Kidney Week

Abstract: TH-PO284

Estimated Revenue Gains Associated with Relative Blood Volume Monitoring (RBV-M) in Hemodialysis (HD) Clinics: An Economic Model Using Real-World Data and a Case Size of 12 Medicare Incident Patients

Session Information

• Dialysis: Cost, Socioeconomics, Quality of Life
  October 25, 2018 | Location: Exhibit Hall, San Diego Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

• 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

• Rosen, Melissa M., Fresenius Medical Care Renal Therapies Group (RTG), Waltham, Massachusetts, United States

Melissa M. Rosen,

• Li, Yisha, Fresenius Medical Care Renal Therapies Group (RTG), Waltham, Massachusetts, United States

Yisha Li,

• Ficociello, Linda, Fresenius Medical Care Renal Therapies Group (RTG), Waltham, Massachusetts, United States

Linda Ficociello,

• Balter, Paul, Nephrology Associates of Northern Illinois and Indiana (NANI), Oak Brook, Illinois, United States

Paul Balter,

• Mullon, Claudy, Fresenius Medical Care Renal Therapies Group (RTG), Waltham, Massachusetts, United States

Claudy Mullon,

• Kossmann, Robert J., Fresenius Medical Care Renal Therapies Group (RTG), Waltham, Massachusetts, United States

Robert J. Kossmann,

• Singer, Gary G., Midwest Nephrology Associates, Saint Peters, Missouri, United States

Gary G. Singer,

Background

There are over 100,000 new HD patients (pts) per year (USRDS). For these pts, the first 90 days following HD initiation are associated with elevated hospitalization and mortality rates, along with high healthcare costs. We conducted an economic analysis for incident HD pts using data from a fluid management (FM) quality improvement project (QIP) using RBV-M.

Methods

RBV-M was performed using Crit-Line^® Monitors in 9 Renal Research Institute (RRI) Clinics. The QIP was associated with an average of 5.3 fewer hospital days and an estimated reduction of 2.5 missed treatments (txs) per year in incident HD pts (n=1068). Revenue gains from fewer missed txs were calculated using a cost minimization model from a facility level perspective. We assumed that HD clinics continuously served 12 Medicare incident pts with 2 monitors and disposable supplies associated with RBV-M. It was also assumed that pts received HD 3 times per week and HD txs were reimbursed at $350 per patient (i.e. standard Medicare reimbursement amount plus the onset of dialysis adjustment).

Results

Implementing a FM initiative with RBV-M has the potential to generate additional revenue from reducing 2.5 missed txs per year. This translated into gains of $2,048, annually per clinic (with 12 Medicare incident pts) in the implementation year, after accounting for the cost of the monitors and disposable supplies. Once the machines are paid for, either in the second year or if the clinic already owns monitors, annual gains are $6,048, including the cost of disposable supplies. These results do not include potential savings associated with averted hospitalizations or other benefits of the QIP.

Conclusion

RBV-M QI initiatives have the potential to reduce missed txs in incident pts and increase revenue in HD clinics. Assuming a reimbursement of $350 per dialysis treatment and 12 incident pts per clinic, potential revenue gains associated with RBV-M were found to be $2,048 in the start year and $6,048 in the year following implementation (or for clinics who already own monitors). Future cost-effectiveness studies of FM initiatives should consider the additional value gained from including prevalent HD pts who are also likely to benefit from RBV-M.

Funding

• Commercial Support –