Effective January 2021, Independence will launch a new nephrology pay for value (NeP4V) program focused on chronic kidney disease (CKD) and end-stage renal disease (ESRD) members. The NeP4V program is the first incentive-based model offered to nephrology practices in the Independence network.

Independence is pleased to see all the work being done to improve the lives of those with CKD and ESRD. The Centers for Disease Control and Prevention estimates that 37 million people in the United States have CKD, and more than 726,000 have ESRD.¹

Over the last two years, there has been a growing number of initiatives launched to address CKD and ESRD including:

• The Advancing American Kidney Health initiative to reduce the risk of kidney failure, increase access to home-based dialysis, and boost availability of kidney transplants.
• The Department of Health and Human Services released a mandatory model encouraging greater use of home dialysis and kidney transplants for Medicare members with ESRD and four voluntary models that test new Medicare payment options to improve care for patients with kidney disease.
• Centers for Medicare & Medicaid Services rule that would allow patients diagnosed with ESRD to access Medicare Advantage coverage.

The NeP4V program will give nephrology practices an opportunity to earn incentives for continually improving the quality of medical care and service they provide Independence Commercial and Medicare Advantage members with advanced CKD (stages 4 and 5) and ESRD. Practices must meet certain prerequisites to be eligible for participation and payment in the NeP4V program.

Payment incentives will be based on:

• how well a nephrology practice performs relative to other qualifying participating nephrology practices;
• the practice’s performance compared to all participating practices to determine the practice rank;
• the practice’s evaluation on its performance relative to defined Kidney Care Measures.

Learn more

More information regarding the NeP4V program will be provided in December 2020. If you have questions, please email us at NeP4V@ibx.com.

¹Centers for Disease Control and Prevention, Chronic Kidney Disease Initiative. “Chronic Kidney Disease in the United States, 2019.” 2019. Available from:https://www.cdc.gov/kidneydisease/publications-resources/2019-national-facts.html