Partnering with health plans to combat kidney disease: Business solutions to report against the Kidney Health Evaluation Measure and close gaps in care
The importance of kidney health
Kidney disease is one of the leading causes of death in the United States according to the CDC. Perhaps even more alarming is that of the 37 million adults estimated to have chronic kidney disease (CKD), 90% don’t know they have it even if their kidneys are working at an extremely reduced functionality, given their lack of symptoms.
Decreased kidney health is also linked to a number of chronic and comorbid conditions like heart disease and diabetes. Socioeconomic barriers, ethnicity, age and other factors are known to have an impact on kidneys, which combined with new quality measures, make it critical to work toward solutions to close kidney health gaps in care.
New kidney health quality measures
The National Kidney Foundation partnered with the National Committee for Quality Assurance to develop the Kidney Health Evaluation for Patients With Diabetes (KED) as a new measure in the Healthcare Effectiveness Data and Information Set (HEDIS®). One of healthcare’s most widely used performance improvement tools, HEDIS results are reported by health insurance plans that cover more than 200 million people.
This quality measure—specific to 18- to 85-year-olds diagnosed with Type 1 or Type 2 diabetes—assesses whether an individual has received the KED annual kidney health evaluation. The KED includes a blood test for kidney function (an estimated glomerular rate or eGFR) and a urine test (a urine albumin-creatinine ratio or uACR ), which also helps determines kidney damage.
The goal of this new measurement is to improve the rate of testing for CKD among people with diabetes. Public reporting of the KED HEDIS measure is set to begin in late 2023 or into early 2024.
KED impact on Medicare Advantage plans and Medicare Part D
For 2024, Medicare Advantage plans and Medicare Part D plans will report against the KED for the Star ratings system. Star ratings help Medicare measure quality performance and help consumers compare the quality of competing Medicare health and drug plans.
Why kidney health matters to health plans
Health plans are seeing rising numbers in diabetics, impacting workforce capabilities and population health. Those factors, combined with an even greater focus from the Centers for Medicare & Medicaid Services on health equity and the ability of plans to provide resources to equitable solutions in care, are more challenging than ever.
Health plans also face ongoing pressure to provide accessible solutions in kidney care and maximize performance in the new KED measure. In addition, they must ensure an optimal patient experience, as that is a third of the overall health plan’s Star rating—all while controlling costs and maintaining efficiency.
Labcorp gaps in care solutions to combat CKD
Less than 50% of people diagnosed with diabetes receive both the eGFR and uACR tests annually. Reaching underserved and geographically limited patients with the right partnership can result in timely and effective solutions to combat CKD.
Labcorp's gaps in care program works to support your focus on reducing cases of advanced CKD and slowing the progression of a chronic condition, particularly non-symptomatic kidney disease, with preventive tests. Labcorp has kidney health kits and other solutions to detect issues related to cholesterol and A1C, as well as:
- A combined eGFR and uACR option
Healthy outcomes and seamless experiences designed to meet quality requirements
Successful gaps in care programs, much like successful Star ratings for Medicare Advantage and Medicare Part D plans, are designed with the patient at the center. When patients, clinicians and health systems understand the risks and resources available, as well as have the shared readiness to solve clinical quality issues, improved quality of life is achievable. For the most vulnerable populations, understanding the risk and resources available can be particularly challenging.
Labcorp can help you achieve your highest quality goals, assist your organization in taking a broader look at your patient population, stratify at-risk populations across lines of business, assess and measure trends, and strategize with your plan toward optimal outcomes. A successful gaps in care program and an array of kit solutions should:
- Increase personal health awareness
- Engage patients through multiple convenient testing kit options
- Be consistent through high-quality, readily available test kit products
- Positively impact health outcomes among your patient population
- Achieve high performance across multiple quality metrics
- Simplify processes, drive informed actions and enhance end-to-end patient experience for optimal results
Labcorp’s solutions range from full-service support to supplemental services to support existing programs. Our full-service engagement solutions help increase patient compliance with guided support across the patient journey. Our supplemental services, such as convenient at-home sample collection tests, can help close gaps in care no matter where your patients are located.
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Learn more about how our different gaps in care programs can boost patient experience with convenient solutions for at-home testing.
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HEDIS® is a registered trademark of the National Committee for Quality Assurance.