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Medical University Optimizes Chronic Kidney Disease Care and Outcomes

In 2017, a medical university partnered with Cedar Gate Technologies to integrate value-based care solutions to facilitate better outcomes for their 100+ locations and a network of more than 1,000 healthcare providers. The organization was participating in the Medicare Shared Savings Program (MSSP) Enhanced Track and wanted to focus on chronic kidney disease (CKD) management.

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Client Profile

The medical university faced three main challenges in CKD management:

  • Patients with decreasing kidney function that could lead to ER visits were experiencing an increase in average spend while still dealing with unmanaged disease progression.
  • Cost analysis and patient satisfaction ratings revealed that hemodialysis treatment was sub-optimal compared to peritoneal dialysis.
  • Patients with chronic comorbid conditions had worsening CKD, resulting in higher levels of hospitalization when compared to patients without these conditions.
VBCA Screenshot

The Cedar Gate Solution

Based on its existing relationship with Cedar Gate, the university adopted a threefold strategy to deal with these central issues:

  • Implementing Cedar Gate’s Value-Based Care Analytics (VBCA) software
  • Identifying and applying appropriate care measures for CKD patients
  • Soliciting actuarial and other consulting services from Cedar Gate

Value-Based Care Analytics generates insights to maximize performance in value-based care agreements. It’s a key component for orchestrating VBC contract lifecycles and maximizing cost savings and quality.

VBCA enabled the university to track patients by CKD stage based on factors such as their ER spend, locations, PCPs, preventable, and unpreventable conditions. It helped the organization identify the people currently utilizing hemodialysis and demonstrate the potential value of shifting appropriate patients to peritoneal dialysis. It also pinpointed patients with complicating comorbidities that were resulting in hospitalization so care providers could take steps to reduce hospitalization whenever possible with this high-risk group.

Operational Impact

The university aligned VBCA with each of the main challenges, beginning with employing Emergency Room (ER) Utilization Management. This helped the university’s service locations reduce unnecessary ER visits for patients with chronic kidney disease. Through an analysis of hemodialysis and peritoneal dialysis utilization, providers were able to align existing patients to cost-effective treatment and improve satisfaction.

Lastly, there was ongoing improvement in managing complicating comorbidities and reducing avoidable and undesirable hospital admissions for patients.

Graphic 4Since investing further in Cedar Gate’s VBCA solution, from 2020 to 2021, the university has seen improved outcomes for CKD patients, including a 3% improvement in the number of patients with comorbidities who avoided hospitalization. Those patients who avoided hospitalization had an average savings of $36,100.

In the fall of 2021, the organization committed a Care Coordinator to strategic CKD management initiatives to:

  • Conduct post-discharge follow-up
  • Analyze dialysis location and utilization patterns
  • Establish patient programs
  • Standardize documentation across practices
  • Encourage use of peritoneal dialysis when appropriate
  • Provide disease-specific education to CKD patients


Adaptable, Self-Service Performance

Our self-service Value-Based Care Analytics application generates the insights needed to maximize performance in value-based care agreements. Actuarial modeling capabilities enable the orchestration of the entire contract lifecycle, from design, negotiation, and activation, through settlement, measurement, and optimization.


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