The rationale, implementation, and effect of the Medicare CKD education benefit.

Although it affects <1% of the US population, stage 4 chronic kidney disease (CKD) has increased in prevalence in the United States, grown 67% between the early 1990s and the first part of this decade. It is important to consider new strategies to slow or halt this increase. A frameshift in patient care delivery is underway in kidney health care in the United States with a Medicare education benefit for patients with stage 4 CKD. This Medicare benefit is a unique program that has the potential to inform patients and families about CKD and prepare them for transitions in health states and kidney health care. For the greatest value of this benefit to be realized, it is critical for the health care community to accurately gauge patient understanding of CKD and provide curricula that are comprehensible and actionable for patients. This type of benefit is patient centered, yet it will succeed only with a willingness to review its effectiveness and revise it if needed.

[1]  S. Datta,et al.  Medical Clinics Versus Usual Care for Patients With Both Diabetes and Hypertension , 2010, Annals of Internal Medicine.

[2]  Andrew Steptoe,et al.  Health Literacy and Health Actions: A Review and a Framework From Health Psychology , 2009, Health education & behavior : the official publication of the Society for Public Health Education.

[3]  Dianne Davis,et al.  Addressing Literacy and Numeracy to Improve Diabetes Care , 2009, Diabetes Care.

[4]  E. Gordon,et al.  Health literacy and kidney disease: toward a new line of research. , 2009, American journal of kidney diseases : the official journal of the National Kidney Foundation.

[5]  Kerri L Cavanaugh,et al.  Patient dialysis knowledge is associated with permanent arteriovenous access use in chronic hemodialysis. , 2009, Clinical journal of the American Society of Nephrology : CJASN.

[6]  J. Savageau,et al.  Improving the health of diabetic patients through resident-initiated group visits. , 2009, Family medicine.

[7]  D. Boren,et al.  A pilot study: reports of benefits from a 6-month, multidisciplinary, shared medical appointment approach for heart failure patients. , 2008, Military medicine.

[8]  S. Soroka,et al.  Perceived knowledge among patients cared for by nephrologists about chronic kidney disease and end-stage renal disease therapies. , 2008, Kidney international.

[9]  Darcie L. Keller,et al.  Impact of Health Literacy on Health Outcomes in Ambulatory Care Patients: A Systematic Review , 2008, The Annals of pharmacotherapy.

[10]  Kamlesh Khunti,et al.  Educational interventions in kidney disease care: a systematic review of randomized trials. , 2008, American journal of kidney diseases : the official journal of the National Kidney Foundation.

[11]  G. Samsa,et al.  Opportunities for Improving Management of Advanced Chronic Kidney Disease , 2008, American journal of medical quality : the official journal of the American College of Medical Quality.

[12]  J. Antonucci A new approach group visits: helping high-need patients make behavioral change. , 2008, Family practice management.

[13]  M. Wise,et al.  Self-efficacy and self-management behaviors in patients with chronic kidney disease. , 2008, Advances in chronic kidney disease.

[14]  C. Darling-Fisher,et al.  Implementation and outcomes of group medical appointments in an outpatient specialty care clinic , 2008, Journal of the American Academy of Nurse Practitioners.

[15]  Alan B Leichtman,et al.  Kidney transplantation as primary therapy for end-stage renal disease: a National Kidney Foundation/Kidney Disease Outcomes Quality Initiative (NKF/KDOQITM) conference. , 2008, Clinical journal of the American Society of Nephrology : CJASN.

[16]  C. Dismuke,et al.  Do diabetes group visits lead to lower medical care charges? , 2008, The American journal of managed care.

[17]  T. Pendergraft,et al.  Improving access to diabetes care in an inner-city, community-based outpatient health center with a monthly open-access, multistation group visit program. , 2007, Journal of the National Medical Association.

[18]  J. Coresh,et al.  Prevalence of chronic kidney disease in the United States. , 2007, JAMA.

[19]  David C Aron,et al.  Shared medical appointments based on the chronic care model: a quality improvement project to address the challenges of patients with diabetes with high cardiovascular risk , 2007, Quality and Safety in Health Care.

[20]  T. Ikizler,et al.  Balancing Fistula First with Catheters Last. , 2007, American journal of kidney diseases : the official journal of the National Kidney Foundation.

