FAQs
Cricket Health is working with your patient’s health plan to help their in network kidney care specialists enhance the quality of life for their patients. Cricket Health offers a personalized, evidence-based approach in managing chronic kidney disease (CKD) and end-stage kidney disease (ESKD). The Cricket Health multidisciplinary kidney disease support team includes a nurse, pharmacist, social worker, dietitian and trained patient mentor. The Cricket Health team can also work together with the patient’s current medical providers to help keep them healthy, at home, and out of the hospital.
The Cricket Health program does not offer medical treatment or advice, rather, the program supplements the treatment plan that PCPs and specialists provide to members with chronic kidney disease. Cricket Health can help members better manage their condition, allowing them to live their best quality of life. Cricket works with the members’ providers outside of the physician’s office. This approach can help our members make informed decisions and remain engaged with their Cricket team that’s accessible online or by phone.
No. Blue Cross Blue Shield of Massachusetts provides this program at no additional cost to their 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, MyCricket™, is a portal where members can learn about chronic kidney disease, ask questions, “chat” with their Cricket Health team, and join member/community support groups.
We recommend that providers encourage eligible members to enroll in the Cricket Health program. Eligible members will receive a letter or email from Cricket Health inviting them to participate in the program along with enrollment instructions. Members can accept or decline participation in the program with no impact to their coverage or benefits. Cricket Health will reach out to providers who have eligible members to discuss the program and give them the option to contact Cricket’s Provider Relations department at 1-888-656-1731.
Each month Cricket Health will send a report to nephrology practices indicating which of our members are eligible for the program, enrolled in the program, and who have left the program. Commercial members who have late-stage chronic kidney disease or end-stage kidney disease are identified through claims data.
No. Members continue their relationship with their doctors. The Cricket Health program does not provide medical advice and is intended to support members in adhering to your treatment plan. The team works together with a member’s providers to be the eyes and ears outside the physician’s office.
Each patient has a dedicated multidisciplinary kidney care team that includes a nephrologist, nurse, pharmacist, social worker, dietitian, and trained peer mentor. This team works in unison to provide supplemental services to a provider’s care, 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
- Assisting with wellness and weight management coaching
Cricket Health provides patients with educational content from renowned clinicians on a Cricket Health digital platform. Through this platform, patients are connected to an online community of peer groups and trained peer mentors who can share useful insights about managing kidney disease.
Cricket keeps physicians informed about their patients by providing updates and actions in four circumstances.
- Provider Panel Report: Physicians receive a periodic report on patients’ status of enrollment and outreach activities with Cricket Health. The purpose is to inform the physician of which patients are participating in Cricket Health’s program and which patients are eligible but have not yet enrolled in the program.
- Provider Enrolled Member Progress Note: Physicians receive regular reporting on patient activities, including blood pressure & weight measurements, medication lists, and other general health updates, including ESRD treatment preference, dialysis modality preference, and transplant readiness.
- Escalation Notice: When clinically necessary, physicians are immediately alerted if there are any urgent changes in clinical status or sensitive clinical concerns. Physicians will be provided information regarding the sensitive medical situation
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 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.
With patient-specific questions, physicians can call Cricket Provider Relations a 1-888-656-1731 or send an email to: providers@crickethealth.com.
The Cricket Health team will coordinate with other 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.
Yes. Cricket Health has seen marked improvements in key clinical and financial measures for patients from other health plans that are participating in the program. This includes:
- 50% fewer hospital admissions than the status quo
- 77% of members start dialysis in an outpatient setting, compared to the average of 40%.
- 45% of members who need renal replacement therapy initiate on a home modality compared to the status quo of 11%.
