NANI is the largest independent kidney care group in the United States. They have over 170 doctors and nurse practitioners working in Illinois, Indiana, and New Jersey. NANI focuses on value-based care and takes part in programs like the Medicare End-Stage Kidney Disease Seamless Care Organization (ESCO). The group has grown fast, adding 28 new providers last year to meet demand.
Strive Health only works with value-based kidney care. Their team grew by 600% last year. They now partner with almost 400 kidney care providers in six states. Strive Health and NANI have teamed up to manage financial risk payment models together. At first, they focus on patients with serious kidney problems in Illinois and Indiana where yearly medical costs go over $400 million. This partnership lets both groups share risks and work with Medicare, Medicare Advantage, and private insurers. They combine full care services into NANI’s clinics to improve patient health and reduce costs.
Brian O’Dea, CEO of NANI, said, “Kidney disease is a widespread health issue that kidney doctors can best handle, and the future of nephrology is value-based.” Both groups agree on this. They align clinical work with new payment plans.
Traditional fee-for-service pays doctors based on the number of services they give. This can lead to extra tests and treatments that don’t help the patient. Value-based payment models are different. They pay based on the quality and efficiency of care. These models also share financial risks with payers. That creates a reason to stop complications and hospital visits.
The deal between Strive Health and NANI shows how value-based care is changing kidney treatment. They manage global risk contracts where providers take care of their patients’ whole health and costs. This mostly focuses on people with chronic kidney disease (CKD) and end-stage kidney disease (ESKD). Their “whole patient” plan includes prevention, special programs, data use, and managing other health problems like diabetes that often come with kidney disease.
These payment models can cut down on unnecessary medical costs and improve patient health. Better management can reduce hospital stays for kidney failure and other health problems. Improvements like these also take some pressure off the healthcare system.
The partnership works to improve both patient care and doctors’ work experience. Manish Tanna, MD, who leads NANI’s value-based care team, says Strive Health uses kidney-focused knowledge with new clinical tools made for kidney doctors. This helps them manage kidney disease better using real-time data and focused clinical help.
In real life, NANI’s providers get help from teams made up of nurse practitioners, dietitians, pharmacists, and social workers. These teams manage many health needs of kidney patients, such as nutrition advice, medicine help, and social support. These are important for total care but often missing in old care models.
These partnerships also make the doctors’ jobs easier by cutting down paperwork. Strive Health’s technology tools help with managing risk contracts and data. This lets doctors and staff spend more time on patient care instead of on paperwork and insurance talks.
Artificial intelligence (AI) and automation help support value-based care in kidney treatment. This partnership and similar groups use technology to help with clinical decisions, patient involvement, and office work.
Technology in Data Analytics and Risk Management: Strive Health uses data tools that predict which patients might get worse or have problems. The technology looks at many data sources like health records, lab results, and insurance claims. This helps care teams make better plans for each patient.
AI-Driven Workflow Automation: Automation helps with routine tasks such as scheduling appointments, sending medicine reminders, and follow-ups. This helps patients stick to their treatment plans, which is very important for kidney disease. Automated phone systems can handle calls, appointments, and reminders without needing a person each time. This cuts wait times and improves patient experience.
Clinical Decision Support Systems (CDSS): AI systems help doctors by showing them care guidelines during visits. This makes sure kidney care follows the best evidence for treating CKD and related health problems.
Administrative and Billing Automation: Value-based contracts can be complex. Automation helps handle claims and payments faster and with fewer mistakes. This lets kidney practices put more energy into care instead of paperwork.
Using AI and automation frees up medical workers and doctors from repeated tasks. This lowers burnout and gives more time for direct patient care. For office managers and IT teams, these technologies improve how the clinic runs while supporting complex risk-sharing plans.
Doctors need to be involved in designing value-based payment plans to make them work well. The American Medical Association (AMA) supports doctor-led Alternative Payment Models (APMs). Doctors know clinical care best and can spot problems and ways to fix care delivery.
Several kidney-focused APMs have been made with help from groups like the Renal Physicians Association. These models match financial rewards with patient-centered care. They focus on cutting hospital stays, improving dialysis results, and linking care for related health problems.
NANI takes part in new payment programs like Medicare’s Kidney Care Choices Model. This shows doctor leadership. It helps make sure these payment plans are fair, financially sound, and work well clinically. It also deals with worries that kidney specialists might be blamed for things outside their control.
The partnership between NANI and Strive Health starts in Illinois and Indiana but plans to grow to more areas and add new insurance contracts. As more providers and payers use value-based models, kidney care can change from billing per visit to ongoing, full care management.
This model is designed to serve more patients with better coordination and lower costs. The expansion fits with a wider trend in specialty care moving to value-based payments. This is supported by growing proof that such models improve patient health and save money.
The partnership’s plan to manage global risk fits national goals by groups like CMS and the AMA. They want more accountable and value-driven healthcare, especially in specialties like kidney care that deal with complex health issues and high costs.
The partnership aims to jointly pursue and manage global risk payment models to enhance kidney care delivery for patients with chronic kidney disease (CKD) and end-stage kidney disease (ESKD) through a ‘whole patient’ approach.
Strive and NANI plan to embed complete-care resources within NANI practices, including preventative care, clinical programs, data integration, and management of risk contracts to improve patient outcomes.
NANI is the largest independent nephrology group in the U.S. with over 170 physicians, excelling in value-based kidney care and innovative payment models.
They will share financial risks and management of risk contracts with government and commercial payors, initially targeting Medicare and Medicare Advantage.
The partnership provides NANI with the opportunity to improve patient care, enhance physician experience, and grow the value of its practice in a value-based framework.
Strive Health empowers nephrologists through advanced technology, integrated care resources, and a focus on value-based outcomes.
Approximately 37 million adults, or 15% of U.S. adults, are affected by kidney disease, resulting in significant unmanaged medical spending.
NANI is leading initiatives for practice transformation to enhance whole-patient care and integrate workflows for a better patient experience.
Strive Health’s rapid expansion and partnerships with nearly 400 nephrology providers is advancing a movement towards risk-based care in nephrology.
Strive and NANI plan to actively expand their partnership and payor contracts as NANI grows into new regions.
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