The Advantages of Kidney Care First

Nephrology Care Alliance (NCA) supports nephrologists by analyzing new value-based care (VBC) offerings and sharing insights about those programs. The Centers for Medicare & Medicaid Services’ (CMS) Kidney Care First (KCF) model is a physician-centric VBC program that aligns incentives with what’s right for patients. It’s a win-win for everyone. Your practice is empowered to participate on your own and earn new benefits.

The initial program begins on January 1, 2022 for those who applied in late 2019. Another opportunity to participate begins on January 1, 2023.

KCF Summary

  • Nephrologist-only model
  • Medicare Fee for Service patients
  • Restructures payments for CKD 4/5 and dialysis care
  • Adds a bonus for successful kidney transplant
  • 4 or 5 year program depending on start date
Patient Minimums
  • Patient-alignment through nephrologist (based on claims)
  • 350 late-stage chronic kidney disease (CKD) and 200 end stage kidney disease (ESKD)
  • Practices can aggregate to meet minimums; do not have to be geographically connected or work together
Reimbursement Model
  • CKD and ESKD payment adjusted based on performance relative to other KCF practices and national benchmarks
  • Initial quality metrics are 1) depression remission, 2) patient activation and 3) utilization measures – optimal start rate and cost of care
  • Home and transplant bonuses and new CKD payments

Our Assessment of KCF

NCA has analyzed and modeled the KCF program and we believe nephrology practices should take full advantage of the program and benefits. While this requires a shift from the traditional fee-for-service framework, it is imperative for practices to build or expand upon their value-based care capabilities to have success in the program now and avoid being left behind in the future.

Why practices should consider KCF

  • Learning opportunity to develop skills and capabilities to succeed in VBC
  • Opportunity to further improve patient outcomes
  • Potentially meaningful economics with limited downside risk, greater upside opportunity with high-performance
  • All economics go directly to practice, not a separate risk entity
  • Payment incentives in Home and transplant
  • Additional waivers provide more operational flexibility, e.g. Kidney Disease Education (KDE) waivers

Leverage Support to Help You Succeed

In the event that you need a helping hand as you participate in KCF, we’ve got you covered.

Our history in VBC programs can help you navigate program elements that are less familiar and strive towards maximizing the benefits of KCF while focusing on high-quality patient care. While NCA doesn’t formally participate with you, we can provide consulting services to help your practice succeed.

Prepare for launch and create a roadmap for KCF with:

  • Financial modeling to understand practice-specific performance scenarios
  • A readiness assessment to evaluate your practice's ability to perform optimally on KCF-specific elements
  • Value-based care readiness assessment to identify foundational capabilities to prioritize as your practice prepares for KCF and other programs (e.g. behavioral health coordination)

NCA Support Overview

NCA has a nephrologist-friendly, kidney-specific portfolio of services—customized to support practices in the KCF program.

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Reporting, dashboards and advanced analytics to better understand KCF program performance

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A dedicated NCA team focused on interpreting data, optimizing workflows and helping improve KCF outcomes in your practice

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Access to a larger network of KCF participants for sharing best practices and benchmarking comparisons

To help you further assess the KCF program and learn how to participate please contact us at

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