Case Study for ESRD Patient Care Logistics Solution: What Medicare Advantage Plans Need to Know

As of January 1, 2021, Medicare Advantage plans have started serving members with End-Stage Renal Disease (ESRD).

Finding effective and efficient ways to serve your members with ESRD better while controlling for costs is critical to the long-term financial health of your Medicare Advantage plan.

Learn how California’s largest dual healthcare provider-payer saved time and money by implementing a patient care logistics solution for transportation of members who are on dialysis.

Quick Facts

Client: State’s largest dual healthcare provider and payer

Location: California

Member population: 12+ million members

Results:

• Used our patient care logistics solution to execute 800K complex dialysis transportation trips in 2020.
• Reduced RN time spent on patient transportation requests by 15 minutes - translating to $22.2M in annual savings.
• Grew transportation operations by 40% without incurring additional costs.

Challenge: ESRD-Dialysis Reimbursement Landscape

In the State of California, only 1% of Medicare beneficiaries have ESRD, yet they REPRESENT 8% OF REIMBURSEMENT COSTS.

While out-of-pocket limits for services will increase in 2021, there is rising concern that CMS’ RECENT PROPOSED RULE will lead to underpayment of Medicare Advantage plans.

Finding new and innovative ways to drive down reimbursement costs related to ESRD services has become a business imperative.

Solution: Improved Scheduling with Patient Care Logistics Software

Scheduling standing orders for members with ESRD who need transportation to and from dialysis appointments can be complex and time-consuming for both the care team and payers.

For plans managing millions of lives and tens of thousands of members on dialysis, the ability to efficiently schedule those standing orders at scale is essential.

In 2020, our client used our VectorCare Hub patient care logistics solution to execute 800,000 dialysis-related trips for its members.

Read more about how our client IMPLEMENTED A PATIENT CARE LOGISTICS SOLUTION.

Outcomes: Operational Efficiency Leads to Significant Cost Savings

Before: Prior to implementing a patient care logistics solution for transportation, our client’s nurses and case managers were spending nearly 20 minutes per request. Rides were scheduled using a complex and error-prone system of spreadsheets, faxing, and phone calls.

After: After implementation, care team members could schedule 365 dialysis trips in 3-5 minutes.

Results: Our client saved on average 15 minutes per request, translating to $22.2M in annual savings.

Additional benefit: The care team has access to securely view and collaborate on trip information online without time-consuming phone calls or faxes.

What Medicare Advantage Plans Need to Know

We don’t have to tell you how important it is to control the rising costs of healthcare as the industry moves to a value-based care model.

Innovations in patient care logistics are an opportunity for Medicare Advantage plans to manage costs while also providing valuable benefits to members with ESRD.

Learn how a PATIENT CARE LOGISTICS SOLUTION to schedule transportation for members with ESRD  can help your Medicare Advantage plan drive down costs.