963-P: Preservation of Renal Function in Patients with Diabetes and Comorbid CKD 3 as Measured by eGFR in 1,877 Elderly Patients at CanoHealth. A Two-Year Retrospective EHR-Based Analysis.

Abstract

This study sought to explore the effect of the CANO Model of Care (CMC) on renal function in elderly Medicare Advantage patients. A 2-Y retrospective review of laboratory data for patients new to CANO (≤3 mos) between Jan 1 and Dec 31, 2018 with diabetes and CKD 3 was conducted. We identified 1,877 patients and collected eGFR, A1C, BMI, SBP/DBP at baseline and at various time points for 24 months (Table 1) . Mean age was 76.5 +/- 9.2Y. Preservation of renal function as represented by eGFR was evident at all time points. Statistically significant improvements in eGFR values were observed during the first 15 months, with no significant changes from baseline for months 18 to 24. Renal function in patients with diabetes and CKD 3 decreases over time. In this cohort renal function, as measured by eGFR, was preserved for 24 months. Subgroup analysis of patients with CKD 3b (n=606) shows similar results. The preservation in renal function may be attributable in part to the Cano Model of Care. The CMC includes a propriety population health platform (CanoPanorama™) which informs care management decisions, imbedded structured data within the EHR, attainment of high PCP NCQA recognition for diabetes care (1) , monthly coordinated physician CMEs, pursuit of 5-star HEDIS® (2) quality metric ratings, and addressing clinical inertia (3) . Disclosure R.Aguilar: Speaker's Bureau; Boehringer Ingelheim International GmbH, Lilly Diabetes, Novo Nordisk A/S. R.E.Kenney: None. E.Antunez: None. M.Osorio: None. M.Herman: None. M.Conger: None. M.Aguilar: None.