(Part 2)
LAS: In Part One of our interview, you indicated that your new company is working in partnership with aligned health plans to ensure that kidney patients are treated in a culturally relevant way. What does that look like?
DVA: I have an office downtown, so I’m taking care of folks from South L.A., all the way to east L.A. and north of here. But I’m also, in the next few months, expanding and establishing an office down in the Inglewood area where I started when I first moved out here in 2006.
We’re going to take care of kidney disease very well and we’re going to take those proceeds and put them into prevention programs. One of our goals is to make sure we start advocating for prevention programs in the way that kidney disease and the kidney disease correlates, but economically, we’ve got to be able to sustain ourselves.
Related Stories
Kaiser Physicians Donate $10,000 to Domestic Violence Prevention and Intervention
Again, less than 1% of all CMS patients are dialysis patients. If 35% are Black and 30% are Latino, and they start cutting services to the dialysis population because they’re trying to cut costs — because remember, it’s 7% of the spend — then who gets affected the most? We do, so our people die or don’t get access to therapy, or it’s late to the party and they’re already very sick.
So, it’s got to be tied to economics. Our company K.CARE IPA actually is a physicians group dedicated to high-level care, high-level quality and really addressing how the patient is functioning. How is the patient doing? Do they have the meals that they need? Do they have the diet that they need? Do they have activities that keep them active? Does a dialysis patient have a wellness mindset?
LAS: Incredible, this sounds like a holistic approach to kidney care, which will have positive health effects beyond the kidneys. Within the context of K.CARE and its focus, talk a bit about what it means to have a wellness mindset.
DVA: I sometimes throw people when I say that. [Some might respond with:] “What do you mean? They’re already sick!” Wellness is a mindset. If you have a disease—diabetes, heart disease, whatever it may be — you still have to have a wellness mindset in order to eat the right foods, in order to make sure you get the right supplements, in order to make sure you get the right medicines, to make sure you take your medicine, to make sure you see the doctor, to make sure you ask questions of the doctor to keep yourself well inside of your chronic disease.
Too often, wellness is only used with those people who [aren’t ill yet], and we ignore those people who actually have illness. The Kidney Institute and K.CARE IPA, these two companies that I have, absolutely address that in terms of how we approach each patient group. So, it’s vitally important that we understand the economics of kidney disease and how it’s going to hurt us in the long run if we don’t start building business around it and putting that money back into community education and wellness programming.
LAS: This sounds like it’d be beneficial to lots of patients, but health plans can be very restrictive. How will the system work?
DVA: The unique thing about our program is that we have what’s called nephro-extensiveness. That is, the kidney specialist is the primary care doctor for the dialysis patient. Every other plan out there has a separate primary care doctor and a nephrologist.
The patient signs up with the health plan only if the program is good for that patient, but if they have certain doctors they want to keep, we at K.CARE IPA are going to make those doctors part of our specialist list. For instance, if a patient has a cardiologist that s/he wants to stick with, we’re going to try to get a contract with that cardiologist. We’re going to be their primary care doctors as well as their nephrologists.
Dialysis patients typically don’t see their primary care doctor because they see the nephrologist at least once a month, and the nephrologist winds up handling the primary care. If you have a cold, the nephrologist will give you a prescription for cold medicine. That’s why I think this will grow because it’s going to save the health plan money. It’s going to increase the quality of care that patients get and change things back to doctors being responsible for that quality directly.
Patients seeking a primary care physician or a chronic kidney disease (CKD) consultation can contact Kidney Care Institute at (213) 484-3929.
Dialysis patients interested in hearing more about K.CARE IPA can email [email protected] or call the Kidney Care Institute at (213) 484-3929 to request more information.
Learn more in Part 3 of Kidney Conversations next week.
