5. Tailor efforts to promote in-home dialysis
Many members likely don’t know that dialysis needn’t take place in a clinical setting — in fact, it can often be conducted right in the privacy of their own home. With in-clinic dialysis lasting up to 5 hours, with 3 sessions each week, often for several years, an in-home alternative saves patients time and energy. But it also removes any potential social determinants of health (SDOH) barriers — from lack of transportation or childcare to needing to take time off work for treatments — that can make adherence so hard for vulnerable populations.
Yet here, too, health disparities interfere. Black and Latino patients are far less likely than white patients to be treated with in-home dialysis. And research suggests that systemic bias and social barriers are clear contributors to those lower rates, alongside geographic, demographic and clinical factors.14
Greater awareness and front-line promotion can bolster adoption rates, improving quality of life for patients and helping plans curb their rising dialysis spend. Other tactics on health plan radars include reimbursing patients for days when training requires missing work, increasing telehealth and home visits, providing transportation assistance, and providing coverage for a trained caregiver to oversee in-home dialysis.
Such efforts also align plans with the Biden Administration’s goal of increasing equitable access to in-home dialysis. The Advancing American Kidney Health Executive Order of 2019 set a target that, by 2025, 80% of patients with incident kidney failure should be started on in-home dialysis or receive a kidney transplant.
While there’s no single solution that will solve the entrenched racial disparities in kidney disease management, health plan leaders can affect real change through a constellation of initiatives and efforts. What matters less, perhaps, than perfecting any singular strategy is to simply take action — then measure results, evaluate outcomes and iterate on those strategies.
Learn more about Optum Kidney Solutions.