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Payors

VillageHealth's integrated care management program is NCQA accredited and has been operating and continuously improving since 1997. We work with private and government health care plans  to provide care management services to over 5,900 individuals with chronic kidney disease (CKD) and end stage renal disease (ESRD). We work with nine commercial payors and operate two demonstration programs for the Centers for Medicare & Medicaid Services (CMS).


The table below profiles representative client program results.

 Commercial Clients CMS Demonstrations
Program Name

9 national and regional managed care organizations (MCOs)

Key to Better Health

Medicare ESRD Demonstration

Launched

1997

2005; renewed in 2008

2006

Target Populations

CKDand ESRD

CKD and ESRD

ESRD

Active Patient Participants

3,711

1,900

437

Key Results
  • Provided 3:1 return on investment; average net savings of $800 per member per month (national MCO)
  • Lowered overall cost trends by 43% when compared to client's historical trends (regional MCO)
  • In its first year, regional MCO reduced:
    • Medical cost by 7%
    • Inpatient utilization by 7%
    • SNF visits by 14%
    • ER visits by 7%
  • Unable to release results due to CMS regulations

 

  • Achieved 74 out of 79 Quality Initiative Program targets over life of program
  • Reduced hemodialysis catheter rates from 21% to 8% since program inception
  • Increased vaccination rate for pneumonia and influenza to >90%
  • Triple the reduction in hospital admits compared to Fee For Service programs, over 2-year period

Success Stories

" I am a 53-year-old man living in Riverside, CA who had a kidney ... more "
David
" I am the caregiver for my wife who had a stroke and cannot talk very ... more "
Vickie
" When I was in the hospital, my VillageHealth Nurse was my lifeline. ... more "
Eleanor
" The Key to Better Health gives me a place to go for information and ... more "
Nicholas
" I am a 62-year-old man who lives in San Bernardino, CA and I have ... more "
Robert
" I am a 60-year-old woman who lives in San Bernardino, CA and I have ... more "
Margaret
"

I am a 56-year-old man who lives in San Bernardino, CA ... more "

William
"

The Key to Better Health helps me feel better. My ... more "

Ann
"

I was blessed the day Key to Better Health first ... more "

Salvatore

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