When Rex, a 70-year-old retired construction worker in Utah, lost his kidney transplant after 24 years, he faced a familiar and daunting reality: a return to in-center dialysis. In the past, clinic-based treatment had dominated his life – long, exhausting sessions several days a week that left little room for family or daily routines.
Rex’s experience changed after working with a care coordinator from Interwell Health, a participant in Medicare’s Comprehensive Kidney Care Contracting (CKCC) model. Under CKCC, Interwell embeds care coordinators in nephrology practices to support value-based care interventions, support patient education, and personalized care delivery. Rex’s coordinator spent hours helping him navigate better treatment options like home dialysis, becoming “like my second daughter almost” in the process.
Instead of defaulting to in-center dialysis, Rex received:
- One-on-one education on all treatment options, including home dialysis
- Hands-on support to select and prepare for home treatment
- Ongoing care coordination to monitor his condition and prevent complications
With that support, Rex transitioned to home dialysis. The change was immediate. Dialyzing at home reduced the physical toll of treatment, restored flexibility, and allowed him to safely integrate care into everyday life—spending time with his 18 grandkids.
By emphasizing early education, coordinated care, and prevention, the CKCC model helps patients like Rex avoid hospitalizations and unnecessary institutional care. His story shows how accountable care can turn complex chronic treatment into something more manageable, sustainable, and aligned with patients’ lives.
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A4H’s Kidney Care Coalition outlines a roadmap to strengthen and sustain specialty-focused kidney care models in Medicare. The paper offers policy recommendations to improve stability, expand participation, strengthen accountability, and ensure continued access to value-based kidney care beyond 2027.
A4H’s Kidney Care Coalition partnered with independent actuaries at Wakely to reassess the early financial performance of Medicare’s Comprehensive Kidney Care Contracting Model. The analysis found the model could have generated meaningful net Medicare savings under CMS’s 2026 policy changes, with savings expected to grow as providers gain experience and care transformation efforts mature.
A4H’s Kidney Care Coalition released new resources showing that accountable kidney care is improving outcomes and has stronger savings potential than early evaluations suggest. With the CKCC Model set to end in 2027, CMS should build on this progress by creating a stable, long-term pathway for kidney care providers to continue delivering coordinated, patient-centered kidney care.
