This week’s episode goes over how Chronic Kidney Disease (CKD) is a major driver of high claims costs, but we don’t often see it at the top of claims reports. Kimberly Langford, a registered nurse and the director of Business Development – Specialty Care Management, discusses the major causes of kidney disease and how businesses can mitigate the risks associated with it, particularly in terms of reducing high-cost dialysis claims.
What You’ll Learn From This Episode:
- 2:27 What keeps companies from offering prevention
- 4:55 Why does CKD go undetected and how to prevent at least 60% of cases from requiring dialysis
- 14:09 How can a company like Specialty Care Management assist businesses in minimizing risks of high-cost claims?
- 15:11 In terms of claims, how do employers and advisors who review claims reports fail to notice CKD and other diseases that could have been avoided?
- 15:56 The average cost for a patient once they have a diagnosis
- 19:46 Key points for benefits advisors when discussing the implications of prevention approach with a client
1:49 “Look out the windshield, it’s way more important. That’s why it’s five times the size of the rearview mirror.”
3:16 “You cannot have the ROI or the outcomes without involving that member in the center. And you cannot motivate and empower people with an app, a text, a letter that they’re not even going to read.”
4:08 “You know that concept of hedonic adaptation, we kind of get used to when you’re cruising down the road at 80 miles an hour, it starts to feel normal, and you step back to a 55, 60 miles an hour speed limit, you feel like you’re going through molasses. So, a lot of the contributing causes – the major drivers for kidney disease being diabetes and hypertension, most people don’t feel bad, with a touch of sugar till they’re in a coma.”
4:18 “Diabetes is the number one driver. About 40% of the new cases of CKD, that’s the driver and diabetes affects every single organ in the body. Diabetes and high blood pressure go together. The heart has to work a lot harder to push sugar. Syrup is harder to push.”
13:53 “The problem is that no alarms go off until it [GFR] drops under 60. But if you’re 90, and then you’re 80, and then you’re 70, and you’re 61. It’s still a big drop, but no alarms are going to go off until it drops under 60.”
20:13 “If you see diabetes in your group, and especially if you see poorly managed diabetes in your groups, you have kidney disease, you just might not be seeing diagnoses for kidney disease.”