CLEVELAND, Nov. 16 /PRNewswire/ -- Using a newly-developed network of kidney dialysis centers may enhance care while lowering coinsurance payments for Anthem Blue Cross and Blue Shield (Anthem) members coping with kidney failure. In Northern Ohio, more than 50 providers who participate in Anthem's new network have been credentialed and their certification verified with the Centers for Medicare and Medicaid Services (CMS).
"We created this network to improve quality and coordination of care. Many patients receive their dialysis treatments from free-standing outpatient facilities, but traditionally, the quality of care from these providers has been difficult for health plans to assess," said Alena Baquet-Simpson, M.D., Anthem's Ohio Medical Director. "Plus, utilizing network providers may help members preserve their lifetime maximum benefits."
The need for quality, coordinated and cost-effective care for kidney patients is growing. According to the National Kidney Foundation, 20 million Americans have chronic kidney disease (CKD) and at least 20 million more are at risk. More than 100,000 people now develop the disease annually in the United States, and this number has doubled each decade since 1980. In Ohio alone, more than 2,500 patients are in kidney failure and waiting for a kidney transplant.
Diabetes is the most common cause of kidney failure among adults, according to the National Institutes of Health, and the prevalence of diabetes as a primary diagnosis of end-stage renal disease continues to rise more rapidly than that of any other diagnosis, reports Healthy People 2010. The costs of treating kidney failure are high, reaching $18 billion nationally in 1999.
While more people are developing CKD, research shows that it remains under-diagnosed. Anthem has created a comprehensive CKD program, including a dialysis provider network, to help heighten physician awareness and offer more support to those at all stages of the disease.
In March 2004, the company began providing targeted materials to members with mild to moderate kidney disease and expanded case management services to those at risk for, or in, renal failure. In addition, physicians were sent information and nationally developed guidelines for managing the care of CKD patients.
"When Anthem members self-refer to the CKD program, or are recommended by their physician, they gain access to a variety of services to help maximize their current health and well-being and slow or stop the progression of mild to moderate cases of kidney failure," noted Dr. Cramer. "For members whose disease has progressed to renal failure, the new dialysis provider network provides additional safeguards by allowing coordination of care across delivery sites."
Anthem's mission is to improve the health of the people it serves. The Anthem Blue Cross and Blue Shield companies, including Anthem Blue Cross and Blue Shield in Ohio, provide health care benefits to more than 12.5 million people. Anthem Blue Cross and Blue Shield in Ohio is a subsidiary of Anthem, Inc. ; both are independent licensees of the Blue Cross and Blue Shield Association. Anthem is the Blue Cross and Blue Shield licensee for Indiana, Kentucky, Ohio, Connecticut, New Hampshire, Colorado, Nevada, Maine and Virginia, excluding the Northern Virginia suburbs of Washington, D.C. More information about Anthem is available at http://www.anthem.com/ .
Anthem Blue Cross and Blue ShieldCONTACT: Chip Palazzo of Anthem Blue Cross and Blue Shield,+1-216-643-0101
Web site: http://www.anthem.com/