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.
California voters have rejected a ballot measure to require a doctor or highly trained nurse at each of California’s 600 dialysis clinics. With more than 9 million votes tallied Tuesday, Proposition 23 had just 37% of votes. It is the second measure seeking to regulate dialysis clinics placed on the ballot in recent years by unions that represent health care workers and drew more than $110 million in spending. Opponents, financed by dialysis clinic companies, say that under that mandate, between two and three doctors would be required at every facility because most are open at least 16 hours a day, creating a financial burden that could lead some clinics to close.
CMS on Monday signed off on its proposal to pay providers extra money if they use home dialysis machines to treat end-stage renal disease patients. The final rule expands a transitional add-on payment to cover home dialysis machines that CMS Administrator Seema Verma touted in July when the agency proposed it, saying the COVID-19 highlighted the need to increase home dialysis access. CMS expects it will pay $9.3 billion in 2021 for renal dialysis services. It increased the prospective payment system rate from $239.33 to $253.13. The proposed rule also updated payment rates for acute kidney injury dialysis and made changes to the ESRD Quality Incentive Program. The changes take effect Jan. 1.
American Renal Associates Holdings, Inc. (NYSE: ARA) (“ARA” or the “Company”), a leading provider of outpatient dialysis services, today announced that it has entered into a definitive agreement to be acquired by Innovative Renal Care, LLC (“IRC”), an affiliate of Nautic Partners, LLC (“Nautic”), a middle market private equity firm, in an all-cash transaction that values the Company at an aggregate enterprise valuation of approximately $853 million excluding non-controlling interest. Under the terms of the agreement, ARA shareholders will receive $11.50 per share in cash. This consideration represents an approximate premium of 66% to the Company’s closing price on October 1st, 2020.
CMS on Friday unveiled its alternative payment model for patients with chronic kidney disease. The End-Stage Renal Disease ESRD Treatment Choices—ETC—model encourages increased home dialysis use and kidney transplants. According to the agency, it will affect nearly a third of kidney care providers and save the federal government about $23 million over five and a half years. “This new payment model helps address a broken set of incentives that have prevented far too many Americans from benefiting from enjoying the better lives that could come with more convenient dialysis options or the possibility of a transplant,” HHS Secretary Alex Azar said in a statement.
The CMS on Monday proposed paying physicians and providers additional money if they use home dialysis machines to treat end-stage renal disease patients. Medicare beneficiaries with end-stage renal disease are in the most at-risk group for COVID-19. CMS data released last month showed there were 1,341 hospitalizations per 100,000 people in this category. They often have other comorbities such as diabetes and heart failure, and are unable to shelter-in-place due to dialysis and other treatment requirements, the agency said. Monday’s proposed rule would expand a transitional add-on payment to cover home dialysis machines. About 750,000 Americans have ESRD and 530,000 have Medicare benefits. Approximately 85% of ESRD patients travel three times a week or more to receive dialysis treatment.
Nephrology Associates, P.C. has announced its participation and investment in a new entity aimed at improving healthcare outcomes for Americans living with kidney disease. This new population health management company, InterWell Health, is an alliance currently consisting of over 650 nephrologists and the nation’s leading provider of kidney care products and services, Fresenius Medical Care North America. InterWell Health participants are many of the most influential in their field, and more provider groups will be invited to join. This partnership was formed to support nephrologists nationwide towards a more rapid adoption of value-based care models in an environment that promotes the full continuum of care for renal patients. The focus spans the CKD and ESRD populations with collaboration on care models to slow progression, to maximize the availability of transplant and home therapies, as well as prioritize optimal starts on dialysis.
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