Blue Cross and Blue Shield of Minnesota inked a new value-based care plan with a DaVita Kidney Care affiliate on Monday, in a move to provide more cost-effective treatment to its new cohort of Medicare Advantage members. The partnership represents the latest example of an insurer rushing to offload—or at least, better manage—the risk of patients suffering from permanent kidney failure, who are now eligible to enroll in Advantage plans for the first time this year.
Care for end-stage kidney disease, which disproportionately affects people of color, has been predominantly delivered in dialysis centers, even when home dialysis would offer the same benefits with less cost and more convenience for the patients. The Covid-19 pandemic made the expansion of home care essential for many diseases. The authors explore how to preserve and expand home care for dialysis patients with regulatory changes and better coordination among programs.
Innovative Renal Care (IRC), a brand of American Renal Associates (ARA), announced today its acquisition of the assets of Kidney Treatment Center of San Antonio (KTC), an independently owned and operated patient-centered renal dialysis company offering highly personalized care to patients across three dialysis centers in San Antonio. The acquisition includes all three KTC clinics, Northwest, West and East. KTC patients will continue to have access to high-quality services and resources, and Dr. Bruce Brockway, the former owner of the KTC dialysis centers, is continuing as the medical director of the KTC Northwest location.
An analysis of the recently concluded Comprehensive End-Stage Renal Disease Care (CEC) alternative payment model found promising but modest results over the four performance years, with improvements on some quality and health care utilization measures as well as a decrease in total payments. The CEC Model is an Advanced Alternative Payment Model (Advanced APM) that creates financial incentives for dialysis facilities, nephrologists, and other Medicare providers to coordinate care for Medicare beneficiaries with ESRD. The model is designed to improve clinical and patient-centered outcomes for Medicare beneficiaries with ESRD, while promoting value and reducing per-capita payments.
Carrick Capital Partners (Carrick), a growth-oriented investment firm focused on software and software-enabled businesses with more than $1B in assets under management has made a significant investment in Renalogic, the industry leader in dialysis risk management and cost containment. The deal represents a major new investment in the category of health solution providers to the self-funded market and reflects Carrick’s thesis that self-funded employers, particularly in the mid-market, will increasingly explore innovative approaches to cost containment and risk management to combat rising PPO costs.
Nautic Partners and its portfolio company, Innovative Renal Care (IRC), have completed the previously announced transaction to acquire American Renal Associates Holdings, Inc. (NYSE: ARA), effective January 25, 2021. The transaction creates a unique opportunity to shape the future of kidney care during a dynamic time of change, innovation and transformation in the industry. As a privately held company and wholly owned subsidiary of IRC, ARA will no longer be a publicly traded company on the NYSE.
Global Nephrology Solutions (“GNS”) announced a strategic growth investment from Audax Private Equity (“Audax”) to help expand the innovative, physician-led model shaping the future of renal care. GNS is one of the nation’s leading physician-led nephrology organizations, with more than 300 providers and 500 employees, supporting physicians who provide care across 10 states. GNS is transforming the kidney care space by leveraging next-generation data analytics, vast industry knowledge and experience, and cost-effective population health initiatives.
The nation’s dialysis industry has poured $233 million into California campaigns over the past four years, establishing its leading companies as a formidable political force eager to protect their bottom line and influence state policy. Most of the money the industry spent from Jan. 1, 2017, through Nov. 30, 2020, funded the defeat of two union-backed ballot measures that would have regulated dialysis clinics — and eaten into their profits. But the companies and their trade association also stepped up their offense, dedicating about $16.4 million to lobbying and political contributions during the same period, a California Healthline analysis of state campaign finance records shows.
Nephrology practices across the country are gearing up to participate in new alternative payment models for kidney care that are launching next year. The Comprehensive Kidney Care Contracting option of the Kidney Care Choices model (CKCC) is a new Center for Medicare and Medicaid Innovation (CMMI) payment innovation model that incentivizes healthcare providers to manage the care of Medicare beneficiaries with chronic kidney disease (CKD) stages 4 and 5 and end stage renal disease (ESRD). Unlike prior value-based kidney care models, CKCC addresses both CKD and ESRD beneficiaries and aligns patients based on nephrology care, not dialysis treatments. The implementation period for the program started on Oct. 15, 2020, and the official launch of the performance period is on April 1, 2021.
Through the third year of an alternative payment model focused on end-stage renal disease (ESRD), the ESRD Seamless Care Organizations (ESCOs) reduced total Medicare Parts A&B spending by $93 per beneficiary per month, or 1.5 percent, and appeared to lead to better coordinated care. The Comprehensive End-Stage Renal Disease (ESRD) Care Model (CEC) was created in 2015 to test whether alternative payment arrangements would improve care and reduce the cost of care for Medicare beneficiaries with ESRD. In a commentary on the third-year performance year results, the Centers for Medicare & Medicaid Services (CMS) said the cost savings were driven by lower payments for acute inpatient, post-acute institutional care, and hospitalizations due to ESRD complications.
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