Chronic kidney disease and end-stage renal disease increase morbidity, decrease quality of life, and can be extremely costly for the healthcare system. By using artificial intelligence (AI), healthcare providers can identify high-risk patients at earlier stages, which allows them to provide more effective, less expensive care.
This was a major theme in a discussion at Becker's Payer Issues Roundtable, led by Joe Vattamattam, President and Founder of Healthmap Solutions, and Stephanie Toth-Manikowski, MD, MHS, nephrologist and National Medical Director at Healthmap Solutions. They discussed how Healthmap Solutions is working to slow disease progression for kidney disease patients while reducing healthcare costs.
Key takeaways were:
1. Early engagement is crucial in preventing the progression of kidney disease. According to Mr. Vattamattam, Healthmap Solutions has looked at more than $25 billion worth of claims data for kidney disease patients. "We know who is likely to have an adverse event and progress in their disease," he said. "The next step is finding those patients' physicians and sharing that information in an actionable way." He added, "We have to engage and identify early to be able to make a difference in that preventable window."
2. Broad provider access is necessary to reach a larger population and provide comprehensive care. "To reach the masses, you have to go broad with your providers," Mr. Vattamattam said. "For a successful kidney program, you can't go narrow, so you have to be able to be inclusive of multiple provider specialties, with PCPs being a large part of these providers. Keep in mind that these kidney patients may be seeing three to four different doctors and taking 15 to 20 different drugs in a year. There's a lot of management."
3. Titration of interventions is important, as not all patients require the same level of care and engagement. Individual patient goals vary depending on the specific stage of kidney disease, other comorbidities, and current management. "Not everybody needs a visit in the home and not everybody can be managed digitally," Mr. Vattamattam said. "You have to be able to meet the patient where they are and be flexible in terms of the way you engage with them."
4. Materially reducing facility costs is a significant opportunity for cost savings in kidney health management. Better engagement shifts costs from the expensive advanced stages to the less expensive early stages. "We drop facility costs anywhere from 20% to 30%," Mr. Vattamattam said. "In a good kidney program, you should expect to see outpatient and physician costs increase because you're driving them to the physician more often. The reason dialysis costs go down is because we're slowing disease progression by 30% plus, pretty consistently across all CKD stages."
Healthmap Solutions' approach of early engagement, broad provider access, titration of interventions, and reduction of facility costs successfully slows kidney disease progression and reduces overall healthcare costs.