Renal Disease Management Program

Program Overview

Since 1997, Humana and VillageHealth have collaborated to provide the renal disease management program for members with ESRD. Under an arrangement with Humana, VillageHealth created renal care networks in Humana's markets. These networks are the result of a collaborative effort among Humana's contracted primary care physicians, nephrologists, and VillageHealth. The services provided through these networks include member identification, comprehensive member assessment, and outcome evaluation.

How the program works

Each identified member is assigned a VillageHealth nurse who is a locally based registered nurse with extensive experience in renal disease. The VillageHealth nurse monitors the member's health status, facilitates compliance with the physician directed goals, communicates with the member's physicians, and serves as a liaison and advocate for the member and his or her family.

Program components

• Patient assessment and care planning within the member's identified interdisciplinary team and coordinated by a VillageHealth nurse (this includes the primary care physician, nephrologists, other care specialists and case manager)
• Case management and care coordination, overseen by a panel of experienced nephrologists
• Member education that includes, but is not limited to, compliance in taking medications as prescribed, management of comorbidities, management of lifestyle issues, and identification of member-identified goals
• Adherence to national evidence-based protocols and guidelines to help prevent the development of other serious conditions