Cricket Health is a comprehensive kidney-care provider with a personalized, evidence-based approach to managing chronic kidney disease (CKD) and end-stage kidney disease (ESKD). The Cricket Health multidisciplinary kidney care team includes a nurse, pharmacist, social worker, dietitian, and trained patient mentor. The Cricket Health team works alongside a patient’s current medical providers throughout the full spectrum of care to manage the patient’s condition and help keep them healthy, at home, and out of the hospital.
Clover Health is committed to ensuring that our members have access to high-quality, affordable, and equitable health care with a positive consumer experience. This program aims to bring comprehensive quality care to members who are living with kidney disease, and who can benefit from personalized, evidence-based support outside of their doctor’s office.
So much of what happens with a patient occurs between appointments with their doctors. Cricket Health’s multidisciplinary team works alongside a patient’s current care team to make sure their daily needs are supported between appointments.
Patients can interact with their Cricket Health team by phone or online from the comfort of their home. This approach enables a patient to get the support they need on their schedule. Engaged patients are better able to make informed decisions about their care options.
No. Clover Health provides this program at no additional cost to eligible members and providers. Even though these services are covered 100%, members may still receive an Explanation of Benefits that details any care or services they receive.
No, there is no member cost share associated with this program.
The Cricket Health digital platform, MyCricketTM is a portal where members can learn about chronic kidney disease, ask questions, “chat” with their Cricket Health Care team, and join member/community support groups.
We recommend that providers speak with eligible members about the Cricket Health program. Eligible members will receive a letter or email from Clover Health and Cricket Health inviting them to participate in this program along with enrollment instructions.
Members can choose to accept or decline the program with no impact on their coverage or benefits. Cricket Health will reach out to providers with eligible members to discuss the program and also give them the option to contact their Provider Relations department at 1-888-656-1731.
Clover Health Medicare Advantage members with certain conditions and in select states are eligible for this program. To learn more about eligibility, call Cricket Health Provider Relations at 1-888-656-1731, or send an email to email@example.com.
Each month Cricket Health will send a report to nephrology practices indicating which of our members, your patients, are eligible for the program, enrolled in the program, and who have left the program. Clover Health identifies Medicare Advantage members who have late-stage chronic kidney disease or end-stage kidney disease through claims data.
A provider can refer a patient through email at firstname.lastname@example.org, by calling 888.780.0253, or by visiting crickethealth.com/referrals. While referrals are appreciated, they aren’t necessary for enrollment. Eligible patients will receive a letter or email from Clover Health and Cricket Health with the invitation to participate in this program along with enrollment instructions. Members can choose to accept or decline the program with no impact on their coverage or benefits.
No. Clover Health members continue their relationship with their PCP and specialists. The Cricket Health care team works collaboratively with a member’s providers to complement the care they’re already receiving and reinforce their care plan. Cricket Health’s care team provides extra support and supplemental care management services between appointments.
Providers will be kept informed about their patients who are engaged with Cricket Health and can choose how much or how little they want to engage with the Cricket Health program. There is no requirement for provider involvement. Member participation is voluntary as well, and members can choose to opt-out at any time; however, providers cannot opt-out their patients.
Each member has a multidisciplinary kidney care team that includes a nurse, pharmacist, social worker, dietitian, and trained patient mentor. This team works with the patient’s current providers to offer supplemental services, such as:
- Helping implement the patient’s care plan.
- Coordinating care between medical providers.
- Answering condition or medication-related questions from patients
- Connecting patients with community resources and peer groups.
- Educating patients on renal replacement therapy.
Cricket Health provides members with educational content from renowned clinicians on the MyCricket™ digital platform. Through this platform, patients are connected to an online community of peer groups and trained mentors who share insights about managing kidney disease because they’ve gone through a similar experience.
Cricket Health keeps physicians informed about their patients in the following ways, and works with the providers to determine how and when they would like to receive these status updates:
Monthly Patient Enrollment Reports
Physicians will receive a regular report on their patients’ enrollment status and outreach activities with Cricket Health. The report lists which patients are participating in the program and those who are eligible but have not yet enrolled.
Clinical Progress Notes
Physicians will receive regular reports on blood pressure and weight measurements, medication lists, and other general health updates.
Renal Replacement Therapy Modality Preference
Physicians will receive a report on the patient’s preferences, including end-state kidney disease treatment preference, dialysis modality preference, and transplant readiness.
When clinically necessary, physicians will be immediately alerted if there are urgent changes in clinical status or sensitive clinical concerns.
The Cricket Health team will coordinate with other Clover Health programs as necessary and make referrals to other resources as appropriate. Member participation in the Cricket Health program is strictly voluntary (members may opt out any time) and does not affect access to benefits or other programs or resources.
Cricket Health is driving marked improvements in key clinical and financial measures including:
- With the benefit of educational resources, 83% of Medicare Advantage members who completed modality education on renal replacement therapy options with Cricket Health, made a choice other than in-center dialysis for ESKD treatment.
- Preliminary results show 100% of Medicare Advantage members who started dialysis began this treatment in an outpatient care setting.
*Does not include Clover Health Members.