[21]  E. Okonofua,et al.  Group Visits: Promoting Adherence to Diabetes Guidelines , 2007, Journal of General Internal Medicine.

[22]  M. Wise,et al.  In-center hemodialysis patients' use of the internet in the United States: a national survey. , 2006, American journal of kidney diseases : the official journal of the National Kidney Foundation.

[23]  Andrew Pleasant,et al.  Advancing Health Literacy: A Framework for Understanding and Action , 2006 .

[24]  Raja Jaber,et al.  Group visits: a qualitative review of current research. , 2006, Journal of the American Board of Family Medicine : JABFM.

[25]  G. Devins,et al.  Predialysis psychoeducational intervention extends survival in CKD: a 20-year follow-up. , 2005, American journal of kidney diseases : the official journal of the National Kidney Foundation.

[26]  N. Powe,et al.  Frequency of patient-physician contact in chronic kidney disease care and achievement of clinical performance targets. , 2005, International journal for quality in health care : journal of the International Society for Quality in Health Care.

[27]  D. Schatell,et al.  Activating chronic kidney disease patients and family members through the Internet to promote integration of care , 2004, International journal of integrated care.

[28]  B. Chewning,et al.  Self-management, knowledge, and functioning and well-being of patients on hemodialysis. , 2004, Nephrology nursing journal : journal of the American Nephrology Nurses' Association.

[29]  B. Becker,et al.  Evaluation of eHealth web sites for patients with chronic kidney disease. , 2004, American journal of kidney diseases : the official journal of the National Kidney Foundation.

[30]  A. Torres,et al.  Predialysis nephrologic care and a functioning arteriovenous fistula at entry are associated with better survival in incident hemodialysis patients: an observational cohort study. , 2004, American journal of kidney diseases : the official journal of the National Kidney Foundation.

[31]  A. Collins,et al.  The association of initial hemodialysis access type with mortality outcomes in elderly Medicare ESRD patients. , 2003, American journal of kidney diseases : the official journal of the National Kidney Foundation.

[32]  G. Devins,et al.  Predialysis psychoeducational intervention and coping styles influence time to dialysis in chronic kidney disease. , 2003, American journal of kidney diseases : the official journal of the National Kidney Foundation.

[33]  D. Cope,et al.  Evaluating concordance to American Diabetes Association standards of care for type 2 diabetes through group visits in an uninsured or inadequately insured patient population. , 2003, Diabetes care.

[34]  B. Kasiske,et al.  Preemptive kidney transplantation: the advantage and the advantaged. , 2002, Journal of the American Society of Nephrology : JASN.

[35]  Ethan M Balk,et al.  K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification. , 2002, American journal of kidney diseases : the official journal of the National Kidney Foundation.

[36]  G. Segoloni,et al.  Patient Knowledge and Interest on Dialysis Efficiency: A Survey , 2002, The International journal of artificial organs.

[37]  C. O'boyle,et al.  Quality of Life: Impact of Chronic Illness on the Partner , 2001, Journal of the Royal Society of Medicine.

[38]  I. Venohr,et al.  Cooperative health care clinics: a group approach to individual care. , 1998, Geriatrics.

[39]  N. Powe,et al.  Patient's view of dialysis care: development of a taxonomy and rating of importance of different aspects of care. CHOICE study. Choices for Healthy Outcomes in Caring for ESRD. , 1997, American journal of kidney diseases : the official journal of the National Kidney Foundation.

[40]  M. A. Blosky,et al.  Improving detection and treatment of osteoporosis: redesigning care using the electronic medical record and shared medical appointments , 2008, Osteoporosis International.

[41]  C. Fox,et al.  Primary care physicians' knowledge and practice patterns in the treatment of chronic kidney disease: an Upstate New York Practice-based Research Network (UNYNET) study. , 2006, Journal of the American Board of Family Medicine : JABFM.

[42]  Elizabeth Greenberg,et al.  A First Look at the Literacy of America's Adults in the 21st Century. NCES 2006-470. , 2006 .

[43]  M. D. Swartz,et al.  The role of patients in the implementation of the National Kidney Foundation-Dialysis Outcomes Quality Initiative. , 1999, Advances in renal replacement therapy.