The New InterWell Health – Transforming Value-Based Kidney Care in America's Dialysis Industry

Ben H.

Ben H.

Feb 09, 20244 min read

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The New InterWell Health – Transforming Value-Based Kidney Care in America's Dialysis Industry

In a groundbreaking announcement, Fresenius Health Partners, InterWell Health, and Cricket Health have come together in a three-way merger to form the nation's premier value-based kidney care provider under the name InterWell Health. This new entity is set to revolutionize the way kidney care is delivered, with a focus on expanding and improving the quality of care for patients across the continuum of kidney care.

One of the key strengths that Fresenius Health Partners brings to the table is its expertise in value-based contracting and performance. Over the years, they have worked closely with InterWell Health to build a network of over 1,600 nephrologists. Together, they have achieved remarkable results, significantly reducing hospitalizations and readmissions, while also generating savings for payor partners. This experience in value-based care will undoubtedly play a vital role in the new InterWell Health's mission to transform kidney care.

Cricket Health, on the other hand, brings a unique set of capabilities to the table. Their machine learning and predictive analytics capabilities are set to revolutionize patient engagement and enable earlier intervention. By leveraging these innovative technologies, InterWell Health aims to provide personalized care and support to patients, ensuring better outcomes and improved quality of life.

The dialysis industry in America has long been dominated by just two companies – DaVita Kidney Care and Fresenius Medical Care. According to a Freakonomics Podcast, out of a total of 7,500 dialysis centers in the country, 5,000 of them are owned by these two giants. Their growth has been primarily driven by acquiring small, independent dialysis centers.

However, economists from Duke University have studied these acquisitions and made some intriguing discoveries. They found that the change in ownership of these dialysis centers resulted in a 200% increase in the use of an anemia shot called EPO, despite no change in the patients' clinical condition. This sheds light on the potential impact of ownership changes on patient care and raises questions about the motivations behind such acquisitions.

Furthermore, the researchers also found a 9.5% decrease in patients receiving kidney transplants or being listed for transplants after the DaVita or Fresenius acquisition of independent clinics. This is a significant finding as a kidney transplant eliminates the need for dialysis, resulting in a loss of customers for these companies. This raises concerns about the influence of financial incentives on patient care decisions.

The Freakonomics Podcast delves even deeper into the dialysis industry, highlighting how commercial health insurance pays DaVita and Fresenius four times more than what Medicare pays for the first 30 months a patient is on dialysis. This discrepancy in reimbursement rates raises questions about the fairness and transparency of the payment system and its impact on the quality of care provided.

In addition, the podcast uncovers a scheme where the American Kidney Fund pays insurance premiums for patients, allowing them to stay on commercial insurance for the maximum amount of time. Interestingly, DaVita and Fresenius supply 80% of the American Kidney Fund's budget, raising concerns about the potential conflicts of interest and the impact on patient care decisions.

As the new InterWell Health takes shape, there are several actionable pieces of advice that healthcare providers and policymakers can consider to address the challenges and improve the quality of kidney care:

  • 1. Promote competition and diversify ownership: Encourage the growth of independent dialysis centers to foster competition and reduce the concentration of ownership in the hands of a few companies. This can lead to better patient outcomes and increased access to care.
  • 2. Enhance transparency in reimbursement: Work towards a more transparent and equitable reimbursement system that aligns payments with the actual cost of care. This will incentivize providers to focus on delivering high-quality care rather than maximizing profits.
  • 3. Foster collaboration and innovation: Support initiatives that leverage technology and data analytics to improve patient engagement, enable earlier intervention, and enhance the overall delivery of kidney care. Investing in research and development can lead to breakthroughs in treatment options and better outcomes for patients.

In conclusion, the merger of Fresenius Health Partners, InterWell Health, and Cricket Health to form InterWell Health represents a unique opportunity to transform value-based kidney care in America's dialysis industry. By leveraging their respective strengths and capabilities, this new entity aims to expand and improve kidney care, ultimately leading to better outcomes and improved quality of life for patients. However, it is crucial to address the challenges and potential conflicts of interest in the industry to ensure that patient care remains the top priority. By promoting competition, enhancing transparency in reimbursement, and fostering collaboration and innovation, we can strive towards a future where every patient receives the highest quality kidney care they deserve.

Resource:

  1. "The New InterWell Health – A Unique Opportunity to Transform Value Based Kidney Care", https://fmcna.com/insights/articles/new-interwell-health/ (Glasp)
  2. "#Dialysis Industry: According to Freakonomics Podcast, 5,000 Out ", https://www.linkedin.com/posts/ericbrickermd_dialysis-acquiring-anemia-activity-7099699061817044992-FeRJ/?utm_source=share&utm_medium=member_desktop (Glasp)

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