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Problem Tech Solves
Tech Brief
Kidney care in the U.S. has been broken for too long. Even though chronic kidney disease (CKD) is incredibly common in the United States, with an estimated 1 in 7 Americans affected, we do relatively little to identify it early, slow it down, or understand who is at risk for kidney failure. As a result, nearly 90 percent of people go undiagnosed, untreated, and unmanaged until they advance to a later stage or even ESKD. Cricket Health, now part of InterWell Health, developed an innovative way to identify kidney disease early with its StageSmart™ predictive analytics model, which uses claims data and predictive GFR (pGFR™) algorithm to determine if an individual may have or be at risk for a specific stage of kidney disease. This innovative company serves as the eyes and ears between appointments with nephrologists, acting as a care extender for providers. Members interact with their Cricket care teams weekly on average, with 40 percent of members connecting an average of 10 times per month, or every two to three days. By comparison, most people with kidney disease only see their kidney care specialist two to four times per year. In between appointments, members have access to stage-specific educational resources, and a peer community to share questions and information, all available 24/7.
Tech Differentiators
Cricket Health, now part of InterWell Health, has shown measurable results with Medicare Advantage and commercial health plans with more than 50 percent fewer hospital admissions than the status quo, its integrated care model has demonstrated proven enhancement in outcomes for people living with kidney disease across key metrics. Seventy-seven percent of members starting dialysis do so in an outpatient setting (compared to the status quo of 40 percent), and 45 percent of members who need dialysis are initiating at home, (compared to the status quo of 11 percent). Sixty percent of those starting dialysis do so with a permanent access placed (compared to the status quo of 45 percent). The model uniquely connects individuals with a trained peer mentor and a community of peer support. Due to the lack of attention and education about kidney disease, people with kidney disease often feel alone and overwhelmed by their diagnosis. To transform what a kidney disease diagnosis means for patients, providing educated peer support was prioritized early on. Each member is partnered with a trained peer mentor through a multi-modal care platform. In addition, patients have access to a peer support community to chat with others who are also managing kidney disease about what’s working for them. Empowering patients to share with and learn from one other has been a key driver of a reimagined kidney care experience that delivers results.
Validation
MA In December 2021, Cricket Health released its outcomes for Medicare Advantage beneficiaries from a six-month period. The results demonstrated the effectiveness of Cricket Health’s model in significant cost savings: per member per month (PMPM) spend reduction of 17 percent for CKD patients at stage 3B or greater and a PMPM reduction of 27 percent for CKD patients at stage 4 or greater. This also resulted in improvements in key health outcomes: reduced hospital admissions by 37 percent for patients on dialysis and by 25 percent for CKD patients at stage 4. Blue Shield of California One-Year The one-year partnership saw improvements across early intervention, clinical outcomes, and increased engagement. With the benefit of educational resources, 90 percent of Blue Shield members enrolled with Cricket Health made a choice other than in-center dialysis for ESKD treatment. Eighty-three percent of BSC members who started dialysis began this treatment outside of the hospital setting. Cigna One-Year The one-year partnership saw a more than 45 percent reduction in hospitalizations, and 100 percent of patients made a choice other than in-center dialysis for their end stage kidney disease (ESKD) treatment. The NPS score increased to 89, and patients on home therapies have reported higher quality of life ratings in several domains and higher satisfaction with their care overall.
