Value-Based Kidney Care
Kidney care is a journey. It's a journey of the patient, their family, and the medical team that supports them.
Panoramic Health prides itself on integrating a value-based kidney care model which is a significant improvement compared to the previous ‘fee-for-service’ model. For many years, the ‘fee-for-service’ model has been standard care for people with chronic kidney disease (CKD) and end-stage renal disease (ESRD). However, care under the ‘fee-for-service’ model is more expensive and less in tune with the varying needs of CKD patients.
What is value-based kidney care?
What is value-based kidney care?
The value-based kidney care model drives improved patient outcomes, slows chronic kidney disease progression, and lowers overall health care costs all while providing financial incentives to physicians, and other healthcare providers. Value-based kidney care creates a pathway for our patients to get the care they need and when they need it.
It is designed to help patients take charge of their care through increased patient engagement, greater involvement in decision-making, and better communication between providers and patients.
This patient-centered approach ensures that each person with kidney disease receives the highest level of care possible based on their unique needs.
Value-based kidney care also helps providers keep up with the latest advances in treatment options and provide more comprehensive care.
How is the ‘value-based kidney care model’ better than the ‘fee-for-service model’?
The difference between the value-based kidney care model and the fee-for-service model can be best described as the difference between quality versus quantity. Under the fee-for-service model, physicians, doctors, or healthcare providers are paid for the services they provide for the patient, whereas with the value-based approach, they are paid for the outcome. Thus, it's a classic case of compensating for amount or quantity rather than quality.
Here’s how value-based care has improved kidney care:
•More accountability
•Integrated care management
•Holistic care
•Decreased costs
This has taken its toll on the healthcare system, especially on expenditure and utilization. It was estimated in 2019 that via the fee-for-service model treating Medicare's beneficiaries with chronic kidney disease (CKD) costs around $87.2 billion, while those with end-stage renal disease (ESRD) cost an additional $37.3 billion
A value-based reimbursement model encourages nephrologists to defer kidney disease progression to kidney failure, promotes home-based renal replacement therapies, supports preemptive transplants, and fosters dialysis in an outpatient setting.
Additionally, with a value-based approach shifting the paradigm of healthcare, we're no longer only focusing our attention on patients with end-stage renal disease (ESRD), but we're also expanding our care to include patients with chronic kidney disease (CKD) in a preemptive attempt to prevent further advancement of the disease and improve patients' quality of life.
Here’s how value-based care has improved kidney care:
•More accountability
•Integrated care management
•Holistic care
•Decreased costs
This has taken its toll on the healthcare system, especially on expenditure and utilization. It was estimated in 2019 that via the fee-for-service model treating Medicare's beneficiaries with chronic kidney disease (CKD) costs around $87.2 billion, while those with end-stage renal disease (ESRD) cost an additional $37.3 billion
As a result, the Center for Medicare and Medicaid Services (CMS) took action by launching the Kidney Care Choices model (KCC) in 2022, which included two subcategories:
•Kidney Care First (KCF) - mainly designed for new value-based nephrology practices
•Comprehensive Kidney Care Contracting (CKCC)
The kidney care choices model (KCC) encourages nephrologists to defer kidney disease progression to kidney failure, promotes home-based renal replacement therapies, supports preemptive transplants, and fosters dialysis in an outpatient setting.
Additionally, with a value-based approach shifting the paradigm of healthcare, we're no longer only focusing our attention on patients with end-stage renal disease (ESRD), but we're also expanding our care to include patients with chronic kidney disease (CKD) in a preemptive attempt to prevent further advancement of the disease and improve patients' quality of life.
The value-based approach is the best example of preventative care for patients with chronic kidney disease, the Comprehensive Kidney Care Contracting (CKCC) model, which aims to identify patients before they even require dialysis.
Why a value-based kidney care model?
