January 20, 2016

Adler-Milstein awarded grant to study seamless care coordination of ESRD

Assistant Professor of Information Julia Adler-Milstein has received a $158,030 grant from the Centers for Medicare & Medicaid Services for her project surrounding the Comprehensive End-Stage Renal Disease (ESRD) Care (CEC) Initiative.

The project was established in response to a Task Order Request for Proposal, in which the University of Michigan Kidney Epidemiology and Cost Center – within the School of Public Health – will act as sub-contractor to evaluate the impact of the CEC Initiative.

adler milstein
Julia Adler-Milstein

End-Stage Renal Disease (ESRD) is present in more than 600,000 Americans, and it requires life-sustaining dialysis treatments several times a week. While ESRD beneficiaries comprised only 1.1% of the Medicare population in 2012, they accounted for approximately 5.6% of total Medicare spending.

These high costs often result from underlying disease complications, multiple co-morbidities, and a mortality rate that is higher than the general Medicare population. Due to complex health needs related to ESRD, beneficiaries are often required to visit multiple providers and to follow multiple care plans, which can be challenging if care is not coordinated.

The CEC Initiative, authorized under the Affordable Care Act, aims to join dialysis clinics, nephrologists and other providers to create Seamless Care Organizations (ESCOs) that coordinate care for beneficiaries. This model encourages dialysis providers to step outside their traditional roles in care delivery and to provide patient-centered care that addresses health needs both in and outside of the clinic.

Under this grant, Adler-Milstein will design and conduct an evaluation of the CEC Initiative, which includes assessing the impact of the initiative on care quality, health outcomes, and Medicare expenditures of beneficiaries with ESRD. The analysis will combine data from sources including claims, surveys, clinical quality measures, medical records, and market information.

The data collected from this project will also support the ongoing improvement of ESCOs by evaluating care improvement efforts, documenting the effectiveness of improvement strategies, and assessing the strength of a shared learning system for beneficiaries and dialysis care providers.