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Cricket Health Improves Outcomes for Medicare Advantage Beneficiaries Living With Chronic Kidney Disease

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Results from support and management of Medicare Advantage patients show reduction in total cost of care, hospital admission rates

San Francisco and Boston (December 21, 2021) – Cricket Health, a value-based kidney care provider, today released Medicare Advantage results from a 6 month period. The findings demonstrate the effectiveness of Cricket Health’s care model and provide a case study for comprehensive, value-based care delivery for chronic kidney disease (CKD) and end-stage kidney disease (ESKD).

Results from the six months of deployment show positive results in key measures:

  • Significant cost savings: Per member per month (PMPM) spend reduction of 17 percent for CKD patients at stage 3B or greater and a PMPM reduction of 27 percent for CKD patients at stage 4 or greater.
  • Improvements in key health outcomes: Reduced hospital admissions by 37 percent for patients on dialysis and by 25 percent for CKD patients at stage 4.

“The most important measures in health care revolve around outcomes and costs — and within just months of collaboration, Cricket Health delivered on both of these metrics for our thousands of Medicare Advantage patients,” said Robert Sepucha, CEO of Cricket Health. “The Cricket Health model provided stability and accessibility that kept patients healthy between appointments with their provider and out of the hospital. We look forward to improving the long-term health journey of even more people living with kidney disease nationwide.”

Cricket Health’s results demonstrate that comprehensive care management for kidney disease is key to improving outcomes and controlling high costs for health plans, who face up to nine times greater costs for the kidney disease population compared to MA averages. Cricket Health’s value-based kidney care offering is specifically designed for MA plans, helping them provide care management services for plan members with late-stage CKD and end-stage kidney disease. This includes patients who have not yet progressed to dialysis and can benefit from preventative care from a full care team, as well as patients who are on dialysis and can benefit from at-home care and a better understanding of their care options — which can lead to a better quality of life for individuals with kidney disease.

As part of the collaboration, Cricket Health first used its proprietary machine learning disease identification model, StageSmart™, to identify and risk-stratify the MA patients living with, or at-risk for, kidney disease. Then, patients accessed MyCricket™, a comprehensive patient support program that connects patients with kidney disease with peer support, a peer mentor, a care team, and stage-specific educational resources available 24/7. Multidisciplinary care teams — including a nurse, pharmacist, social worker, dietitian, and trained patient peer mentor — worked in unison with the existing network of medical providers, including primary care providers, nephrologists, and other specialists. For patients who did progress to kidney failure, Cricket Health deployed an ESKD-specific program that has been proven to increase transplant referrals and adoption of home dialysis. 

“Our work with MA health plans is centered around our shared goal of managing CKD progression through comprehensive care, making Cricket Health’s best-in-class model a natural fit for this value-based environment,” said Ryan Jacobs, Cricket Health’s Chief Commercial Officer. “Our work together has empowered patients to make decisions that are right for their own care journeys, all at no additional cost to them or their nephrologist’s practice.”

Learn more about Cricket Health’s comprehensive, evidence-based approach to kidney care for MA plan members here.

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