How Panoramic Health drove a 36% increase in SGLT2i adoption to improve outcomes in patients with combined CKD and heart failure

Summary

Within a one-year timeframe (Nov. 2023-Aug. 2024), Panoramic Health helped raise the use of Sodium-Glucose Transport Protein 2 Inhibitor (SGLT2i) medications from 27% to 37% across its affiliated practices, giving more patients with chronic kidney disease (CKD) and heart failure (HF) stronger protection against heart failure progression and kidney disease decline. One practice reached 48% appropriate prescribing rates. CKD/HF patients who received an SGLT2i were 11% less likely to be hospitalized than those not treated.

Through a combination of physician education, pharmacy support, and data-driven feedback, Panoramic Health demonstrated how practical, innovative strategies can drive meaningful improvements in kidney and heart health.

Challenges

Despite strong clinical evidence and updated KDIGO 2024 guidelines recommending SGLT2 inhibitors for patients with chronic kidney disease (CKD) and heart failure (HF), prescribing rates remained low. Many nephrology providers were hesitant to initiate these medications due to therapeutic inertia, discomfort with managing diabetes-related medications, and concerns about cost or side effects—particularly in female patients.

At baseline, SGLT2i use among eligible patients with both CKD and HF was only 27.4% (and only 18.0% in all CKD patients), with even lower rates in some practice settings. Provider surveys revealed that while many clinicians believed they were prescribing these medications in most CKD patients with HF, actual prescribing data told a different story.

The Solution

Panoramic Health launched a comprehensive initiative to close the gap between clinical guidelines and everyday practice, focusing on empowering clinicians with the knowledge, tools, and data transparency they needed to improve adoption of SGLT2i therapy.

Key interventions included:

Physician Education: Peer-led educational sessions, including town halls and one-on-one discussions, along with system-wide interventions and updated practice guidelines, focused on the benefits and safety of SGLT2 inhibitors for CKD patients and patients with both CKD and CHF. These efforts ensured clinicians had the information needed to make informed decisions.
Proactive Identification: The Panoramic Health central team helped identify eligible patients and notified physicians ahead of scheduled appointments, encouraging appropriate SGLT2i prescribing.
Data Transparency: Monthly reports showed prescribing rates at the practice level, allowing clinicians to visualize their progress and compare with peers. After seeing their own data, providers recognized opportunities for improvement in Guideline-Directed Medication Therapy (GDMT) and were able to drive improvements in their patients.
Barrier Reduction: Resources were developed to address common concerns, including financial assistance programs, clinical scripts, and guidance on managing side effects, helping clinicians feel confident in prescribing SGLT2i therapy.
System Enhancements: Point-of-care prompts and streamlined documentation tools were integrated into practice workflows, making it easier for clinicians to prioritize SGLT2i therapy in their daily routines.

This combination of education, data transparency, and workflow support was key to improving prescribing practices and enhancing patient care across diverse clinical settings.

The Results

The initiative delivered meaningful, measurable appropriate prescribing results across the Panoramic Health network:

SGLT2i prescribing rate for dual CKD/HF patients, up from 27.4%, within nine months of implementation.

prescribing rate achieved by a leading practice.

lower hospitalization rate among patients prescribed an SGLT2i, demonstrating clear clinical value.

increase in SGLT2i prescribing across the entire CKD population—not just those with heart failure—rising from 18.0%

Panoramic-provided numbers as of 5/31/2025. Patient records accessible via practice partnerships

Why it matters

Every prescription of an SGLT2 inhibitor is more than just a medication—it’s an opportunity to prevent hospitalization, slow disease progression, and improve the quality of life for patients living with both CKD and heart failure.

And the impact didn’t stop at the initial gains. Over the following nine months, SGLT2i use continued to rise, reaching 39.7% in patients with both CKD and heart failure and 35.3% across the entire CKD population. This sustained improvement highlights the power of ongoing focus and provider engagement.

By tackling clinical inertia with data, education, and team-based support, Panoramic Health is helping affiliated providers embrace guideline-directed medical therapy (GDMT) that makes a real difference. This initiative proves that even small changes in prescribing behavior can have a measurable impact on patient outcomes.

About Panoramic Health

Panoramic Health is kidney care’s leading integrated provider group, supporting a network of aligned nephrology practices across the U.S. treating hundreds of thousands of patients. Our mission is to slow disease progression and improve quality of life by empowering nephrologists with state-of-the-art clinical, operational, and financial solutions.

Founded by nephrologists, for nephrologists, Panoramic Health has a deep commitment to preserving clinical autonomy while supporting practice growth and reducing administrative burden. Our integrated model is built around the needs of complex kidney patients and enables partner practices to enhance care quality, reduce total cost of care, and access new revenue opportunities.