ESCOs: A Way to Better Coordinate Patient Health Care

The Philadelphia-Camden Integrated Kidney Care ESCO is an ESRD Seamless Care Organization (ESCO) in the Medicare Comprehensive ESRD Care model. An ESCO is a group of dialysis facilities, nephrologists, and other health care providers working together with Medicare to coordinate and improve the quality of care for patients.

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The goal of an ESCO is for dialysis facilities, nephrologists, and other health care providers to communicate closely with other health care providers, so they can deliver high-quality care that meets the individual needs and preferences of the patient.

Philadelphia-Camden Integrated Kidney Care ESCO Benefits

Patients, physicians and payors all benefit from ESCO’s integrated care management approach:

About Your ESCO

Clinical and Administrative Leadership

ESCO Participants

Participants in the Philadelphia-Camden Integrated Kidney Care ESCO include:

Nephrologists Groups

Dialysis Providers

DaVita, Inc.

Joint Venture Dialysis Provider

Vascular Access Centers

South Jersey Vascular Institute

Governing Body

Governing body members of the Philadelphia-Camden Integrated Kidney Care ESCO:

• Roy Marcus, M.D., Governing Manager, Clinical Renal Associates LTD
• Brett Cohen, Governing Manager, DaVita Integrated Kidney Care
• Lisa Miller, Governing Manger, DaVita Inc.
• Jackson Williams, Governing Manager, Consumer Representative, Dialysis Patient Citizens
• Karen Mooney, Governing Manager, DaVita Inc.
• Lawrence Weisberg M.D., Governing Manager, Cooper University Hospital

For nearly two decades, DaVita has invested, and continues to invest, in building the infrastructure and capabilities to holistically care for ESRD (End Stage Renal Disease) and CKD (Chronic Kidney Disease) beneficiaries. Our goal is to prepare for a future when integrated care is available to all patients. The ESCOs (ESRD Seamless Care Organizations) are one vehicle in which DaVita provides integrated care to our patients.

Amount of Shared Savings/Shared Losses

As a participant in CMS’s (Centers for Medicare & Medicaid Services) Comprehensive ESRD Care (CEC) Model, the Philadelphia-Camden ESCO is a joint venture comprised of dialysis facilities and nephrologists. The Philadelphia-Camden ESCO achieved more than $12M in shared savings in Performance Year 1, which ran from October 2015 through December 2016. The Philadelphia-Camden ESCO returned 100% of the shared savings that it earned to its participant owners, who, in turn, used a portion of those savings to recoup their upfront financial investments in the ESCO venture, including infrastructure for Performance Year 1 and future years. The ESCO participants elected to reinvest any remaining surplus shared savings into redesigned care processes to support ESRD Medicare beneficiaries who are aligned to the ESCO.

During Performance Year 2 (calendar year 2017), the ESCO generated more than $13 million in shared savings. For PY2, the amount of shared savings invested in infrastructure and other resources to improve clinical outcomes is $6,600,802, and $6,868,278 will be distributed as shared savings payments.

During Performance Year 3 (calendar year 2018), the ESCO generated more than $8 million in shared savings. For PY3, the amount of shared savings invested in infrastructure and other resources to improve clinical outcomes is $5,975,746, and $2,412,957 has been distributed as shared savings payments.

During Performance Year 4 (calendar year 2019), the ESCO generated more than $12 million in shared savings. For PY4, the amount of shared savings invested in infrastructure and other resources to improve clinical outcomes is $6,605,187, and $5,895,804 will be distributed as shared savings payments.

For performance year 1, all quality measures were in pay-for-reporting status. The Philadelphia-Camden ESCO successfully reported on all ESCO quality measures for a total quality score (TQS) of 100%. During performance year 2, the ESCO achieved a total quality score of 80.56%, exactly in line with the overall average for all markets. During performance year 3, the ESCO achieved a total quality score of 85.7%, about average with all markets. During performance year 4, the ESCO achieved a total quality score of 93.1%, about average with all markets.