Chronic Kidney Disease Data Analysis Strategy

At the intersection of value-based¹ reimbursement models, data analytics, and population health strategies, the opportunity to address a crisis of undiagnosed and therefore untreated chronic kidney disease waits for active engagement and necessary change.

Few public health crises lend themselves better to leverage data analytics to impact value-based reimbursement than chronic kidney disease (CKD).

• CKD is incredibly prevalent, affecting 1 in 7 adults.
• It is extremely underdiagnosed with just 10% or 4 million of the estimated 37 million Americans with CKD even aware they have it.
• CKD is a disease multiplier. It significantly increases risk for cardiovascular events and mortality². However, annual testing, early diagnosis, and risk factor management can slow progression and reduce rising cardiovascular risk. ^3,4
• Complications of CKD are a significant and avoidable expense. The health care cost burden for CKD is substantial with over $115 billion spent annually in Medicare alone. People with CKD comprise 14% of the Medicare population but account for 25% of expenditures.⁵
• 80% of people with undiagnosed CKD have information in their medical records illustrating that their kidneys are impaired. ⁶

To understand the impact of unrecognized CKD in their populations, organizations can leverage existing laboratory data to determine the rate of CKD testing or diagnosis in this population.  They can also evaluate guidelines in concordance with recommendations to slow or stop CKD progression.

State Health Departments, through a review of all payer claims database (APCD), data can identify the burden of CKD in a population, and so can health systems, primary care practices, insurers, and accountable care organizations.  Through an algorithm and process developed by the National Kidney Foundation the people at highest risk for CKD – those with hypertension or diabetes – can be identified, evidence of CKD can be uncovered, and further testing to fully diagnose and stage patients can be conducted using CKD Intercept-Practice-Assessment, a framework for CKD-related data analysis. 

Once the data is established on the disease burden within a specific region, a health system’s population, or an insurance carrier’s membership, steps can be taken, with support from the NKF and the CKDintercept program. These actions not only can improve the health of the population, but also prevent or significantly delay future health care costs.⁷

CKDIntercept is a groundbreaking initiative from the National Kidney Foundation to improve chronic kidney disease testing, recognition and management in primary care.

• Kidney Evaluation Health Measure
• CKD Change Package
• Improving Patient Education
• Ending Disparities in Chronic Kidney Disease: NKF Leadership Summits
• Community Health Workers
• CKD Data Analysis Summary
• Laboratory Engagement Initiative 
• Chronic Kidney Disease Learning Collaborative

¹https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/Value-Based-Programs/Value-Based-Programs
²https://pubmed.ncbi.nlm.nih.gov/24647050/
³https://diabetesjournals.org/care/article/43/Supplement_1/S98/30822/9-Pharmacologic-Approaches-to-Glycemic-Treatment
⁴https://www.sciencedirect.com/science/article/pii/S0085253815547406
⁵https://www.niddk.nih.gov/about-niddk/strategic-plans-reports/usrds/prior-data-reports/2019
⁶https://pubmed.ncbi.nlm.nih.gov/25427285/
⁷https://pubmed.ncbi.nlm.nih.gov/31747237/