The prevalence of Chronic Kidney Disease (CKD) is on the rise, recently increasing from 10 percent to 13 percent.1 While kidney disease is a common condition, it is also progressive, making it both complex and costly.
OptumHealth offers a comprehensive suite of products to help individuals manage the quality and cost of care associated with chronic kidney disease. Whether an individual is in the early stages of chronic kidney disease or has progressed to kidney failure, our programs help members understand their condition, its implications and how to take informed action to best manage their condition.
Comprehensive Kidney Solution
The Comprehensive Kidney Solution (CKS) delivers value by partnering with the patient to delay the progression to renal failure. Our complete solution manages patients with Chronic Kidney disease from Stages 4 and 5 through to End-Stage Renal Disease. Nurse advocates prepare members at each state for the challenges they will face by educating them and providing them with tools needed to live life as normally as possible.
Chronic Kidney Disease
The Chronic Kidney Disease (CKD) program offers support for members who have not yet started dialysis. Through the management of lifestyle, diet and other clinical aspects of patients in Stages 4 and 5 of CKD, the CKD program is designed to delay progression to dialysis and avoid co-morbidities. If dialysis is unavoidable, our nurse advocates guide patients to quality in-network dialysis facilities, communicate with providers and dialysis centers and educate and coordinate transplant referral options.
End-Stage Renal Disease
OptumHealth offers an End-Stage Renal Disease (ESRD) program for members receiving dialysis. The program is customized to meet each member’s needs, with individuals' care management and education based on national clinical treatment guidelines. The ESRD program is designed to reduce medical complications associated with ESRD. Our nurse educates members regarding treatment decisions, and consults on financial and provider options.
OptumHealth partners with top dialysis centers across the country to provide quality care and negotiate the best discounts and terms for dialysis services. We offer a network of more that 1,800 contracted dialysis centers, including more that one-third of Medicare-certified centers. In situations where members cannot conveniently access a contracted dialysis center, OptumHealth will negotiate patient-specific discounts to get the best possible rates.
1 National Health and Nutrition Examination Surveys (NHANES), 1988- 1994 vs. 1999-2004, published in JAMA, November 7, 2007 – Vol 298, No. 17.