Kidney care team forms

George Washington, Hopkins create firm to manage treatment

Largest in mid-Atlantic

Health care

January 12, 2000|By Lorraine Mirabella | Lorraine Mirabella,SUN STAFF

Johns Hopkins Medicine and George Washington University announced yesterday that they have formed a company to manage the care of kidney disease patients in the mid-Atlantic region.

Integrated Renal Solutions, owned equally by the medical institutions, will be the largest entity in the region managing care for end-stage renal disease, Johns Hopkins officials said yesterday.

Using community-based patient care guidelines developed by Dr. Paul Scheel Jr., clinical director of Hopkins' department of nephrology, nurse coordinators hired by Integrated will visit patients at home and help monitor their diet, medication and treatment.

The nurses will report to Dr. Scheel and Dr. Juan Bosch, chief of renal diseases and hypertension and professor of medicine at George Washington. The two doctors will serve as co-medical directors of the joint venture.

Using Dr. Scheel's guidelines over the past three years at its Bond Street Dialysis Center in Baltimore, Hopkins has seen 10 percent fewer deaths and a drop in hospital admissions for end-stage renal disease.

By teaming up, the two medical institutions hope to expand such services beyond their own patients -- which will number about 100 including George Washington University's patients -- and serve kidney patients covered by health plans and insurers in the region, said Michael Thompson, Hopkins' vice president of managed care and president of Johns Hopkins Health Care.

Within Integrated's geographic reach from central Virginia to Delaware, an estimated 7,000 people suffer from end-stage renal disease, which affects a disproportionate number of African-Americans and Hispanics and can cost from $5,000 to $9,000 a month to treat, Thompson said.

"Many times, these patients are not under the active care of a nephrologist and not receiving the optimal care," Thompson said. The disease is often under-diagnosed and not picked up in people who have diabetes.

Joining with Hopkins "helps us to [increase] market share and to provide a broader, better sense of care," said Dr. James G. Barnes, senior associate vice president for health affairs and business development at George Washington.

"Renal dialysis patients are highly dependent patients. The key to this is being able to be there and satisfy the demands of these patients in a way that's more cost-effective."

The joint venture represents a growing health care trend of "managing" chronic diseases, said James Unland, president of Health Capital Group of Chicago, a consulting firm.

"This is going on around the U.S. The insurance companies want to keep people out of the hospital as much as possible. And patients don't want to be running to hospitals and doctors any more than they have to," the consulting executive said.

For the hospitals joining forces to offer such services, it is a way to remain competitive while expanding market share in a region, he said.

"If Johns Hopkins and GW put this in place, they can go to the payers and say, `We can disease-manage these patients better than anybody in the region. Give us a chance to do that,' " Unland said.

IRS is negotiating its first contract with CareFirst BlueCross BlueShield, based in Owings Mills, and hopes to add at least two more regional managed care organizations this year, Thompson said.

Integrated hopes to have all the area's major managed care organizations as clients. Integrated would not replace the patients' doctors, only monitor patient care, he said.

Eventually, the company could provide services as well to patients before they reach end-stage renal disease, to prolong the period before hospitalization, he said.

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