10/21/2021 | Press release | Distributed by Public on 10/21/2021 09:23
In 2020, Blue Shield of California announced a new collaboration with Cricket Health as part of its Health Reimagined initiative to transform the healthcare system for individuals, families, and communities.
Together, we launched an innovative, personalized, and comprehensive care coordination program for Blue Shield fully insured commercial Preferred Provider Organization (PPO) and Exclusive Provider Organization (EPO) members with late-stage chronic kidney disease (CKD) or end-stage kidney disease (ESKD) at no additional cost to them. Now that we have completed the program's inaugural year, we have promising results based on Blue Shield's claims data: increased visits with nephrologists, improved clinical outcomes, high satisfaction ratings from members, and fewer hospitalizations.
Seeking increased care
Blue Shield members who enrolled in the Cricket Health plan had an increased average number of interactions with care teams. While the average kidney care patient sees their nephrologist four times a year, early data has shown that Blue Shield members enrolled in the Cricket program are interacting with their care team every two to three days. Blue Shield attributes this increased engagement to Cricket's innovative model and patient-support program, as well as the continued interest in members staying on top of health needs - at a distance - during the ongoing COVID-19 pandemic.
The strong engagement between Blue Shield members and the Cricket Health team is yielding positive results in key clinical measures for kidney disease:
Cricket Health provides members with peer support, education, and advice to help them confidently navigate their personal kidney-care journey.
Blue Shield members are highly satisfied with the program, with a Net Promoter Score (NPS) of 53. The NPS indicates the level to which a current patient would recommend Cricket Health to a family member or friend. NPS scores range from -100 to 100, with anything above 50 considered excellent. Here's one patient's Cricket Health story.
"I was blown away," Rick said of his first interactions with his Cricket Health team. "It was just the beginning of a very in-depth, detailed conversation about my kidney disease and how to make changes in my life that would make me feel so much better."
Rick appreciates the regular, attentive care he receives from his Cricket Health team: "In almost all healthcare these days, you meet with a specialist, and they say, 'Come back and see me in three months.' The real benefit I found with Cricket Health was a lot more contact and help on dialing in things at a detailed level that I just wasn't aware of. Also, they teamed up with my regular nephrologist, who welcomed the help."
Rick's care team helped him create a daily management plan and diet. He has lost 50 pounds, which improved his diabetes control, kidney health, and blood pressure. Rick's goal is to meet the eligibility requirements for a kidney transplant, and this mission drives him to stay engaged with his care team.
"Cricket Health was an absolute turnaround for me," said Rick. "I'm pretty informed as a patient. But there was a time when I was very uninformed and somewhat cavalier about all this stuff and thought I had all the time in the world to deal with it. The important takeaway for anyone who has kidney problems -- or any other chronic problem -- should be if you're only seeing your specialists every few months, you need to find other resources. In the case of kidney disease, Cricket Health has modeled the way to help patients. And I really appreciate that. Do it now. Don't wait."
How the Cricket Health program works
Cricket Health offers a multidisciplinary care team that includes nurses, pharmacists, social workers, dietitians, and trained peer mentors through a patient support program. The program is offered for Blue Shield members enrolled in Blue Shield's fully insured commercial Preferred Provider Organization (PPO) and Exclusive Provider Organization (EPO) benefit plans.
The team, available online and by phone, works closely with the participating member's medical providers, including primary care physicians, nephrologists, and other specialists, to help ensure that the patient remains healthy, at home, and out of the hospital through an evidence-based approach to managing kidney disease. Members also have access to stage-specific educational resources, as well as a peer support network to share stories and ask questions.
Early identification and intervention
Cricket Health helps Blue Shield identify members with late-stage chronic kidney disease or end-stage kidney disease. Using a proprietary algorithm, the Cricket analytics platform uses Blue Shield claims data to identify kidney disease stages 3b and beyond with 96% accuracy, and to assess and predict clinical risk for informed outreach and interventions.
This predictive analytics platform allows Cricket Health providers to intervene well before kidney failure with a personalized care plan for each member, designed to slow disease progression. For members whose kidney disease does progress, Cricket Health helps them understand treatment options and empowers them to choose the right treatment for their unique situation.