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Kidney Week

Abstract: PO0854

Benefits of Telephonic Case Management: Increased Home Dialysis and Decreased Hospitalizations

Session Information

Category: Coronavirus (COVID-19)

  • 000 Coronavirus (COVID-19)

Authors

  • Dhawan, Rahul, Optum Inc, Eden Prairie, Minnesota, United States
  • Bannister, Wade M., Optum Inc, Eden Prairie, Minnesota, United States
  • Gong, Cindy, Optum Inc, Eden Prairie, Minnesota, United States
  • Tao, Jiang, Optum Inc, Eden Prairie, Minnesota, United States
  • Plosser, Kevin, Optum Inc, Eden Prairie, Minnesota, United States

Group or Team Name

  • KRS Team
Background

Home dialysis has been noted to improve quality of life in patients receiving dialysis. Patients at risk for COVID-19 include those on dialysis. The pandemic has resulted in additional focus on social distancing and home dialysis offers this distinct advantage compared to in center hemodialysis. The ASN also similarly has supported advancing education around home dialysis, and COVID is being noted as a true catalyst to home dialysis care. Our study on a commerical poppulation analyzed cost of care with regards to home versus in center dialysis.

Methods

The KRS Case Management program identified and educated commerical patients with this case management benefit regarding the options for home versus in center hemodialysis. Patients were enrolled in the program and educated on the benefits of home dialysis, the benefits of permanent access, and the benefits of transplantation. Cost of care analysis was conduted using claims paid until February 2020, and variables studied included in-patient cost, skilled nursing facility cost, professional cost for dialysis service, facility cost for dialysis service, non dialysis outpatient cost and professional cost for physician visits. Patients were educated telephonically of the benefits of home dialysis and permanent access placment, and demographics including age and gender were also calculated.

Results

A total of 6692 members were analyzed. Of these patients 1793 members were attributed to home based dialysis. It as noted that when adjusting for per diseased member per month, there was a 62% decrease in cost of care for in-patient hospitalizations in the home dialysis group. In addition, there was a striking reduction of 247% in skilled nursing facility costs for the home dialysis group as well. After adjusting for all variables, there as a 5% cost savings in the home dialysis group as compared to in-center.

Conclusion

There are cost of care benefits to home dialysis. Further studies are needed to help identify barriers to home dialysis, and given the advent of COVID-19, it is important to consider home dialysis for all patients more now than ever before.