{"id":22268,"date":"2021-02-25T16:07:38","date_gmt":"2021-02-25T10:37:38","guid":{"rendered":"https:\/\/mobisoftinfotech.com\/resources\/?p=22268"},"modified":"2025-12-10T12:43:54","modified_gmt":"2025-12-10T07:13:54","slug":"value-based-care-for-chronic-kidney-and-end-stage-renal-disease","status":"publish","type":"post","link":"https:\/\/mobisoftinfotech.com\/resources\/blog\/value-based-care-for-chronic-kidney-and-end-stage-renal-disease","title":{"rendered":"A Holistic Approach to Value-Based Care for Chronic Kidney and End-Stage Renal Disease"},"content":{"rendered":"

The recent health evaluations have been experiencing a staggering increase in providing value-based care. According to the estimates by the Center for Disease Control and Prevention (CDC), 37 million people from the US suffer from <\/span>Chronic Kidney Disease (CKD)<\/span><\/a>. According to the same report, about 726,000 of the population are diagnosed with end-stage renal disease (ESRD). <\/span><\/p>\n\n\n\n

According to the Medicare Advantage plan, ESRD and CDK were previously not covered under Medicare Advantage. Hence, the cost for treatment for Medicare beneficiaries with Chronic Kidney Disease incurred USD 84 billion for treatment of patients, and for ESRD an additional USD 36 billion, according to CDC in 2017. The cost as stated was one of the many effects that caused distress for members with these conditions. Apart from the cost, the quality of care for both ESRD and CDK skyrocketed as kidney care focused mainly on patients with the late-stage diagnosis. <\/span><\/p>\n\n\n\n

Medicare Advantage Offering Plans to Cover End-Stage Renal Disease and Chronic Kidney Care for MA Plan Members via Value-Based Care <\/h2>\n\n\n\n

With the onset of 2021, Medicare advantage remodified its plan offerings. Now, people under the MA plans are eligible to apply for ESRD coverage, minimizing the expenditure factor that affected receiving proper kidney care. The recent efforts provided from the federal level are targeted to transform the traditional approach to kidney care treatments and encouraging providers to intervene at the earliest, for a more holistic value-based care delivery. The <\/span>Center for Medicare and Medicaid Innovation<\/span><\/a> (CMMI) established the payment innovation model structure for chronic care management. This model encourages strong financial incentives for primary care providers and assists them in chronic care management services for Medicare beneficiaries affected by chronic kidney disease (stages 4 and 5) as well as ESRD.<\/span><\/p>\n\n\n\n

The Kidney Care Choices program (KCC), is an alternative voluntary payment structure, that focuses on incentivizing the nephrologists, facilities for dialysis, and practices for ESRD healthcare. Therefore, supporting coordinating care and taking a patient-centered approach can be a collaborative approach for payors and providers in the and delivery of value-based care solutions. This KCC model has been structured to encourage healthcare practices, and delay the process of dialysis, and focus primarily on the transplant. <\/span><\/p>\n\n\n\n

According to CMS, <\/span>there are over 430,000 Medicare beneficiaries <\/span><\/a>under Fee-for-service diagnosed with ESRD, spending an average of 12 hours receiving in-center hemodialysis. Out of this, many suffered from higher rates of hospitalization resulting in poor and unsatisfactory health outcomes. Hence, the complication of underlying diseases and various co-morbidity occurs.<\/span><\/p>\n\n\n\n

The announced voluntary kidney care options provided by KCC under CMS offers: <\/span><\/p>\n\n\n\n