Value-based care is a way of paying for healthcare that rewards providers for better patient results and saving money rather than just how many services they give. In kidney care, this is important because chronic kidney disease affects about 15% of people in the U.S.—more than 37 million—and many don’t find out until the disease is advanced. Medicare spends over $130 billion every year on kidney patients, making it a big concern for healthcare systems.
Value-based care supports early treatment, better teamwork among care providers, and more patient education. These efforts help slow the disease, reduce hospital stays, and avoid urgent treatments like dialysis or kidney transplants. The aim is to get better health results at a lower cost. Providers take on more financial risk to focus on managing the disease well instead of giving many services.
An example of value-based care is the partnership between Panoramic Health and the San Antonio Kidney Disease Center (SAKDC). Panoramic Health leads kidney care with a platform run by doctors. Together with SAKDC, a nephrology group serving South Texas, they provide care to almost 100,000 patients in big Texas cities like Houston, Dallas, and San Antonio.
Panoramic Health handles over $1.5 billion in risk spending through 18 Kidney Contracting Entities, covering more than 30,000 Medicare patients. They use data tools and clinical workflows to help kidney doctors while allowing them to keep control of their medical decisions. SAKDC runs 30 dialysis centers and works with 15 hospitals to give full kidney care, including patient education on diet, kidney health, and preventing disease.
Rocky Chanana, a senior leader at Panoramic Health, says this partnership keeps kidney doctors central while using Panoramic’s value-based system. Dr. Wesley Calhoun, President of SAKDC, supports patient-focused care and the change to managing population health.
Value-based care in kidney treatment has led to real improvements in patient health and healthcare system efficiency. Seeing a kidney specialist early and having coordinated care after leaving the hospital can slow disease, lower readmissions, and reduce deaths.
Research shows that patients who visit a nephrologist within two weeks after hospital discharge are about 25% less likely to be readmitted. This quick follow-up stops many avoidable hospital stays, which cost a lot. Value-based care programs also show results like:
Interwell Health, a partner in these efforts, said a regional health plan saved $3.6 million after starting value-based kidney care. The plan also saw a 60% rise in patient involvement, a 30% drop in hospital stays, and a 27% increase in starting dialysis in the best way. These show better patient care and money savings.
These results focus on preventing disease, early treatment, and patient teaching — all key for managing long-term illness.
Using artificial intelligence (AI) and automatic workflows is becoming important in value-based kidney care. Panoramic Health and others use AI to look at large amounts of data, like electronic health records, to spot high-risk patients early and guide care decisions.
For example, AI can predict which kidney patients might get worse or need hospital stays. This helps care teams target resources, plan treatments, and manage patients ahead of problems. Automated workflows send alerts to doctors and coordinators, make sure care plans are followed, and help with follow-ups.
These tools help with:
AI is not required yet for success in value-based care, but it shows promise for better cost control and patient outcomes, especially as data-driven care grows. Research suggests AI and advanced data tools will soon be needed to compete.
Practice administrators and IT managers in kidney care need to understand the changes in care and operations when moving to value-based care. Besides clinical quality, running the practice efficiently and using technology are key to meeting goals and helping patients.
Important operational points include:
In Texas, where Panoramic Health and SAKDC work, these improvements support broad care in cities with many kidney patients. Administrators and IT teams should invest in health IT systems that talk to each other, have strong predictive analytics, and are easy to use to work well in value-based care.
Money management in kidney practices is affected a lot by value-based contracts. CMS’s move to programs like Kidney Care Choices shows this trend, rewarding providers for better care without raising costs.
The U.S. spends a lot on kidney disease — Medicare alone spends over $130 billion each year, about a quarter of its total budget. Patients with end-stage kidney disease make up a small group but use a large part of these funds.
Value-based programs help control costs by promoting home dialysis, transplants, and preventive care that slows disease. Private insurers and hospitals using these models report savings from 3% to 20%, depending on risk and care levels.
Groups that take financial risk and management service organizations (MSOs) are growing. They help kidney care groups handle contracts, data, and transitions better.
Healthcare differences are still a problem in kidney care, especially for people with fewer resources. Researchers like Dr. Sri Lekha Tummalapalli from Weill Cornell Medicine work on adding social factors into payment and care models.
By dealing with barriers like access to healthy food, education, housing, and transport, kidney care can better meet patients’ full needs. Population health plans that include these issues can improve how people follow treatments and their health results.
Programs such as SAKDC’s kidney health education classes show how patient teaching and involvement help manage the disease. Supporting patients beyond doctor visits can lower preventable problems, hospital stays, and costs under value-based contracts.
The use of value-based care models is expected to grow fast. Research predicts the number of patients under these contracts will increase by 10-15% each year and may double in five years. Investments by private funds in value-based healthcare companies have grown four times between 2019 and 2021, showing confidence in this approach.
Fields like kidney care, cancer, orthopedics, and heart care are leading this change. For kidney care, this means moving to care that is integrated, focused on results, and supported by data and technology.
Practice leaders and IT managers should know success depends on good operations, advanced data tools, workflow automation, and strong teamwork in care. Changing to value-based care requires organization changes but offers better patient care and financial stability.
Practice administrators, owners, and IT managers in kidney care should consider these steps to prepare for value-based care:
By following these steps, kidney practices can manage clinical risks well while joining value-based programs that serve patients better and use resources wisely.
Value-based care models mark a major change in treating chronic kidney disease and end-stage kidney disease. Through partnerships like Panoramic Health and SAKDC in Texas, and by using AI data tools and workflow automation, kidney care practices can improve quality and control costs. The change needs careful operational work but offers strong benefits to patients, providers, and payers in today’s healthcare system.
Panoramic Health is the nation’s leading integrated, physician-led value-based kidney care platform, enhancing patient outcomes for chronic kidney disease (CKD) and end-stage renal disease (ESRD) through strategic partnerships.
The partnership integrates Panoramic Health’s predictive analytics and holistic care coordination, allowing SAKDC to improve patient outcomes while maintaining clinical autonomy.
Value-based care focuses on patient outcomes and cost reduction, encouraging nephrology practices to adopt innovative care models that prioritize efficiency and quality.
Panoramic Health, through collaborations like SAKDC, serves nearly 100,000 patients across key Texas metropolitan areas.
Panoramic Health offers a suite of tools including predictive analytics, clinical workflows, and access to one of the largest CKD databases to enhance care delivery.
The mission of SAKDC is to provide comprehensive, innovative, patient-centered care while leading the nephrology community in value-based care and population health management.
SAKDC provides free classes on kidney health, diet, and disease prevention, showcasing its commitment to patient education and proactive health management.
Panoramic Health manages over $1.5 billion in risk spending for more than 30,000 Medicare beneficiaries across 18 Kidney Contracting Entities.
Integrating dialysis centers like SAKDC into Panoramic Health’s framework aims to streamline patient care, optimize outcomes, and control costs.
Panoramic Health’s Clinical Research division collaborates with sponsors to bring innovative treatments to patients, enhancing the standard of care in kidney disease management.
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