The evolution of value-based kidney care: policy, treatment, and payment | Tim Fitzpatrick (Signals Group)

Tim Fitzpatrick, founder of Signals Group, joins to discuss innovation and value-based care (VBC) in nephrology. 

He outlines how CMMI kidney models have evolved from focusing on ESRD hospitalizations (CEC) to home dialysis and transplant incentives (ETC) and now earlier-stage CKD transitions (KCC), citing reported improvements like higher optimal starts, home dialysis use, and preemptive transplants, while noting open questions on cost effectiveness.

The conversation covers the growing landscape of kidney VBC operators beyond DaVita and Fresenius, the levers they use to manage total cost of care (care coordination, addressing social needs, avoiding hospitalizations), and early consolidation among providers. 

They discuss why the US lags in home dialysis, DaVita’s investment in home care (Elara), and how the dialysis bundled payment system may stifle innovation and the key areas to watch in policy and kidney drug development. 

The three part series on value-based kidney from Signals FS care can be found here: 
- Part 1: https://media.signalsfs.com/p/the-current-landscape-of-value-based
- Part 2: https://media.signalsfs.com/p/the-current-landscape-of-value-based-26d
- Part 3: https://media.signalsfs.com/p/the-current-landscape-of-value-based-1d4
- DaVita’s investment in Elara: https://media.signalsfs.com/p/brief-davitas-investment-in-elara

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