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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
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.
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.

Comprehensive Kidney Care Contracting (CKCC)

The Comprehensive Kidney Care Contracting (CKCC) model is a value-based care model that focuses on slowing chronic kidney disease progression, improving patient outcomes, and providing comprehensive kidney care for patients with end-stage kidney disease. It emphasizes partnering with patients to increase their engagement in their treatment, including access to education about their condition and ways to manage it at home.
The CKCC model also allows hospitals to actively work with patients to slow chronic kidney disease progression by connecting them with community resources that can help them do so. This includes things like enrolling them in clinical trials or helping with local transportation options that allow them to get around without driving themselves.

How did the value-based kidney model start?

How did the value-based kidney model start?

The value-based kidney model was started back in 2015 by the Center for Medicare and Medicaid Services (CMS), launching the Comprehensive ESRD Care Model, which aimed to reduce the cost of spending.
It started by pairing up nephrologists with other healthcare providers for better-utilized kidney care by incentivizing a more holistic kidney approach in earning through outcome as opposed to service. As a result, it could generate some cost savings, but it wasn't enough to produce the necessary change. This was believed to result from only focusing on patients with end-stage renal disease and dialysis providers, not nephrologists.
Thus, the CMS improved the CEC model considering these key learnings and launched the improved model for the value-based kidney approach, which is the Kidney Care Choices (KCC).

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

What can the KCC model offer for Kideny care?

The KCC model can help in shaping the future of kidney care by providing the following:
Better managing of patients by having up-to-date insights
Providing nephrologists with a leading role in kidney care
Focused preemptive care as opposed to just dialysis care
While these remain to be confirmed through upcoming analyses, there seems to be great promise and potential for the value-based kidney care approach.
The KCC model can help in shaping the future of kidney care by providing the following:
Better managing of patients by having up-to-date insights
Providing nephrologists with a leading role in kidney care
Focused preemptive care as opposed to just dialysis care
While these remain to be confirmed through upcoming analyses, there seems to be great promise and potential for the value-based kidney care approach.

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.