Transforming Kidney Population Health Management: How Healthmap Solutions’s Unique Approach is Lowering Costs and Improving Quality of Care for Kidney Disease Patients

It’s no secret that healthcare costs are on the rise, especially for patients with complex chronic conditions like chronic kidney disease (CKD) and end-stage renal disease (ESRD). Since CKD is generally asymptomatic in its early stages, many patients are unaware that they have CKD until their disease or comorbidities have progressed, and a confirmed CKD diagnosis is identified. This unknown and therefore unmanaged diagnosis often leads to unplanned dialysis starts (crashing to dialysis), emergency department visits, hospital admissions/readmissions, negative health outcomes, and overall increases in cost. Healthmap Solutions (Healthmap), an NCQA-accredited kidney population health management company, aims to improve care and lower costs for this population using its end-to-end Kidney Health Management program.

Healthmap serves health plans, health systems, accountable care organizations (ACOs), and provider groups using our value-based care solution to improve the lives of millions of Americans living with kidney disease. The company’s holistic, clinically focused, patient-centered approach combines the use of proprietary algorithms, predictive analytics, and clinical acumen to identify and address intervention opportunities and care gaps.

“Healthmap Solutions is unique in our approach to kidney population health management. One aspect of our program that is especially distinctive is our commitment to ‘moving upstream’ to identify patients early in their CKD diagnosis in order to establish a treatment pathway based on the patient’s unique and specific risk and stage of CKD, with a goal of slowing disease progression and improving outcomes,” explains Eric Reimer, CEO of Healthmap Solutions.

Compass, the company’s HITRUST CSF® certified and NCQA pre-validated technology platform, uses proprietary algorithms to analyze data from various sources, including medical claims, lab, pharmacy, ADT, and Personal Health Assessment data. This helps to develop personalized Healthy Action Plans at scale, identify patients with a high likelihood of having CKD, determine who is at risk for disease progression, and identify who could have a clinical event requiring a hospital admission over the next six to twelve months. “We also identify who we can impact by surfacing gaps at a patient level that are correlated with adverse events and poor health,” explains Reimer.

When it comes to kidney population health management, the initial market reflex has been on the high costs associated with ESRD care. However, Healthmap goes beyond ESRD in its expertise, and manages patients who have CKD stages 3, 4, 5, and Unspecified, in addition to ESRD patients. The company has made its mark in the industry by focusing on early identification, which has helped Healthmap make a much larger impact on this population as a whole, in terms of both financial and clinical outcomes. Further, the company has achieved outstanding member engagement rates, thanks to the support of its multidisciplinary Care Navigation team. Registered Nurses, Social Workers, Registered Dieticians, Pharmacists, and other Specialists interface directly with patients to promote treatment adherence and overcome barriers to care. “We have proven that Healthmap stands a mile ahead of the competition in our program engagement rates of 65% to 75% of eligible members, compared to our competition who are at 30% to 40%. It is these high engagement rates that have allowed Healthmap’s results to stand out in the industry,” adds Reimer.

Healthmap’s program focuses on personalized, whole-patient care, which necessitates a thorough understanding of each patient’s comorbidities. Many CKD and ESRD patients also struggle with diabetes and/or hypertension, among other conditions. Oftentimes, these patients are seeing multiple specialists, who may not be collaborating or communicating effectively to manage the patient’s care. Healthmap alleviates these challenges by offering dedicated in-office resources to support more effective collaboration and care management, while reducing the overall administrative workload and burden for physicians and their office staff. By facilitating more effective communication between and with providers, this approach eliminates challenges associated with siloed, fragmented care, which is all too common for CKD populations when multiple comorbidities are involved. “We maintain partnerships with all providers on the patient’s care team and facilitate collaboration between patients, providers, and the Healthmap team. By focusing on both provider and patient engagement, our clinical teams are able to ensure that all parties have the tools they need to achieve the best possible outcomes,” says Reimer.

Since its inception, Healthmap has been delivering successful population health management solutions to its clientele. Healthmap’s future is bright and has a clear strategy for continued success to include continued market expansion to provide a complete national footprint. The company also plans to enhance the population health management model to maximize value for all stakeholders. This is in addition to a robust technology roadmap with the inclusion of new chronic conditions that would benefit from the current Healthmap model.