Kidney Care Choices: Show Me the Money!

Why This Topic Matters

Nephrology practices need to understand how new CMS/CMMI model structures can change practice revenue timing and overall financial exposure, especially in the early years of participation.

Article Sections

1. Getting started

   Introduces the main financial areas the article will examine and frames the discussion around model participation and practice revenue effects.

2. AMCP

   Discusses the monthly capitation component of the model and how practice mix and utilization patterns may affect revenue timing.

3. CKD cap

   Covers the quarterly capitation component tied to late-stage kidney disease patients and the issues involved in estimating practice-level impact.

4. Alignment and payer mix

   Explores how patient mix and alignment patterns influence the balance between chronic kidney disease and end-stage renal disease patients in the model.

5. All together now

   Brings the earlier payment components together to describe their combined effect on practice cash flow and overall financial exposure.

6. PBA

   Summarizes the role of performance-based adjustment considerations for participants in one of the Kidney Care Choices models.

7. Everything else

   Introduces additional revenue sources and incentives that may influence the overall financial picture beyond the main capitation payments.

8. Transplant bonus

   Describes a transplant-related incentive and its timing in relation to anniversary-based payment recognition.

9. QPP

   Addresses the relationship between participation in an advanced alternative payment arrangement and broader quality payment program effects.

10. CKCC

    Reviews the shared-savings and downside-risk aspect associated with one of the Kidney Care Choices models.

11. The calculator

    Discusses a payment calculator and the practical considerations practices should review when modeling the financial impact of participation.