Integrated renal care: are nephrologists ready for change in renal care delivery models?
The Affordable Care Act is the most visible element of health care reform. However, both before the Affordable Care Act and now with the acceleration since its passage, the Centers for Medicare and Medicaid have been and are testing integrated care models in medicine in general as well as nephrology. The pressures to do so come from the well known increasing costs of health care in the face of a number of clear gaps in quality. The future will likely be more and more integrated care with less and less fee for service. More measurement of quality and the linking of quality measures to payments are also all but certain future elements of the health care economy. Nephrologists need to educate themselves on these trends and be prepared to engage them for the good of the profession and the improvement in care for patients.
Delaware Valley Nephrology and Hypertension Associates, Philadelphia, Pennsylvania; and dredj@comcast.net.
Edward R
ER
Jones
Case Western Reserve University, School of Medicine, University Hospitals, Cleveland, Ohio.
Thomas H
TH
Hostetter
D060866:Accountable Care Organizations / Q000458:organization & administration; D019033:Delivery of Health Care, Integrated / Q000191:economics / Q000331:legislation & jurisprudence / Q000458:organization & administration*; D017048:Health Care Costs; D018166:Health Care Reform; D006291:Health Policy; D006801:Humans; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D006278:Medicare / Q000458:organization & administration; D017146:Models, Organizational; D009398:Nephrology / Q000191:economics / Q000331:legislation & jurisprudence / Q000458:organization & administration*; D058991:Patient Protection and Affordable Care Act; D010819:Physician's Role; D010820:Physicians / Q000191:economics / Q000331:legislation & jurisprudence / Q000458:organization & administration*; D011050:Policy Making; D012051:Reimbursement Mechanisms / Q000458:organization & administration; D014481:United States; D000078329:Workforce
CKD; ESRD; economic effect