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Examining the Shift to Value-Based Kidney Care Delivery in 2021
On this episode of Managed Care Cast, we speak with the new chief financial officer of Strive Health, a value-based kidney care company that works with payers and providers to create an integrated care delivery system for chronic kidney disease and end-stage renal disease (ESRD). We discuss the changes coming to nephrology practices, as well as new ways of looking at the whole patient to halt the slide to irreversible ESRD.
In 2021, CMS is launching new payment models to address the high cost of care for Medicare beneficiaries with kidney disease and to improve patient outcomes. Chronic kidney disease (CKD) and end-stage renal disease (ESRD) are among the most expensive conditions in Medicare; about 37 million Americans have CKD and 725,000 have ESRD. The situation is expected to get worse as the population ages, rates of diabetes and obesity soar, and demand for dialysis increases.
On this episode of Managed Care Cast, we speak with Brandi Riddle, who recently joined Strive Health as its chief financial officer. Strive Health is a value-based kidney care company that works with payers and providers to create an integrated care delivery system for CKD and ESRD. We discuss the changes coming to nephrology practices, as well as new ways of looking at the whole patient to try and halt the slide to irreversible ESRD.
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ACOs’ Focus on Rooting Out Fraud Aligns With CMS Vision Under Oz
April 23rd 2025Accountable care organizations (ACOs) are increasingly playing the role of data sleuths as they identify and report trends of anomalous billing in hopes of salvaging their shared savings. This mission dovetails with that of CMS, which under the new administration plans to prioritize rooting out fraud, waste, and abuse.
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New Research Challenges Assumptions About Hospital-Physician Integration, Medicare Patient Mix
April 22nd 2025On this episode of Managed Care Cast, Brady Post, PhD, lead author of a study published in the April 2025 issue of The American Journal of Managed Care®, challenges the claim that hospital-employed physicians serve a more complex patient mix.
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Contributor: For Complex Cases, Continuity in Acute Care Is Necessary
April 23rd 2025For patients with complex needs and social challenges like unstable housing, the hospital has become their de facto medical home—yet each visit is a fragmented restart, without continuity, context, or a clear path forward.
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Personalized Care Key as Tirzepatide Use Expands Rapidly
April 15th 2025Using commercial insurance claims data and the US launch of tirzepatide as their dividing point, John Ostrominski, MD, Harvard Medical School, and his team studied trends in the use of both glucose-lowering and weight-lowering medications, comparing outcomes between adults with and without type 2 diabetes.
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