Four ways integrating lab data analytics can improve outcomes for members with chronic kidney disease progression

Nearly 37 million U.S. adults have chronic kidney disease (CKD), and as many as nine in 10 do not know they have the disease¹, making it unlikely they are taking steps for protecting kidney health.

Insights power everything — diagnoses, treatment, prognoses, management — which makes quality, verified data especially valuable. But there’s been frequent criticism that the vast data available — claims, prescriptions, lab results, etc. — is not well integrated or available in a way that is useful.

The power of integrated data

There has been considerable investment in technologies that link data from myriad sources, preserving privacy while generating actionable insights. This combination of data can unlock tremendous value when it comes to managing CKD: visualizing trends, creating patient cohorts, addressing social determinants of health, and even predicting disease progression.

Using integrated data and analytics to predict CKD progression

Predicting CKD progression is a groundbreaking capability that can empower earlier action when outreach and intervention often have the most impact. Diagnostic leaders like Quest Diagnostics® that has access to billions of lab data points have developed unique solutions and algorithms that create complete, actionable, clinical data.

The resulting member insights and predictive analytics can revolutionize the way health plans care for members with CKD in four key ways:

1. Earlier intervention and treatment programs. With combined laboratory results and longitudinal member data, health plans can predict with up to 90% accuracy those members who are likely to progress to end-stage renal disease (ESRD).²  This insight can help health plans accelerate optimal therapies, including renal replacement.


2. The right interventions at the right time for high-risk members. Insights and analytics can provide the clinically suspected CKD stage, and help identify and monitor members who:
   • Are likely to need renal replacement therapy in the next 12 months
   • Have admission and emergency department usage risk in the next six months
   • Are missing key lab results
   • Are likely un- or under-diagnosed


3. Identify members who haven't had guideline-appropriate diagnostics. A health plan’s clinical quality performance is always well-scrutinized. Robust member insights can help promote appropriate, guideline-based testing to optimize a plan’s STAR and/or other quality ratings, as well as help prioritize care.


4. Identify members for third-party risk delegation before they progress to ESRD, and mitigate risk of high-cost member. Longitudinal patient data that includes up to two years of new member historical lab results that predates membership to your plan, along with data from indirect care sources (inpatient, retail locations, etc.), can identify and predict disease progression prior to receiving the first claim and can provide a predictive member cost score.

Conclusion

There’s plenty of data out there. And thanks to integration platforms and algorithms that produce trusted and verified insights, health plans can transform how they care for members by:

• Understanding disease history and future risk
• Decreasing the cost of care by identifying at-risk members sooner
• Engaging members in their care and providing the right interventions at the right time
• Filling in gaps in care for new and existing members to improve population health
• Identifying specific program eligibility for new and existing members
• Identifying services faster to reduce overall member costs
• Delivering overall better experiences by understanding members’ health status and supporting them sooner, leading to higher Consumer Assessment of Healthcare Providers and Systems® (CAHPS) scores

Sponsored by

With access to 65+ billion lab data results and groundbreaking analytics, Quest Diagnostics is committed to helping health plans achieve 5-star ratings. Quest Member Insights with Healthcare Analytics Solutions combines laboratory data and predictive analytics that empower proactive identification of health risks and inequities for new and current members.

Learn more

References

1. CDC. Chronic Kidney Disease in the United States, 2021. Reviewed July 12, 2022. Accessed October 20, 2022. https://www.cdc.gov/kidneydisease/publications-resources/ckd-national-facts.html
2. pulseData. Data on file with Quest Diagnostics; 2021