Kidney failure and life-saving dialysis are both a catastrophic health plan expense and life-changing experience that impact health payors 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 payor, 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.
Joy McGee-Cory, Sr. Exec. VP of Consulting Services at APH, is passionate about ensuring that members with chronic kidney disease have the medical management and support they need. She has assisted many clients in successfully navigating Medicare requirements for dialysis and obtaining favorable provider and facility contracts. From her years of experience, she has written a best practices guide that includes requirements for dialysis and details on obtaining favorable provider and facility contracts.
Founded in 2004, Advanced Plan for Health’s advanced and predictive healthcare analytics platform, Poindexter, delivers customized, precise, cost-saving visibility and actionable recommendations that help health plans, TPAs, brokers, employers, providers and others reduce the cost and risk of healthcare while keeping quality high. From troublesome trends in the health of populations to inefficient provider utilization, APH has the data insight and consultative expertise to help clients quickly implement actions that achieve proven results and support long-term strategies. Other APH offerings include design and management of Nurse Navigation services, engagement and relationship-building with local healthcare providers, and more.