Integrated care enhances clinical outcomes for dialysis patients

DaVita Kidney Care, a division of DaVita Inc., a leading provider of kidney care services in the United States, today announced results of the first performance year in the Centers for Medicare and Medicaid Services (CMS) Comprehensive ESRD Care (CEC) Model as an ESRD Seamless Care Organization (ESCO).

CMS recognizes that end stage renal disease (ESRD) patients benefit greatly from integrated care. The CEC model enables dialysis providers like DaVita to partner with nephrologists to improve clinical outcomes through holistic care coordination. Overall, ESCOs achieved savings of $75 million during the first performance year of the pilot program, suggesting that the renal community is uniquely poised to deliver success on a large scale, which would positively benefit patients, the health care system and participating providers.

"DaVita is committed to partnering with CMS on the long-term vision of providing the gift of integrated care to all ESRD patients," said Javier Rodriguez, president and CEO of DaVita Kidney Care. "We're proud to be part of a disease-specific pilot that has shown great results for patients, is a win for the health care system and demonstrates that the renal community is ready to provide integrated care to all patients."

DaVita and its partners currently participate in three ESCOs located in Arizona, Florida and New Jersey/Pennsylvania. DaVita's ESCO model of care leverages the 12-15 hours per week when patients are in a dialysis clinic to address their kidney and non-kidney health care needs. DaVita's in-person, direct patient engagement model of care is designed to yield the best quality and clinical outcomes over the long term.

"DaVita's integrated care team regularly communicates with nephrologists to better address gaps in care that extend beyond dialysis," added Dr. Roy Marcus, medical director and participating ESCO nephrologist. "This frequent communication means I have the time and details I need to provide better, more holistic care to my patients."

All of DaVita's ESCOs achieved the triple aim of improving clinical outcomes, enhancing patient experience and reducing costs. In the first performance year, DaVita's ESCOs provided integrated care and improved clinical outcomes for more than 5,000 patients. This resulted in total average savings of $4,868 per patient. In the fourth quarter of 2016, when compared to the same timeframe in 2015, hospital readmissions were reduced by 13 percent, based on DaVita's internal data analysis. This resulted in patients being able to spend over 2,700 more days at home due to avoided hospitalizations, including Long-Term Acute Care Hospitals (LTACH) and Skilled Nursing Facilities (SNF).

"DaVita and our nephrologist partners are investing resources in an in-person model of care because it leverages the time patients already have with their trusted care team at the dialysis center. This approach enables timely and effective management of patients' kidney disease, primary care and other comorbid conditions," stated Dr. Bryan Becker, MD, MMM, FACP, CPE, chief medical officer of DaVita VillageHealth. "DaVita is prepared to expand its integrated care model to dialysis patients across the country so they can experience the benefits."

The ESCO pilot is an important step in the evolution to full risk models, but requires important modifications to enable scalability over an extended period of time. DaVita and its partners will continue to work with Center for Medicare & Medicaid Innovation (CMMI), CMS and Congress to create a model that could provide integrated care to all ESRD Medicare patients.

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