Improving Kidney Disease Care

March 30, 2018 · NCQA Communications

March is National Kidney Month, and NCQA and our colleagues at the Centers for Medicare & Medicaid (CMS) know just how serious kidney disease is in this country. We’re working together to help people living with chronic kidney disease.

National Kidney Month

Here are some alarming facts from the National Kidney Foundation:

• One in three American adults is at risk for kidney disease, and the majority of those who have it don’t know it.
• A growing number of Americans are diagnosed with kidney failure and will need dialysis or a kidney transplant but only a fraction of those who need a transplant will receive one.
• Currently, 468,000 people receive dialysis and more than 193,000 have a functioning kidney transplant.
• Diabetes and high blood pressure cause up to two-thirds of cases of chronic kidney disease.

CMS is battling this disease on multiple fronts and NCQA continues to be an ally in this fight.

Comprehensive ESRD Care Model

Through its Innovation Center, CMS is improving care for patients with end-stage renal disease (ESRD), also known as kidney failure. That’s a goal NCQA is happy to get behind! We have joined forces with IMPAQ, the project’s primary contractor, to support the development and implementation of CMS’ Comprehensive ESRD Care (CEC) Model.

The CEC Model offers payment incentives to accountable care organizations—networks of providers including dialysis facilities, nephrologists and other specialists working together to coordinate patient care—that deliver more efficient, higher-quality care.

NCQA partners with IMPAQ to develop and implement the model’s quality strategy, including an annual evaluation of each network’s performance on a set of quality measures: transplant wait lists, patient experience and other care that ESRD patients receive such as immunizations and screenings, diabetes care, medication reconciliation and advance care planning.

Addressing Disparities in Chronic Kidney Disease with the CMS Office of Minority Health

NCQA’s work to improve the quality of care for people living with kidney disease isn’t limited to the CEC Model. NCQA also partners with the Office of Minority Health to identify and address racial/ethnic, geographic and urban/rural disparities in care for Medicare and Medicaid patients with chronic kidney disease.

Our work has found that:

• African Americans, Hispanics, Pacific Islanders and American Indians are at increased risk of developing chronic kidney disease.
• Chronic kidney disease is often unrecognized and poorly documented in the medical record.
• Early diagnosis and treatment of chronic kidney disease can prevent or delay kidney failure.
• Care for patients with chronic kidney disease can be improved in the primary care setting.

We are currently consulting researchers, clinicians and other experts to define best practices in managing vulnerable populations with chronic kidney disease in primary care, with the goal of developing tools for clinical practices.

NCQA is honored to participate in efforts to improve care for patients with kidney disease, especially when so many lives depend on it—not only this month, but all year.