RIVERSIDE: Kaiser Chosen For HCFA Demonstration Project
Kaiser Permanente of Southern California has been chosen as "one of three managed care programs that will test whether HMOs can equal or improve upon the treatment of Medicare patients with serious kidney disease while lowering costs." The Riverside Press-Enterprise reports that under current regulations, Medicare patients with "end-stage renal disease" cannot enroll in HMOs. In the three-year demonstration project, Kaiser will draw patients from Riverside, San Bernardino, Los Angeles, Orange and San Diego counties. The project officially began Sunday and has enrolled 90 patients. Dr. Peter Crooks, medical director for Kaiser's demonstration project, said, "People generally assume managed care organizations don't want to attract large numbers of chronically ill patients. But based on our experience in caring for our own [end-stage renal disease] patients, I believe we can measurably improve their health within the government's budget."
The Press-Enterprise reports that "[e]nd-stage renal disease is one of the costliest chronic conditions." In addition, "[i]t is the only specific disease that Medicare covers for anyone -- regardless of age." Fee-for-service Medicare pays approximately $65,000 to $75,000 per year to care for end-stage renal disease patients. Kaiser will receive approximately $52,800 per year per patient for the project. Kaiser Permanente of Southern California has more end- stage renal care patients than any other HMO in the nation, and its death rate for the disease is 12.7%, compared with a 20.6% average in Southern California. The other HMOs chosen for the demonstration project are Phoenix Healthcare of Tennessee Inc. and Health Options Inc. in Florida (Schwartz, 2/3).