Value Based Care for Nephrologists with Brian O'Dea: Insights from the CEO of NANI
Blog Date: Septemebr 12th 2024
As value-based care (VBC) continues to shape the healthcare landscape, practices like NANI have positioned themselves as pioneers in adapting to this new model. CEO Brian shared how NANI has not only embraced VBC but also thrived by focusing on patient outcomes, cost efficiency, and collaborative care.
NANI’s Leadership in Value-Based Care: An Interview with CEO Brian
NANI has been an early adopter of value-based care, demonstrating a belief in the model’s potential to improve patient outcomes while reducing healthcare costs. Brian explained, “We were one of the six original practices to participate in the ESCO (ESRD Seamless Care Organization) model. The ESCO was initially led by dialysis companies but aimed to manage the cost of care for dialysis patients. CMS estimated an annual cost of around $100,000 per patient, and if we provided care for less than that, we could keep the difference.”
While some might perceive VBC as cost-cutting, Brian emphasized that the goal was to deliver **extra care** to keep patients out of the hospital. “By reducing hospitalizations, each one we avoid saves around $15,000. And by ensuring patients start dialysis with optimal access, like a fistula, we save about $50,000 over their lifetime.”
Brian highlighted that understanding VBC requires more than clinical expertise—it demands a well-structured team and infrastructure. “Tracking patient spending across all services and identifying clinical trends is key to succeeding in VBC. Small practices may find this challenging, but at NANI, we’ve built a sophisticated team to support nephrologists.”
New nephrologists entering the field should prepare for the collaborative nature of VBC. It requires close monitoring of patient data, proactive management of high utilizers, and a team-driven approach to care. At NANI, this includes access coordinators, transplant coordinators, and thought leaders like Dr. Manishtan, who guides the clinical aspects of value-based care.
Brian predicts that VBC will continue reshaping healthcare. “There’s a crisis in nephrology right now. Over the past 10 years, nephrologist compensation has dropped by 28%, and inflation is eating away at income. But value-based care puts nephrologists in control. We’ve transitioned from the ESCO model to the CKCC (Comprehensive Kidney Care Contracting) model, where we now manage both CKD and ESRD patients. Nephrologists, not dialysis providers, are now leading the charge in care management for CMS.”
CMS aims for 100% of its payments to be through VBC by 2030, and the rise of Medicare Advantage reflects this shift. “If you’re not preparing for this now, you’ll have to adjust later,” Brian warned. “But for nephrologists who understand and embrace VBC, it can reverse the trend of declining income and allow them to deliver better care.”
NANI ensures its nephrologists are prepared for the VBC model through robust support systems. Brian shared, “We have an entire team dedicated to helping nephrologists understand VBC. We track high-utilizer patients and provide nephrologists with that data. Additionally, our team includes access and transplant coordinators.”
One of the successes of this model has been in **transplants**. “With the funds from VBC, we’ve been able to hire a transplant coordinator, and as a result, we’ve doubled the number of transplants NANI performs annually—from 250 to 540. That’s over 2% of the total kidney transplants in the country.”
Fee-for-service models have long been the standard in healthcare, but Brian compared it to “a hamster on a wheel— the more you see patients, the more you get paid.” VBC changes this dynamic. “Now, if you provide the right care, get patients transplants, start them on dialysis correctly, and keep them out of the hospital, you’re compensated for the quality of care, not just the quantity.”
CMS’s commitment to VBC by 2030 means this shift is inevitable, and practices like NANI are at the forefront, ensuring their patients—and nephrologists—thrive in this new era of healthcare.
Listen to the Podcast on Spotify or wherever you get your Podcasts. For more information on how NANI is leading the way in value-based care, contact us today!
For nephrologists seeking a dynamic and rewarding career, NANI presents an unmatched opportunity. Listen in on Spotify or wherever you get your Podcasts!
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