May 29, 205
Contact: Erin Hemlin, APG Vice President of Communications
ehemlin@apg.org; tel: 202-770-1901
WASHINGTON — Five specialty kidney care organizations that are members of America’s Physician Groups were among those achieving superior health outcomes for patients in 2023 as detailed in a new report about the Kidney Care Choices (KCC) Model. Among 21 key improved outcomes generally considered hallmarks of high-quality kidney care were a 31 percent increase in optimal timing for initiating appropriate end-stage renal disease care relative to a pre-model comparison group; a 69 percent increase in preemptive kidney transplants to avoid dialysis; a 10 percent increased use of more convenient and safe home dialysis for patients; and 1 percent decreased use of center-based dialysis care.
The five APG groups that participated in the KCC model were Evergreen Nephrology LLC, Interwell Health, Strive Health LLC, US Renal Care, and VillageHealth DM. Overall, these APG members constituted 88 of the 100 total Kidney Contracting Entities (KCEs) — groups of health care providers that contract with the government to provide kidney care to Medicare beneficiaries — that participated in 2023 in so-called Comprehensive Kidney Care Contracting (CKCC) Options (three of the four payment options available in the KCC Model).
Thanks to the effective and patient-focused strategies adopted by KCC participants, improvements over the two years that the model has been in effect are being seen “at every single stage of the kidney disease journey,” said Valinda Rutledge, executive vice president for advocacy and policy at APG. “More patients are moving off dialysis sooner, obtaining more successful transplants, and seeing slower progression of the disease.” Although the evaluation report to the Centers for Medicare & Medicaid Services (CMS) showed a nearly $305 million increase in net Medicare spending in 2023 – in part due to shared savings earned by participating nephrology groups – “we know that it will take time to see the return on investment of restructuring care delivery to see lasting, significant savings from value-based care models in kidney disease,” said Jennifer Podulka, senior vice president of federal policy at APG.
Changes To Beef Up Savings: To further achieve Medicare savings in the KCC model, CMS this week announced changes that will begin in Plan Year (PY) 2026. These include eliminating a bonus paid to physician practices that undertake preemptive transplants to avoid dialysis and reduction by half of a quarterly capitation payment. At the same time, CMS will also extend the model from its scheduled ending in 2026 to 2027. Although some of these changes may reduce financial incentives for model participants, APG is encouraged by the model’s extension and the agency’s ongoing commitment to improve kidney care management – promoting prevention, empowering patients through informed decision-making, and driving competition – all pillars of CMS’s new strategic direction.
About America’s Physician Groups
APG’s approximately 360 physician groups comprise 170,000 physicians, as well as thousands of other clinicians, providing care to nearly 90 million patients, including about 1 in 3 Medicare Advantage enrollees. APG’s motto, ‘Taking Responsibility for America’s Health,’ represents our members’ commitment to clinically integrated, coordinated, value-based health care in which physician groups are accountable for the costs and quality of patient care. Visit us at www.apg.org.
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