A primary care patient-centered medical home (PCMH) program for managing chronic kidney disease (CKD) at different severity levels resulted in lower hospital admissions and readmissions. The program results among those with CKD in class 3, admissions dropped from 362.5 per 1,000 members to 249.0. Among those in class 4, admissions dropped from 311.7 to 219.2 per 1,000; and among those in class 5, admissions dropped from 590.9 to 323.5 per 1,000. Hospital readmissions within 30 days dropped for classes 4 and 5. Among class 4, readmissions per 1,000 dropped . . .

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