How Panoramic Health improved optimal starts in ESKD transitions

Summary

Through a standardized End-Stage Kidney Disease (ESKD) transition pathway, Panoramic Health improved optimal dialysis start rates across 18 practice groups. In the first year, the platform-wide average increased from 29% to 53%; in the second year of the pathway implementation, practices reached an average of 65%. This approach demonstrates a scalable solution for improving patient outcomes, reducing complications, and ensuring smoother transitions into ESKD care.

The Challenge

Starting dialysis with a central venous catheter (CVC) puts patients at significant risk for infection, hospitalization, and increased mortality. Optimal dialysis starts—defined as initiating dialysis without a CVC—ensure a safer transition into end-stage kidney disease (ESKD) care by using permanent access, such as an arteriovenous fistula, graft, or peritoneal dialysis catheter.
Before implementing the standardized ESKD transition pathway, fewer than 30% of patients across Panoramic Health’s affiliated practices achieved an optimal start. Many patients began dialysis in crisis, without proper education or planning for access placement, which contributed to higher complication rates and less successful transitions to ESKD care.

The Results

Panoramic Health’s approach to improving optimal dialysis start rates has set a new standard in the industry, delivering impressive results across all 18 practice groups:

optimal start rate across 18 practice groups in the first year, marking a significant improvement in patient care and the effectiveness of the transition pathway.

average optimal start rate among practice groups with 2 years of implementation, proving the program’s long-term success and sustainability.

Success in diverse clinical settings, with data sharing and peer accountability driving better results and adaptability across different environments.

Results published in The American Journal of Managed Care and presented at the 2024 ASN Kidney Week, underscoring the program’s impact and further establishing its credibility within the kidney care community.

All figures are estimates based on Panoramic Health data as of July 2025. Patient records are accessible via practice partnerships.

These outcomes demonstrate leadership in transforming kidney care, with proven, scalable solutions that improve patient outcomes in a variety of healthcare settings.

Why It Matters

Behind every optimal start is a patient who avoided a preventable crisis. By improving planning and preparation, Panoramic Health is helping patients transition into end-stage kidney disease (ESKD) care more safely and with greater dignity—setting a new standard for ESKD care transitions.

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.