Abstract: TH-PO814

Utilization of Benchmarks to Reduce Transportation Costs for Dialysis Patients

Session Information

Category: Dialysis

  • 607 Dialysis: Epidemiology, Outcomes, Clinical Trials - Non-Cardiovascular

Authors

  • Ketchersid, Terry L., Fresenius Medical Care North America, Waltham, Massachusetts, United States
  • Martin, Michael P., Fresenius Health Partners, Austin, Texas, United States
  • Richmond, Chris, Fresenius Health Partners, Austin, Texas, United States
  • Garza, Greg S., Fresenius Health Partners, Austin, Texas, United States
  • Geary, Daniel E., Fresenius Health Partners, Austin, Texas, United States
  • Larkin, John W., Fresenius Medical Care North America, Waltham, Massachusetts, United States
  • Reviriego-Mendoza, Marta, Fresenius Medical Care North America, Waltham, Massachusetts, United States
  • Usvyat, Len A., Fresenius Medical Care North America, Waltham, Massachusetts, United States
  • Maddux, Franklin W., Fresenius Medical Care North America, Waltham, Massachusetts, United States
Background

End stage renal disease (ESRD) patients have high costs for transportation services. We examined if using benchmark data to identify outliers was associated with reductions in transportation costs. Through the Comprehensive ESRD Care (CEC) Model, Fresenius Medical Care, North America (FMCNA) has partnered with CMS to identify, test, and evaluate new ways to improve care for Medicare beneficiaries with ESRD. We are obligated to disclose that the statements contained in this document are solely those of the authors and do not necessarily reflect the views or policies of CMS. The authors assume responsibility for the accuracy and completeness of the information contained in this document.

Methods

We analyzed annual transportation costs and monthly treatment rates during 2015 to 2016 at 6 FMCNA ESRD Seamless Care Organizations (ESCOs). Two ESCOs with persistent historically high utilization of transportation costs (ESCO “A” & ESCO “B”) were provided with benchmarking metrics and a root cause analysis. Quality improvement (QI) initiatives with enhanced education on medical necessity documentation were implemented.

Results

Mean transportation cost was $174 per member per month (PMPM) at the six ESCOs in 2015. ESCO “A” and ”B” were identified as outliers with a transportation cost of $681 PMPM, and $263 PMPM, respectively. After implementation of the QI initiatives, ESCO “A” and ”B” showed decreased transportation cost PMPM of 25% and 30%, respectively. As % of total PMPM, there was a decrease of 19% in transportation cost PMPM for ESCO “A”, and a 30% decrease for ESCO “B”. Associated with these QI initiatives, ESCO "A" and "B" recognized year-over-year reductions in transportation costs equal to $1,798,940 and $791,185, respectively. We found no differences in dialysis treatment rates before and after the implementation of the initiatives.

Conclusion

Our findings suggest that benchmarking transportation costs in ESCOs may help to identify outliers and lead providers to implement QI initiatives to reduce healthcare costs.

Funding

  • Commercial Support