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Critical Tools for Kidney Care Choices Success

The Kidney Care Choices Model is welcoming a new cohort of participants in January 2023. KCC is a voluntary model for nephrology practices, nephrology professionals and kidney contracting entities.  KCC provides financial incentives to help providers improve the quality and reduce the cost of care for patients with late-stage chronic kidney disease and end-stage renal disease.

The program’s main goals are to delay the progression of CKD to ESRD, effectively manage the transition onto dialysis, support beneficiaries through the transplant process and keep them healthy post-transplant.

In addition to announcing Cohort 2, CMS shared more information on the incentive structure and quality measures current and future participants must understand.

Successful participation in the program will drive:

  • reduction in total cost of care;
  • comprehensive and coordinated care delivery; and
  • improved access to care.

Participants can achieve these benefits through three strategies:

  • analyzing drivers of quality and cost;
  • collecting and assessing timely claims and member data; and
  • tailoring an approach to your practice’s needs.

DataGen offers guidance for each of these critical factors to help new and current participants succeed.

Insights on drivers of quality and cost

To maximize their returns in the KCC Model, practices must identify any opportunities to improve care quality and understand the cost of care across the continuum. A strong data analytics program can offer solid insights into these drivers. For example, it can evaluate when patients have changes in attribution status or disease progression, which impacts population-based payments.

A data analytics program can also help clinicians identify those who have not completed annual wellness visits, those who are at high risk for an emergency department visit or hospital admission, and optimal dialysis starts. These data can help improve the efficiency of clinical care, reduce gaps in care and decrease utilization.

Reports and dashboards make it easy to view critical claims and member data

To succeed in KCC, practices need to analyze complex claims and member data feeds. Easy-to-interpret measurements and visualizations are vital to this work. However, building this expertise in-house can be challenging, so practices should consider partnering with a third-party resource that specializes in claims data analysis, data analytics and payment monitoring. This is especially helpful during periods of resource and staffing shortages. Because of the complexity of managing the data, it is key to obtain leadership buy-in to support this need.

An approach tailored to your practice’s unique needs

Due to the variety of providers that can participate in KCC, participants should implement a program that is tailored to their specific needs. The KCC model is applicable to practices of various sizes and populations, so a one-model-fits-all approach will not maximize the results for a specific provider.

DataGen’s digital health solutions can be custom designed to help providers prepare for and successfully participate in the KCC Model based on their specific practice and beneficiary population.

As the industry embraces digitization, processing data efficiently and interpreting its meaning is no longer optional. Learn more today about how DataGen’s agile platform can help you.


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