Cricket Health has announced a new kidney care programme specifically designed for late-stage chronic kidney disease (CKD) and end-stage renal disease (ESRD) patients enrolled in Medicare Advantage (MA) plans.
The US company claims its programme—which has been launched to more than 4,500 people with kidney disease in Texas—uses a proprietary data analytics model to help MA plans identify and risk-stratify enrolled members with, or at risk of, kidney disease.
Robert Sepucha, CEO of Cricket Health, said: “The key to value-based kidney care is early intervention. We are able to help MA plans identify kidney disease earlier and focus on those who are most at risk for progressing to kidney failure.
“By managing kidney disease earlier, we can provide personalised care roadmaps and targeted interventions that keep people healthy, at home, and out of the hospital.”
This new programme comes after a regulatory shift on 1 January 2021 that saw the 21st century Cures Act remove a long-standing prohibition on ESRD patients enrolling in MA plans—a type of US health insurance that provides benefits through a private-sector insurer.
Cricket Health says it provides each of its MA-enrolled members with a dedicated, multidisciplinary care team including a nurse, pharmacist, social worker, dietitian, and trained patient peer mentor, to provide support at every stage of their kidney care journey. According to the company, patients can access their dedicated team in person, over the phone, or via a virtual care platform, to learn more about their disease and help them make decisions on managing disease progression—with a view to improving health outcomes as well as lowering costs.
And, for patients whose condition does progress to kidney failure, Cricket Health says it deploys an ESRD-specific programme that increases transplant referrals and utilisation of home dialysis, while reducing unnecessary utilisation. Across the full continuum of care, the company also claims its care teams work in unison with MA plans’ existing network of medical providers—including primary care physicians, nephrologists and other specialists.
According to Cricket Health, ESRD costs the American healthcare system more than US$200 billion each year, with more than US$40 billion of this being managed by MA plans. Additionally, the company says research indicates up to 50% of late-stage patients remain undiagnosed, and this patient population can cost up to nine times as much as the average MA beneficiary, making improved care management for kidney patients “critically important” under these plans.
Its newly-announced programme brings the total number of commercial and MA patients under Cricket Health management to 10,000 across the USA and the total medical spend under the company’s management to more than US$500 million.