How Nephrologists Can Succeed in the New Normal

Industry changes have given nephrologists more control, opportunity, and empowerment than ever before. But only those who embrace the new normal will win. Not every nephrologist will be able to transform their practice overnight, nor is that required. However, there are several key steps nephrologists should take now in order to position themselves for success:

• Participate in value-based payment models
• Choose a partner who specializes in innovation and puts nephrologists in the lead.
• Find new ways to integrate into the broader healthcare ecosystem.

PARTICIPATE IN VALUE-BASED PAYMENT MODELS

Value-based payment models are the new standard of healthcare reimbursement, and now nephrologists have more attractive ways to participate than ever before. The CKCC and KCF programs provide clear, and voluntary, “on ramps” for nephrologists that want to grow their value-based footprint.

“These are exciting times to be in nephrology care for sure. The techniques we learn while participating in these payment models will bring dividends for years to come.”

– Keith Bellovich, D.O., Sr. Nephrologist, St. Clair Nephrology in Detroit

KCF is a nephrologist-only program that can be well-suited for nephrologists who have access to deep value-based care capabilities already within their organization (e.g., nephrologists employed by large health systems). Alternatively, CKCC is an ACO-like program where multiple participants form a partnership to collaborate and share resources. This program is better-suited for independent nephrologists who want to focus on the patient care aspects of value-based models and form partnerships to access the technology, care extension, and administrative resources required.

CHOOSE A PARTNER WHO SPECIALIZES IN INNOVATION AND PUTS NEPHROLOGISTS IN THE LEAD

Nephrologists need new capabilities to succeed in the new normal. By definition, these capabilities are new, innovative, and distinct from the legacy constructs of kidney care. They include value-based services focused on upstream CKD patient management, sophisticated technology and data solutions, and integrations with PCPs, health systems, and payors.

“Our practice has been investing in strategies on a small scale for years because they satisfy the quadruple aim. It is now through a broader partnership with extramural support, we can reach more of our CKD patients with higher quality care at what we anticipate will be a lower cost.”

– Keith Bellovich, D.O., Sr. Nephrologist, St. Clair Nephrology in Detroit

The need for innovation has paved the way for the emergence of new tech-focused companies that specialize in value-based kidney care. These companies empower nephrologists to diversify outside of just LDO partnerships, which are valuable but often not technology-forward and inextricably tied to fee-for-service dialysis care.

Also, it is important to choose a partner that is philosophically aligned—i.e., a partner who also embraces nephrologist empowerment. Prior models, such as the ESCO Model, left nephrologists out of solution design and did not enable meaningful practice transformation. New models elevate the role of nephrologists to be central to solution design. Leading value-based kidney care companies do not make unilateral decisions or use leverage to relegate physicians’ role, but they rather embrace the leadership role of nephrologists and support them through care extenders, technology and data, and services that cover the administrative aspects of value-based programs.

FIND NEW WAYS TO INTEGRATE INTO THE BORADER HEALTHCARE ECOSYSTEM

ACOs and PCP groups have narrowed their specialist referral networks based on quality and cost performance. Nephrologists who are armed with data demonstrating their ability to improve quality and reduce total cost of care are now empowered to secure more upstream CKD patient referrals because of it.

Nephrologists can benefit by collecting as much quality and cost data as they can in order to build a case based on value. Getting access to elusive data such as claims can be difficult, but many new value-based payment models provide access to claims data as a benefit of participation. Nephrologists who pair claims data with lab and encounter data stand to present a cohesive case for superior outcomes and value-based referrals.

From there, nephrologists need an audience with ACOs and PCPs to present their case. Those who have those strategic relationships and integration points already developed in their market have an advantage. Some of those relationships can be built organically, while others can be facilitated by specialized value-based kidney care companies who make introductions, help nephrologists craft and present the case for value-based upstream patient referrals, and help negotiate and manage any new contracts that are put in place.

STRIVE HEALTH CAN HELP YOU SUCCEED WITH VALUE-BASED PAYMENT MODELS

The new payment models introduced by the CMS are indicative of an industry shift toward value-based care. Strive Health partners with nephrologists, health systems, payors, and medical groups to create integrated solutions that make effective value-based kidney care a reality.

Our partnerships include solutions to support you and your patients transition to value-based kidney care.  To talk more about value-based care options, complete our contact form and we will reach out

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