Intermountain Healthcare, one of the largest health systems in the country, has continued its shift into the home with the launch of its new Kidney Care Center.
The Kidney Care Center is housed in Intermountain Medical Center and grants kidney patients access to doctors, nurses and dietitians — even in their homes — through at-home dialysis.
“The objective of the program is to identify and manage individuals with this disease in its earlier stages,” Ray Morales, assistant vice president at Intermountain Healthcare, told Home Health Care News. “Our focus is on pre-emptive transplant, which means these individuals would receive a transplant prior to starting dialysis. If dialysis is needed, we have a home-first model.”
Overall, about 700,000 people in the U.S. have chronic kidney disease. About half a million of them are currently undergoing dialysis, according to the United States Renal Data system.
For Intermountain, the goal for the Kidney Care Center is to increase access to treatment, according to Morales.
“[Along with] our dialysis services, we are leveraging telehealth to support these individuals that are on home therapy, so we can connect with them in their preferred setting and do regularly needed follow-up, and address ongoing questions that they might have,” he said.
The scale of the program may serve as a template for other large health systems that are looking to expand its care offerings and move into the home.
Founded in 1975, Salt Lake City-based not-for-profit Intermountain is the largest health care provider in the Intermountain West region, with 38,000 employees, 24 hospitals and 160 clinics, plus an in-house insurance division that serves about 800,000 members.
Intermountain’s new Kidney Care Center is far from its first foray into the home. And quite frankly, there aren’t too many health systems that have focused on the home setting more than Intermountain.
In April, for example, the health system announced plans to expand its Intermountain at Home program. Last year, Intermountain teamed up with Minnesota-based in-home care provider Lifesprk to launch Homespire, a private-duty home care model for Utah’s aging population.
“We have been mostly a very acute-focused organization,” Rebekah Couper-Noles, chief nursing officer of community-based care at Intermountain, said recently while speaking at the 2019 HHCN Summit in Chicago. “We decided to go ahead and reorganize so that we had more emphasis on our community-based services rather than just acute. Our whole focus is on community-based care and trying to drive care into what we believe is the right setting — outside of an acute setting, into the home.”
While Intermountain has always had a platform for home health, home medical equipment and home infusion, the organization has been looking to push the boundaries of what it could accomplish in the home setting, according to Couper-Noles.
“We know that our patients don’t really want to go to an acute center,” said Couper-Noles. “We know that it’s probably better, particularly for low-acute conditions, to not be in an acute center. Across the board of all of our portfolio services, we are looking at how to get ahead, how to become our own disruption and how to care for our community in the best possible way.”
On a high level, the new Kidney Care Center falls in line with Trump administration and Centers for Medicare & Medicaid Services (CMS) efforts to shift more treatment of chronic kidney disease into the home.
In July, federal policymakers proposed a series of new payment models for certain kidney-related conditions, advancing goals set forth by a Trump administration executive order.
For Intermountain, however, the Kidney Care Center had been in the works for some time, predating the executive order. The organization had already created an infrastructure that supported their move into the home, according to Morales.
“The executive order has good intentions and gets to the points that need to be addressed, but this has been several years in the making,” Morales said. “As a health system, we manage a higher portion of our population at risk, meaning we receive a capitated payment to manage these patients. Delivering these services in the home provides a less costly alternative for us.”
Currently, 32 patients are receiving their kidney care services in the home — that’s 12% of Intermountain’s total kidney care population. The organization aims to increase this number moving forward, according to health system officials.
“We are actively encouraging patient education so that they can understand the different options that they have and make the most appropriate choice for themselves,” Dr. Suji Lee, medical director of Intermountain’s Kidney Care Center, told HHCN. “Oftentimes, that is the home option.”
Intermountain now has its eye on new technologies that will further advance its efforts in the home.
“From a dialysis perspective, the technology continues to advance in what we can offer to the patients,” Morales said. “We are looking at a new device for home hemodialysis that hasn’t gotten home indication yet but looks to by the end of the year. As technology advances, I think we will see even more patients be willing to have these services delivered in their homes.”