Value-Based Care and Kidney Disease: Emergence and Future Opportunities

Tummalapalli, Sri Lekha; Mendu, Mallika L.

doi:10.1053/j.ackd.2021.10.001

Cited by 10 publications

(11 citation statements)

References 65 publications

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“…Socioeconomic status is one of the key contributors globally to CKD progression [15], and as the disease progresses, there are increased out-of-pocket expenses, even in countries where there is access to universal healthcare [16]. In the United States, where disparities in kidney healthcare exist, there is a push for service redesign along with new payment models to address these disparities [17]. There are both direct and indirect out-of-pocket expenses of CKD treatment, and the concerns and consequences of these costs is termed financial toxicity.…”

Section: Financial Statusmentioning

confidence: 99%

Multimodal approaches for inequality in kidney care: turning social determinants of health into opportunities

Purtell,

Bennett,

Bonner

2023

Current Opinion in Nephrology &Amp; Hypertension

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Purpose of review Kidney disease is associated with major health and economic burdens worldwide, disproportionately carried by people in low and middle socio-demographic index quintile countries and in underprivileged communities. Social determinants such as education, income and living and working conditions strongly influence kidney health outcomes. This review synthesised recent research into multimodal interventions to promote kidney health equity that focus on the social determinants of health. Recent findings Inequity in kidney healthcare commonly arises from nationality, race, sex, food insecurity, healthcare access and environmental conditions, and affects kidney health outcomes such as chronic kidney disease progression, dialysis and transplant access, morbidity and mortality. Multimodal approaches to addressing this inequity were identified, targeted to: patients, families and caregivers (nutrition, peer support, financial status, patient education and employment); healthcare teams (workforce, healthcare clinician education); health systems (data coding, technology); communities (community engagement); and health policy (clinical guidelines, policy, environment and research). Summary The engagement of diverse patients, families, caregivers and communities in healthcare research and implementation, as well as clinical care delivery, is vital to counteracting the deleterious effects of social determinants of kidney health.

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Section: Financial Statusmentioning

confidence: 99%

Multimodal approaches for inequality in kidney care: turning social determinants of health into opportunities

Purtell,

Bennett,

Bonner

2023

Current Opinion in Nephrology &Amp; Hypertension

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“…44,45 By harnessing coordinated, high-quality care, value-based kidney care adherents should be able to favorably impact the progression of advanced kidney disease, achieving improved population health. [46][47][48] Parallels can also be drawn between attribution methodologies, as both employ a hierarchical approach. 1,13 One key feature of the Shared Savings Program and KCC Model is the two-step process by which patients are attributed.…”

Section: The Stepping Stone To Value-based Kidney Carementioning

confidence: 99%

“…Instead, aligned with the goals set forth in the Advancing American Kidney Health strategy, value‐based kidney care has the potential to transform kidney disease management 44,45 . By harnessing coordinated, high‐quality care, value‐based kidney care adherents should be able to favorably impact the progression of advanced kidney disease, achieving improved population health 46–48 …”

Section: The Stepping Stone To Value‐based Kidney Carementioning

confidence: 99%

Chronic kidney disease and value‐based care: Lessons from innovation, iteration, and ideation in primary care

Berman,

Lowentritt

2023

Hemodialysis International

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Value‐based primary care has reduced health care costs, improved the quality of rendered care, and enhanced the patient experience. Value‐based care emphasizes prevention, outreach, follow‐up, patient engagement, and comprehensive, whole‐person health. Primary care Accountable Care Organizations have leveraged technology‐enabled workflows, practice transformation, and cutting‐edge data and analytics to achieve success. These efforts are increasingly aided by predictive modeling used in the context of patient identification and prioritization algorithms. Value‐based kidney care programs can glean salient takeaways from successful value‐based primary care methods and models. The kidney care community is experiencing unprecedented transformation as novel payer programs and financial models burgeon. The authors contend these efforts can be accelerated by the adoption of techniques honed in value‐based primary care. To optimize value‐based kidney care, though, nephrology thought leaders must transcend the archetype of value‐based primary care. To do so, the nephrology community must: (1) impel behavioral change among fee‐for‐service adherents; (2) harness emerging policy, guidelines, and quality measures; (3) adopt innovative tools, technologies, and therapies. In aggregating lessons from value‐based primary care—and leveraging novel methodologies and approaches—the kidney care community will be better equipped to achieve the quadruple aim for kidney care.

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“…As new models of kidney care are emerging, they should be intentional about advancing health equity by applying an antiracist lens to payment and delivery system reform, and they should be assessed for their effect on kidney outcomes and equity. Kidney care models can adopt strategies that have been successful in the care of other diseases and should promote access to quality insurance; improved scope of coverage to meet medical and social needs, payment reform to incentivize equity care transformations, and support for safety net institutions 11 , 88 – 90 …”

Section: Opportunities For Future Interventions and Researchmentioning

confidence: 99%

“…Kidney care models can adopt strategies that have been successful in the care of other diseases and should promote access to quality insurance; improved scope of coverage to meet medical and social needs, payment reform to incentivize equity care transformations, and support for safety net institutions. 11,[88][89][90] Opportunities for Funders, Academic Medical Centers, and Health Systems The workshop findings offer important information for funding agencies, academic medical centers and health systems committed to reducing health disparities. Indeed, the National Institutes of Health (NIH) has made a commitment to address structural racism to address health disparities, 91 and they and several other entities have recently released funding announcements focusing on structural racism (Table 4).…”

Section: Promote Authentic Community and Stakeholder Engagementmentioning

confidence: 99%

Designing Interventions Addressing Structural Racism to Reduce Kidney Health Disparities: A Report from a National Institute of Diabetes and Digestive and Kidney Diseases Workshop

Crews

Patzer

Cervantes

et al. 2022

JASN

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Structural racism embodies the many ways in which society fosters racial discrimination through "mutually reinforcing inequitable systems" that limit access to resources and opportunities that can promote health and well-being among marginalized communities. To achieve health equity, and kidney health equity more specifically, structural racism must be eliminated. In February 2022, the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) convened the "Designing Interventions that Address Structural Racism to Reduce Kidney Health Disparities" workshop which was aimed at describing the mechanisms through which structural racism contributes to health and healthcare disparities for people along the continuum of kidney disease; and identifying actionable opportunities for interventional research focused on dismantling or addressing the effects of structural racism. Participants identified six domains as key targets for interventions and future research: 1) apply an anti-racism lens, 2) promote structural interventions, 3) target multiple levels, 4) promote effective community and stakeholder engagement, 5) improve data collection, and 6) advance health equity through new healthcare models. There exists an urgent need for research to develop, implement and evaluate interventions that address the unjust systems, policies, and laws that generate and perpetuate inequities in kidney health.

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Value-Based Care and Kidney Disease: Emergence and Future Opportunities

Cited by 10 publications

References 65 publications

Multimodal approaches for inequality in kidney care: turning social determinants of health into opportunities

Multimodal approaches for inequality in kidney care: turning social determinants of health into opportunities

Chronic kidney disease and value‐based care: Lessons from innovation, iteration, and ideation in primary care

Designing Interventions Addressing Structural Racism to Reduce Kidney Health Disparities: A Report from a National Institute of Diabetes and Digestive and Kidney Diseases Workshop

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