The 2000 outcomes were compared with benchmarks established by the Health Care Financing Administration (HCFA) and the United States Renal Data System (USRDS), the latter is the national registry of more than 300,000 ESRD patients coordinated by HCFA.

The benchmarks included: Adequacy of dialysis, an index indicating how well a patient's blood is being cleared of toxins during treatments; hematocrit, a measure of the severity of anemia; hospital bed days; emergency room visits; and mortality.

Results included:

• Nearly 93 percent of Humana members in the program achieved or exceeded dialysis adequacy targets as compared to the national average of 80 percent.

• Nearly 90 percent of Humana members in the program achieved targeted hematocrit levels, compared to the 83 percent national average.

• Hospital bed days for Humana patients were nearly 45 percent lower than the USRDS average.

• Emergency room visits for Humana patients in the program dropped 75 percent between 1998 and 2000.

The article in the May issue of the AJKD cites the mortality and hospitalization ratios for Humana patients in RMS' program and compares them to USRDS benchmarks. The article's lead author is Allen R. Nissenson, M.D., RMS' medical director. Co-authors include researchers from Duke University, who independently analyzed the patient data.

The data in the article show RMS has achieved a standardized hospitalization ratio of 50 percent, meaning patients had half as many hospitalizations as expected compared to the USRDS benchmark for this patient population. RMS also achieved a standardized mortality ratio of 80 percent of the expected mortality for this population, again as compared to the USRDS standard. These published findings in a peer-reviewed journal are the first to document such positive outcomes from a health plan's ESRD disease management program.

"Our members are living the benefits of the Humana/RMS collaboration, which not only results in better clinical outcomes, but also in an improved quality of life for those who have ESRD. It is very rewarding to see the concrete benefits of disease management confirmed in a leading peer-reviewed nephrology journal," said Jonathan T. Lord, M.D., chief clinical strategy and innovation officer for Humana.

"Disease management is an approach to the care of complex illnesses that relies heavily on coordination of care across the continuum of a disease and the various settings in which care takes place," said Nissenson. "These data confirm that excellent outcomes are possible for ESRD patients when enrolled in managed health plans, like Humana's, where coordinated care programs are offered."

Humana Inc., headquartered in Louisville, Ky., is one of the nation's largest publicly traded managed health care companies with approximately 4.9 million medical members located primarily in 15 states and Puerto Rico. Humana offers coordinated health benefits coverage through a variety of plans - health maintenance organizations, preferred provider organizations and administrative service products - to employer groups and government-sponsored plans. More information about Humana is available at www.humana.com.

RMS Disease Management Inc. is an affiliate of Baxter Healthcare Corporation, a global medical-products and services company that provides critical therapies for people with life-threatening conditions. For more information on RMS Disease Management Inc., visit the RMS Web site at www.rmshealthsystems.com .