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.
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:
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.