I S S U E 1 , S E P T E M B E R 2 0 2 0

Driving personalized engagementswith CVS Kidney CareTM analytics

CVSKidneyCare.com34.03.908.1 (9/20)26-52721A 091420

Not all care management programs are created equal.

When it comes to trying to reduce overall health care costs related to chronic kidney disease (CKD), one size does not fit all.

Almost any care management provider will use members’ medical claims to identify those with CKD. But knowing the disease stage alone is not enough to inform effective care management.

That’s where CVS Kidney Care predictive analytics come in.

Going beyond disease stage — rich data, rich insights

We pull added meaning from medical claims by looking at additional aspects of an individual’s health profile — from medical and lab data, to pharmacy and socioeconomic information. Then, we apply this rich dataset to our machine learning models and it points us to the members with the highest three-year risk of starting dialysis.

Compared to stratifying by CKD stage alone, our models can identify 105% more members expected to progress to kidney replacement therapy.1 This means we are including more high-risk members in our engagement approach.

Hypothetical member population

0

15K

Total member population

11K

12K

13K

14K

15K

Number of members identified based on CKD stages 4 and 5

200

12K

13K

14K

15K

Our machine learning model identified twice

as many members

2

Our analytics in action

We know when and how to engage members because we’re better able to predict how quickly someone is progressing toward needing kidney replacement therapy (for example, transplant or dialysis).1

Medical claims information

60-year-old femaleStage 5 CKD

60-year-old femaleStage 5 CKD

Most care management programs would treat these two members the same

Our richer data

Our predictive modeling

Expected time to kidney replacement therapy

0 to 4 months

0 2 4

4 to 18 months

6 8 10 12 14 16 18

Our differentiated analytics reveal these two members should be managed differently.

1CVS Kidney Care analytics, 2020. Latest model performance metrics from CVS Kidney Care Analytics team. All data sharing complies with applicable law, our information firewall and any applicable contractual limitations. Actual results may vary depending on benefit plan design, member demographics, programs implemented by the plan and other factors.

The right support at the right timeWith our unique capability, we can tailor the level and timing of information and support members receive, whether they are progressing slowly (years away from kidney failure) or quickly (only months away from kidney failure).

For those progressing quickly to kidney failure, engagement is aimed at educating them about treatment options and preparing them for that decision. It’s also aimed at helping them avoid hospitalizations and unplanned starts to dialysis.

By engaging people at the right time and with the right support, we can better prepare them to make informed decisions about treatment with a focus on home-first approaches to help improve their quality of life and clinical outcomes.

Improving health, lowering costs

What this means for health plans and payors is predicted health outcomes of your population and tailored engagement aimed at reducing overall health care costs.

To learn more about how we’re transforming kidney care, contact your account manager or email us at

KidneyCare@CVSHealth.com.

CVSKidneyCare.com©2020 CVS Kidney Care, LLC. All rights reserved.34.03.908.1 (9/20) 26-52721A 091420

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