Kidney disease is a costly, common, and complex silent cost driver—but it doesn’t have to be

In 2019, large employers expect to see a 5 percent rise in their health care costs for the sixth consecutive year as total health costs per employee near $15,000 on average. For many employers, wrangling control of their continuously rising health costs has proven more difficult than managing any other top business expense.

That’s why it’s no surprise that employers today are willing to try innovative approaches to address major cost drivers in their employee population.

But employers have yet to address a massive, silent cost driver: chronic kidney disease (CKD) and end-stage renal disease (ESRD). CKD affects more than 1 in 7 American adults, with even more at-risk of developing the condition. And, nationally more than half a million are living with ESRD.

CKD affects more than 1 in 7 American adults, with even more at-risk of developing the condition. And, nationally more than half a million are living with ESRD.

It’s no fault of employers though, as our kidney care system as a whole is fundamentally broken, giving them no viable solution to kidney disease’s immense burden. Despite CKD being so common, the system today does very little to intervene before patients’ kidneys fail and they end up on dialysis. This kind of care fails to manage CKD as the chronic condition it is, with a personal and cost toll beginning far before kidney failure.

As a result, employees with late stage CKD cost employers $3,300 per month on average, while those with ESRD cost them an average of $14,200 per month. And, while dialysis is largely covered by Medicare, the dialysis costs that employers do face are even more out of control. A recent study found that dialysis costs for commercial payers may be up to four times more than that paid by Medicare - regularly adding up to more than $100,000 per patient annually. 

That’s why our team at Cricket Health set out to fix the broken kidney care system, not just for Medicare or Medicare Advantage patients, but for all of those living with or paying for kidney care—including employers.

That’s why our team at Cricket Health set out to fix the broken kidney care system, not just for Medicare or Medicare Advantage patients, but for all of those living with or paying for kidney care—including employers.

We weren’t the only ones to recognize this urgent need for a new kind of kidney care in the employer-sponsored market. We are excited to announce that Consortium Health Plans, a national collaboration of 21 independently licensed Blue Cross Blue Shield (BCBS) Plans, has selected Cricket Health as a Preferred Partner.

This means that Consortium’s membership of BCBS plans will be able to offer Cricket’s innovative model of kidney care to their national accounts, which in total represent nearly 25 million employee members. The goal is to help large national employers access better kidney care that drives better health outcomes and reduced costs for their employees across the country. But, this is just the start of our efforts in the employer space.

We see a great opportunity for Cricket to work with self-funded employers as well as their health insurance brokers and consultants, as our kidney care model offers a few unique benefits in this space:

• First, Cricket delivers our patient-centered care through value-based payer arrangements with large employers. We’re willing to share in financial accountability for patient health outcomes and total renal care costs. Employers are frustrated by innovative new health care solutions that overpromise and underdeliver, but with our flexible, risk-based business model they can be confident in the value they and their employees will see from Cricket.
• Second, Cricket is a total kidney care partner. We offer comprehensive kidney care, which enables us to impact the patient experience throughout the entire care continuum. Our model predominantly focuses “upstream” on managing and slowing the progression of CKD by delivering personalized, multidisciplinary care to each patient during each step of their kidney care journey. This approach means that Cricket can look beyond simply reducing unit cost of individual care services to improving employees’ health and total costs of care through more coordinated, timely care, and reduced cost drivers, like ER visits, hospitalizations, and in-patient starts on dialysis.
• Third, Cricket delivers the best possible ESRD care—not just in-center dialysis. As patients progress to ESRD, we guide them through the smoothest transition possible with the goal of keeping them out of the ER or hospital. We also educate patients and help them select the best possible care plan for their situation. For many, this may not mean dialysis; rather we increase access to transplants, and support patients’ choice of alternatives like conservative care. When it comes time for dialysis, we offer a whole new dialysis experience that is patient-centered, empowering, and puts patients in charge of their care either at home or at our centers. And, as a result, we have seen more than four times as many in-home dialysis starts among Cricket patients than the status quo.

It’s simple— employers and their employees deserve better kidney care. We are excited to partner with Consortium to make that happen, by bringing patient-centered, empowered kidney care to employers across the country.