Delay of Kidney Care Choices model presents opportunity for nephrology practices
On March 8, CMS announced a delay in implementation of the Kidney Care Choices (KCC) demonstration — the new voluntary, value-based care model for nephrologists and providers introduced as part of Advancing American Kidney Health.
Although the delay to Jan. 1, 2022, may rattle some physician practices that have been preparing a transition to one of the volunteer models, it may be seen as a welcome reprieve to others that have been on the fence about participating.
Time to change
The status quo in kidney care has been stretching providers thin for a long time, challenging them financially, and it has been limiting the type of care they can provide to patients. But the kidney community is on the brink of a seismic shift to value-based care, changing the focus from simply treating end-stage kidney disease to caring for the whole patient through early detection and robust intervention well before kidney failure.
Nephrology practices should think of the delay of the KCC demonstration as a pit stop —time to make the necessary tune-ups and refuel to finish the value-based care race.
A checklist
Practices should consider three things during the delay of the KCC model launch.
1. Data analytics are needed for the transition. In order for a value-based model of kidney care to have the most benefit, practices need great data analytics. It is critical to be able to understand which patients are at the highest risk for kidney failure, disease progression or complications. By intervening with this population early, providers will begin to see an upward slope in their overall outcomes and financial benefits in a value-based model.
2. Ask patients what they want. Providers need to adopt a much more patient-centered approach to care delivery. Most practices have care managers who do excellent work keeping in touch with their patients, and that is a great start. But to truly stay engaged and proactively manage their care, patients need ongoing and frequent support between appointments with physicians and their staff — including access to nutritionists, pharmacists, social workers and nurses.
Notably, to truly put the patient at the center of care, the care team needs to be accessible by more than just a visit to the clinic or a phone call.
Virtual care and online educational resources can help increase access to and communication with this team to keep engagement among patients high. In addition, it can help scale a practice’s reach to address the needs of the entire attributed population, which is exactly what will be required under the new payment models. This activity also ensures practices will minimize patient loss to follow up.
The care model also should include home visits for patients who are at highest risk for disease progression or hospitalization. At Cricket Health, when we have used this multi-modal model of engagement, we have seen patients interact with their care teams every 2 or 3 days, about 10 times per month.
3. Prepare your practice. Use this delay in the care models to adopt an approach to the transition that will not overwhelm an already very busy practice. For many practices, that will include finding an effective partner — one that enhances and extends the care practices they are able to deliver, rather than creating an extra burden or more clicks in the documentation system. Partners should also be flexible with payment arrangements to meet the individual needs of the practice.
For many practices, that may mean choosing a partner to handle everything after the consultation and ensuring the value-based care model is improving outcomes and, with it, revenues. For others, this could involve handling only specific areas the practice identifies as in need of support.
Value-based care is an exciting change — people with kidney disease are going to see a real shift in the way they receive care. Nephrologists are leading the charge. It’s time to give them the support they need.
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