools and resources available.

Case managers act as health care advocates to:

  • Coordinate optimal care management through a collaborative, integrated model that facilitates communication and comprehensive management and quality of care.
  • Improve quality of care through early intervention and education.
  • Improve member and provider satisfaction through appropriate medical management.

Program goals

  • Improve clinical outcomes and quality of life through appropriate vascular access, nutritional counseling, lab data monitoring, medication compliance, current immunization status and advanced care planning support.
  • Improve outcomes by avoiding hospitalization and hospital readmission by ensuring compliance with member’s treatment plan.

 

About Companion Care Solutions

Members who are dealing with difficult health issues face some tough decisions. Companion Care Solutions was created to help members get the information and support they need to make important health decisions. Companion Care Solutions is a division of Companion Benefit Alternatives, a separate company that provides program services on behalf of BlueCross.

Companion Care Solutions is a health care advocacy program that pairs members with a dedicated case manager who can help ensure that members get the answers and services they need to reach and maintain optimal health.