The study is presented in The American Journal of Managed Care. That is a peer-reviewed journal with a large number of readers among the healthcare payer community.
The study shows that diagnosing chronic kidney disease (CKD) with using only two tests and finding a treatment based on its level can improve health outcomes for diabetic and hypertensive patients. Additionally, it can also decrease the healthcare and medicinal cost for them.
Primary care physicians – PCPs, who were previously using inexpensive, rarely used urine albumin-creatinine ratio (uACR) test along with another common test called eGFR blood test, were diagnosing the incidence and severity of CKD. Also, they were able to recommend treatment options to reduce the hospital stay and re-admissions to the hospital in the long run.
This research studied nearly 7,000 patients all from CareFirst’s PCMH – Patient-Centered Medical Home program between July 2015 and July 2017. Dr. Joseph Vassalotti is the co-author of the study and NKF’s Chief Medical Officer.
He states that this research helped PCPs in saving thousands of dollars annually on every patient to cover specific healthcare costs. Moreover, it has shown that both tests for CKD, uACR and eGFR blood test, can predict adverse outcomes.
These outcomes include hospitalizations and 30-day readmissions along with expenditures. A simple and scalable CKD quality improvement intervention has revealed short-term improvements in expenditures and hospitalization.
The researchers estimate 37 million American adults to have CKD. But only 10% of these patients know about having it. The health risk is so much that every one in three US adults is at a high risk of having chronic kidney disease.
The National Kidney Foundation’s Kidney Disease Outcomes Quality Initiative and the American Diabetes Association recommends all diabetic patients to go through a uACR test every year to detect any possible kidney disease. However, only 40 percent of US diabetic adults go for this test.
Additionally, this study shows the first-ever real-world data to show that costs increase consistently with severity (albuminuria classification or higher levels of uACR), both pre- and post-intervention.
Dr. Daniel Winn is the CareFirst Chief Medical Officer and co-author of the study. He said that in many cases CKD is under-recognized by the public and under-diagnosed by physicians. The standard and traditional ways to diagnose CKD are useful but aren’t considered as a complete and comprehensive screening.
The eGFR and uACR tests helped to categorize kidney disease in patients. Also, they were able to provide information to the physicians that they need to know before suggesting any treatment plan for their patients.
Among these, 7,420 study participants, the average age was 55.9 years, and nearly 52% of them were women. Next, nearly 42.2% of participants were diagnosed patients of hypertensive and only 19.1% were diabetic, while 38.2% of patients were both hypertensive and diabetic.
NKF and CareFirst, in this collaboration, would help to train both CareFirst employees and community physicians, that includes nurses, nephrologists, PCPs, and nutritionists. By these changes in diagnostic testing and treatment options would help to help the patients.
Dr. Vassalotti said that Health systems and health insurance plans should recognize CareFirst’s diagnostic and treatment plans to develop a similar setup for their patients. Also, they should specifically train their teams to make CKD treatment improved. This way the treatment and healthcare costs would be reduced and the patient would be able to enjoy better health.