How Specialty Care Management is Revolutionizing Renal Health in Employee Benefits

In the latest episode of "Healthcare on the Rocks: Employee Benefits with a Twist," hosts Brittany Hardaway and David Pittman welcomed Will Rumsey, Senior Vice President of Sales at Specialty Care Management, to discuss the critical issue of renal health and its impact on employee benefits and healthcare costs.

Below, you'll find highlights and takeaways from their conversation. Ready to listen to the full episode? Click here.

The Silent Kidney Disease Epidemic: A Hidden Health Crisis

Will Rumsey shed light on the prevalence and impact of chronic kidney disease (CKD):

• 90% of individuals with kidney disease are unaware they have it
• CKD affects people across all demographics but with higher prevalence in certain populations
• The financial impact on employers and health plans is substantial, with individual dialysis claims often exceeding $700,000 per year

“The future of cost containment has really got to be a more proactive approach, and everything is driven by data,” Rumsey said. “Sitting back and hoping is not a solution. So being proactive is really the future, regardless of whatever the claim may be.”

The rising prevalence of kidney disease can be attributed to several factors, including:

1. Comorbidities: Conditions like diabetes, hypertension, and obesity contribute to kidney disease risk
2. Lack of awareness: Many individuals and healthcare providers may overlook early signs of kidney disease
3. Demographic factors: Certain populations have a higher risk, with a 3:1 ratio for African American, Latino, and Hispanic individuals compared to Caucasians

Revolutionizing Renal Care Management

Specialty Care Management is taking an innovative approach to addressing the kidney health crisis. Their solutions include:

• Data-driven risk assessments to identify at-risk individuals
• Chronic Kidney Disease (CKD) management program with dedicated nurse coaches
• Outpatient dialysis risk mitigation with fixed, capitated case rates
• Significant cost savings, averaging 54% off paid charges for dialysis claims
• Enhanced member experience through personalized support and education

As a partner in the Springbuk Activate marketplace, Specialty Care Management's solutions are readily accessible to employers and benefits consultants looking to implement effective renal health management programs.

The Impact on Employers & Employees

Employers partnering with Specialty Care Management are seeing impressive results:

• Budget certainty for high-cost dialysis claims
• Potential for reduced stop-loss premiums and eliminated claim lasers
• Improved member experiences and health outcomes
• Significant cost savings, with one case study showing over $2 million saved for three dialysis patients

By addressing the often-overlooked issue of kidney health, employers can significantly impact their employees' well-being and reduce healthcare costs. As the prevalence of kidney disease continues to rise, solutions like Specialty Care Management are poised to play a crucial role in employee benefits packages.

To learn more about Specialty Care Management and their partnership with Springbuk through the Activate marketplace, visit springbuk.com/activate. 

Listen to the full episode here.