Newfront Dialysis Solution Reduces Employer Spend and Improves Member Experience
By Louisa Bolick | Published December 16, 2024
The Challenge: During a routine claim utilization review for a mid-sized, California-based company, the Newfront team identified a disproportionate spend on End-Stage Renal Disease (ESRD) claims. Upon further review, they concluded that costs associated with dialysis treatments were well above benchmarks, prompting them to seek a more cost-effective solution.
The Solution: The Newfront team, led by Louisa Bolick, focused on identifying a strategic and holistic approach to address the outlying claims. The goal was to prioritize managing and reducing the financial burden of treatment costs for the company while ensuring the highest quality care for affected members.
Newfront explored vendors specializing in kidney disease management and helped the client select a partner, then collaborated with the client’s medical carrier to devise a targeted intervention. By redirecting members to a specialty dialysis provider, patients could work with a medical professional to have dialysis treatment at home—a more comfortable and convenient option for the patient and less expensive than outpatient treatment.
The Results: When given a choice, most members transitioned to the at-home treatment option. In the case of one member, home dialysis accelerated the transition to Medicare as the primary payor, protecting the client’s self-funded health plan from any ongoing liability, including a potential kidney transplant.*
Newfront tracked this cohort to measure engagement and outcomes with the dialysis carve-out program. Over the course of the year, the program resulted in $228,000 annual savings to the employer (8% savings on medical claims). Beyond the financial benefits to the employer, the members and their families received enhanced support from clinicians specializing in dialysis care and coordination. This support ensured high-quality care and improved health outcomes for these members, demonstrating the comprehensive success of the program. “We were able to prioritize both the patient experience and employer cost savings - a win for everyone,” said Bolick, Executive Vice President and Founding Partner - Boston at Newfront.
*According to the NIH, in 2020, the average kidney transplant cost was US$442,500.
Louisa Bolick
Executive Vice President, Founding Partner - Boston
Louisa brings more than 30 years of industry experience as Founding Partner of the Newfront Boston office. Previously, she held positions of increasing responsibility at Arthur J. Gallagher & Co. and William Gallagher Associates. Louisa leads a group of seasoned Employee Benefits experts who partner with forward-thinking companies to optimize their total rewards programs with a progressive, competitive, and creative approach. Specializing in People and Finance groups, Louisa ensures that the plans meet the dynamic needs of a diverse workforce, create an employee experience that reflects their culture and vision, compete in an increasingly complex market, and maximize the investment of both dollars and time.
Connect with Louisa on LinkedIn
