Renal

Renal disease management program

Through an agreement with VillageHealth® Disease Management, Humana offers a renal disease management program designed to provide individual care guidance, patient education and coordination of care for members with late-stage chronic kidney disease (CKD) and end-stage renal disease (ESRD).

Program overview

Each identified member is assigned a registered nurse with extensive experience in renal disease. The VillageHealth nurse monitors the member's health status, facilitates compliance with physician-directed goals, communicates with the member's physicians and serves as a liaison and advocate for the member and his or her family. This nursing outreach may be by telephone or in person.

Patient assessment and care planning within the member's interdisciplinary team are coordinated by the nurse. This team includes the primary care physician, nephrologists and other care specialists.

Case management and care coordination are overseen by a panel of experienced nephrologists.

Member education includes, but is not limited to, the importance of taking medications as prescribed, management of comorbidities, management of lifestyle issues and identification of member-selected goals.

Adherence to national evidence-based protocols and guidelines helps prevent the development of other serious conditions.

Eligibility and cost

The program is available to members in all Medicare lines of business, commercial fully insured groups and administrative services only (ASO) groups that purchase Humana’s clinical programs. It is also available to some Medicaid members. VillageHealth contacts eligible members and offers them the opportunity to enroll in the program. VillageHealth will notify a member's health care provider if the member agrees to enroll.

The program is available to members at no additional cost. Puerto Rico members are not eligible for the renal disease management program. Market participation may vary and is subject to change.

More information

If you have questions or would like more information, please contact VillageHealth at 1-800-767-0063. Assistance is available 24 hours a day, seven days a week. You can learn more about VillageHealth at www.villagehealthdm.com.