Advanced Plan for Health Logo
 

Part 2 - Consumer Guide to High Blood Pressure to Share with Your Population

Part 2 - Consumer Guide to High Blood Pressure to Share with Your Population

Barbara Rutkowski, EdD, MSN, CCM - Vice President, Clinical Operations, Advanced Plan for Health  & Joy McGee-Cory - Senior Vice President, Advanced Plan for Health

The team at Advanced Plan for Health (APH) is passionate about improving the health and well-being of as many healthcare consumers as possible, so in honor of Heart Health Month, we created a Consumer Guide to High Blood Pressure for you to use to share details on the risk of hypertension and some preventative measures with your member, employee and patient populations. We encourage you to share any of this information as you find appropriate.

Part 1 – The Risks of Hypertension and the New 2017 Hypertension Guidelines

Part 1 – The Risks of Hypertension and the New 2017 Hypertension Guidelines

Barbara Rutkowski, EdD, MSN, CCM - Vice President, Clinical Operations, Advanced Plan for Health  & Joy McGee-Cory - Senior Vice President, Advanced Plan for Health

Hypertension (High blood pressure) affects more than 75 million — or nearly one-third of American adults according to the Centers for Communicable Disease (CDC) in Atlanta. About 28 percent of American adults ages 18 and older, or about 59 million people, have pre-hypertension, a condition that raises the chances of having heart disease or stroke or developing chronic kidney disease. Hypertension is often called the “silent killer” because many people do not have symptoms when their blood pressure is elevated.

In addition to the human toll, “high blood pressure costs the nation $46 billion each year” according to the Centers for Disease Control. “This total includes the cost of health care services, medications to treat high blood pressure, and missed days of work.”

Part 3 - The Cost of Dialysis and TPA and Medical Management Best Practices

Part 3 - The Cost of Dialysis and TPA and Medical Management Best Practices

Joy McGee-Cory - Senior Vice President, Advanced Plan for Health & Barbara Rutkowski, EdD, MSN, CCM - Vice President, Clinical Operations, Advanced Plan for Health

Dialysis is big business.

In fact, according to the National Kidney Foundation®, “the annual Medicare spending to treat kidney failure in the U.S. is approximately $31 billion”.

Unlike the private-sector health plans, Medicare has a “Most Favored Nation” clause which means that providers cannot give a discount on billed charges to health plans or others that is greater than what they give to Medicare.

Part 1 - Kidney Failure and Dialysis - What Employers, Health Plans, TPAs and Nurse Care Managers Need to Know

Part 1 - Kidney Failure and Dialysis - What Employers, Health Plans, TPAs and Nurse Care Managers Need to Know

Joy McGee-Cory - Senior Vice President, Advanced Plan for Health & Barbara Rutkowski, EdD, MSN, CCM - Vice President, Clinical Operations, Advanced Plan for Health

Kidney failure and life-saving dialysis are both a catastrophic health plan expense and life-changing experience that impact health plans and lives through probability.  The incidence of chronic kidney / renal disease is about 2 to 2.5 per 1,000 members across the APH customer base. Because lady luck is elusive, lightning can strike twice for the same health plan, resulting in typical annual health plan expenditures between $350,000 and $700,000 for each member on dialysis. According to the National Kidney Foundation, more than 660,000 Americans have end stage renal disease (ESRD), meaning that their kidneys have permanently failed, and dialysis is required to cleanse the toxins from their bodies.   

This is a multi-part blog series. Part two will cover – Preparing for a Kidney Transplant or Dialysis.

Part 2 - Preparing for a Kidney Transplant or Dialysis

Part 2 - Preparing for a Kidney Transplant or Dialysis

Joy McGee-Cory - Senior Vice President, Advanced Plan for Health & Barbara Rutkowski, EdD, MSN, CCM - Vice President, Clinical Operations, Advanced Plan for Health

Members who are in chronic kidney disease at Stage 3 or 4 need to be approached about their plan of treatment. At this point the member may be in denial or unable to determine if they would like to be listed for a transplant, but it is not too early to start the process. The member needs to know about the importance of an early transplant listing decision, because it takes eligible individuals 24 months or longer on the transplant list to get a kidney. They can always change their minds and remove themselves from a transplant list, or list with more than one Center of Excellence to improve their chances for receiving a kidney.

This is a multi-part blog series. Part three will cover – The Cost of Dialysis and TPA and Medical Management Practices