Revolutionizing Kidney Care

The CDC states that 1 in 7 adults, or 35.5 million people, in the US are estimated to have Chronic Kidney Disease (CKD). CKD has five stages to document the severity of a patient’s kidney. If treatment fails, the final stage–CKD 5–means the kidneys are dangerously close to failing. If they do, this is called End Stage Renal Disease (ESRD). Kidney dialysis is recommended when kidney function drops to 15% or less, and is a costly process–both financially and timely. 

Traditionally, kidney care has followed the fee-for-service model, where care providers are paid for the treatment costs. This model poorly incentivizes kidney care providers to act proactively and help prevent patients from needing expensive dialysis services within facilities. To help address this widespread problem within our healthcare system, the Center for Medicare and Medicaid Services (CMS) created the Kidney Care Choices Model (KCC) to promote an alternative payment model that better aligns care providers to patient best interests. The model aims to help reduce the cost of kidney care and improve the quality of care to patients. According to the CMS website, the model also aims to delay the need for dialysis and encourage transplantation when clinically viable. Certain companies have made it their mission to transform kidney care to this value-based care model, where providers are rewarded based on their success in identifying patient needs earlier, delivering preventive services to their patients, leveraging home dialysis when possible, and helping patients live healthier lives with fewer complications.

Companies such as DaVita, Strive, Interwell, HealthMap, and Panoramic have been important players in the efforts to implement a model more focused on value. They provide holistic care, individualized care plans, and patient education. These companies, among many others, have developed innovative technology and analytics to assist in delivering the most proactive and clinically effective patient care. Predictive analytics take into account the patient’s medical history and use significant amounts of data to help providers catch complications early and prevent hospitalizations. These companies are at the forefront of improved kidney care management, and it will be interesting to track the results of the KCC program and the various program participants over the next few years.

Sources:

https://www.fiercehealthcare.com/payers/humana-finds-vbc-leads-fewer-hospital-admissions-kidney-patients#:~:text=CMS%20has%20two%20VBC%20models,Strive%20Health%2C%20DaVita%20and%20Fresenius.

https://www.cdc.gov/kidney-disease/php/data-research/index.html

https://www.cms.gov/priorities/innovation/innovation-models/kidney-care-choices-kcc model#:~:text=The%20KCC%20Model%20is%20designed,chronic%20kidney%20disease%20and%20ESRD.