Employer challenges with the chronic kidney disease population.

BACKGROUND: Employers have not yet begun to focus on chronic kidney disease (CKD) as a major health issue in the workplace. CKD is part of the metabolic and cardiovascular health burden, which is a major threat to the future survivability of the employer-based health financing system. It represents one opportunity for employers to intervene now to save health care costs later.
OBJECTIVE: To describe the impact of CKD in non-Medicare payer populations (i.e., employer group health plans) and the importance of early screening and detection of the disorder to improve patient quality of life and reduce the future cost burden of this disease.
SUMMARY: Twenty million Americans suffer from CKD, and 20 million more are at elevated risk; soon, 1 in 9 Americans will have CKD. Control of comorbidities may slow its progression, and 2 are critical -- type 2 diabetes and hypertension. Health care costs are made up of 2 categories and 5 subcategories: direct costs, which are (1) inpatient, (2) outpatient, and (3) drug costs -- roughly three quarters of the total costs associated with patients who have nondialysis renal insufficiency -- and indirect costs, which are lost productivity due to (4) disability and (5) absenteeism.
CONCLUSION: CKD should be considered part of a larger picture of metabolic health. As CKD is related to cardiometabolic health, it is beginning to capture payers' and purchasers' interest. Investing health care dollars today to identify the disease and slow its progression should improve patient quality of life and reduce the future cost burden of this disease and its associated conditions.