Parity in Kidney Care

Kidney Payment Models and Innovative Care Delivery

Parity in Kidney Care is a key programmatic area for the Parity Center, in part because kidney care and US policy have been tightly intertwined for over half a century. This interplay between policy and kidney disease became prominent in 1972, when President Nixon signed Social Security Amendments that made it so that virtually every US resident was eligible for Medicare if they developed kidney failure (an irreversible stage of kidney disease where people require dialysis or a transplant to stay alive). As a result of this amendment, a large proportion of kidney care is supported by Medicare (over $45 billion in 2022), meaning that changes in Medicare payment and regulation can have a large influence on kidney care delivery. This interlink makes kidney payment models an interesting area for innovation and research, particularly in this new era where the Centers for Medicare and Medicaid Services (CMS) has created new kidney payment models that incorporate randomization to test whether payment innovations can optimize kidney care delivery. 

Our Kidney Program Area, led by Dr. Yuvaram Reddy and Dr. Sri Lekha Tummalapalli, focuses on three pillars: 

1)   Studying the impact of kidney payment models on improving value and narrowing health disparities (using large databases and quasi-experimental study designs), 

2)   Evaluating how value-based kidney care is implemented in real-world settings (using mixed-methods, i.e., quantitative and qualitative methods, in partnership with clinicians, value-based care companies, patients, and insurers)

3)   Informing public policy in kidney care and beyond (through Perspective articles, opinion pieces, and public comments to federal agencies that motivate changes in kidney care policy).