January 10, 2000
Partnership Creates Nation's Largest End Stage Renal Disease Management Provider
Johns Hopkins Medicine (JHM) and George Washington University (GW) have teamed up to form a new company to streamline and enhance dialysis and other kinds of care for patients living in the Mid-Atlantic region and suffering from end stage renal disease (ESRD) and other kidney conditions.
The new company, called Integrated Renal Solutions (IRS), LLC, is built around an evidence-based program developed by JHM that detects renal problems early and closely monitors treatment. GW currently has the largest academic program for renal disease patients in the area with more than 300 dialysis patients.
IRS anticipates better management of renal disease and treatment cost reductions of up to 20 percent, according to Paul Scheel Jr., M.D., clinical director of Hopkins' department of nephrology and co-medical director of IRS. As IRS develops new contracts with insurers and health plans that are already covering patients, these patients will continue to receive care at their current facilities, although IRS will carefully manage all off-site care.
Juan Bosch, M.D., chief of renal diseases and hypertension and professor of medicine at The George Washington University, will co-direct the new company with Scheel. Bosch is also a member of the U.S. Department of Health and Human Services Health Care Financing Administration's ESRD Demonstration Project.
"The IRS program is designed to identify ESRD patients early, educate providers about the most effective treatments, prolong the time before a patient needs to begin dialysis, maintain the optimal health of patients during dialysis, and facilitate successful renal transplants," says Bosch. Identifying patients early with ESRD is critical for effective care and management because adjusting to dialysis the first year is typically difficult. It's also the most costly treatment period, according to Bosch.
"By managing the early problems of renal failure at our Bond Street Dialysis Center in Baltimore, we were able to reduce deaths by 10 percent compared with similar facilities," Scheel says. At the same time, the center also reduced hospital admissions for ESRD from an average of 3.09 per patient per year to 1.8 per year.
Under terms of the joint venture agreement, Johns Hopkins Medicine and George Washington University each have 50 percent equity stakes in IRS. The company will be governed by a six-member board of managers, three appointed by JHM and three by GW.
While the incidence of other chronic diseases has been declining, ESRD is rising, more than doubling this past decade, says Scheel. Moreover, the Mid-Atlantic region, which includes Maryland, Northern Virginia, Washington, D.C., and parts of West Virginia, Pennsylvania and Delaware, has the highest prevalence rate in the nation, according to Scheel. This year, ESRD is projected to affect more than 300,000 people nationwide.
"Historically, ESRD care has not been managed or coordinated in any systematic way," Scheel notes. "As a result, care for patients often has been uneven and has involved significant unnecessary costs."
"We've been looking at the outpatient renal programs from Hopkins and George Washington for some time and have found them very interesting," says Eric R. Bough, M.D., senior vice president for medical affairs and network management for Care First, Blue Cross/Blue Shield, headquartered in Owings Mills, Md. "We believe that these programs, joined together under Integrated Renal Solutions, will provide a quality and uniformity of care we have not seen before. We are very excited about participating in IRS and think it will improve our members' care and reduce costs."
Johns Hopkins Medicine, established in 1995 to unite Hopkins' biomedical research, clinical, teaching and business enterprises, includes The Johns Hopkins University of School of Medicine, The Johns Hopkins Hospital, Johns Hopkins Bayview Medical Center, Howard County General Hospital, Johns Hopkins Medical Services Corporation, Johns Hopkins Bayview Physicians, Johns Hopkins HealthCare and Johns Hopkins Home Care Group. The $2 billion enterprise is one of the largest employers in the state. Its components consistently are named at the top of national rankings for best hospital and best school of medicine, and its faculty consistently win the largest share of NIH research funds. Results of this research continue to advance efforts to diagnose, treat and prevent many diseases.
The George Washington University Medical Center, founded in 1824, is an internationally recognized interdisciplinary academic health center which has consistently provided high quality medical care in the Washington, D.C. metropolitan area for 176 years. The Medical Center comprises the University Hospital; the Medical Faculty associates, which is the premier multi-specialty physician practice in the D.C. metro area; the School of Medicine and Health Sciences, the 10th oldest medical in the country; the School of Public Health and Health Services, the only such school in the nation's capital; and, the GW Health Plan, a 26-year-old health maintenance organization serving nearly 90,000 members.
Johns Hopkins Medicine:
Gary M. Stephenson
George Washington University