There are several benefits to a value-based kidney care approach:
•Cost of care reduction - by investing in strategies that improve patient outcomes, eventually leading to cost savings
•Leveraging partnerships from other specialties to help manage other comorbidities or underlying medical conditions
•Support programs are always in place
•Increased access to experts and care physicians
•Reduced hospitalizations rate by being treated as an outpatient
•Organized care services
•Expanded coordination between different specialties
•Optimal interventions previously identified through evidence-based models
•Patient education to manage their disease and avoid complications
There are several benefits to a value-based kidney care approach:
•Cost of care reduction - by investing in strategies that improve patient outcomes, eventually leading to cost savings
•Leveraging partnerships from other specialties to help manage other comorbidities or underlying medical conditions
•Support programs are always in place
•Increased access to experts and care physicians
•Reduced hospitalizations rate by being treated as an outpatient
•Organized care services
•Expanded coordination between different specialties
•Optimal interventions previously identified through evidence-based models
•Patient education to manage their disease and avoid complications
Improving The Patient Experience Through a value-based Kidney Care Model
Owing to physicians' proactive interventions at the late stages of chronic kidney disease (stages 4 and 5), patient experiences have positively changed, and their outcomes were improved by supporting these pattern implementations:
•Increases planned dialysis starts
•Understanding patient's needs and accommodating them
•Being prepared for any event that may occur
•Reassuring patients and improving their quality of life
•Personalizing a treatment plan best suited for each patient
The advent of the value-based kidney model to this point has encouraged the Centers for Medicare & Medicaid Services to expand their benefits further and include the following:
•Telehealth: E-consultation services and telehealth can be used for ease of communication between beneficiaries and their healthcare providers
•Home health: There will be more flexibility in-home health services
•Post-discharge home visits: Members of the care team will be allowed to conduct home visits after discharge from the hospital
•The skilled nursing facility (SNF) rule: Requirement for beneficiaries to take a 3-day stay at a hospital or in-patient facility will be waived before SNF admission
•Kidney disease education benefit: Allowing practitioners to provide six educational sessions about CKD and ESRD
Owing to physicians' proactive interventions at the late stages of chronic kidney disease (stages 4 and 5), patient experiences have positively changed, and their outcomes were improved by supporting these pattern implementations:
•Increases planned dialysis starts
•Understanding patient's needs and accommodating them
•Being prepared for any event that may occur
•Reassuring patients and improving their quality of life
•Personalizing a treatment plan best suited for each patient
The advent of the value-based kidney model to this point has encouraged the Centers for Medicare & Medicaid Services to expand their benefits further and include the following:
•Telehealth: E-consultation services and telehealth can be used for ease of communication between beneficiaries and their healthcare providers
•Home health: There will be more flexibility in-home health services
•Post-discharge home visits: Members of the care team will be allowed to conduct home visits after discharge from the hospital
•The skilled nursing facility (SNF) rule: Requirement for beneficiaries to take a 3-day stay at a hospital or in-patient facility will be waived before SNF admission
•Kidney disease education benefit: Allowing practitioners to provide six educational sessions about CKD and ESRD
How Panoramic Health Aims to Support You Through Your Kidney Care Journey
At Panoramic Health, we work with you to understand your health goals to develop a holistic, comprehensive treatment plan tailored specifically to your needs and then we'll follow up with regular checkups so that we can keep track of how well your plan is working for you. Whether you need assistance getting to your next appointment, customized nutrition plans based on your care needs, or professional guidance to help manage the emotional toll of CKD, Panoramic Health provides the care you need, when you need it.
We also believe in patient engagement. That's why we work with our patients and their families from start to finish, making sure they understand what's going on at every stage of treatment and recovery.
We want our patients to be informed and empowered because when they're informed and empowered, they're better able to take control over their health outcomes. Additionally, this helps us keep costs low while still offering the best possible care!
Your care team is available around the clock, working together to provide comprehensive health care at every step. We're dedicated to giving you the best treatment possible-from expert advice on which medications are right for you to asking questions before they happen.
