RPA Panel: DaVita Chief Transformation Officer Calls for Acceleration of Value-Based Models, Focus on Upstream Care
Misha Palecek | DaVita Chief Transformation Officer

At the annual Renal Physicians Association (RPA) meeting in Dallas, Texas, March 24-27, DaVita chief transformation officer Misha Palecek spoke candidly about the nephrology community’s imperative to provide better care management for kidney patients and to more aggressively pursue the shift to value-based care.

Palecek participated in a panel conversation, “Business of Nephrology,” with other dialysis provider executives to discuss integrated kidney care and the future of value-based care models.

The panelists answered questions about governance structures, skepticism around value-based care and the importance of nephrologists joining together to propel the community forward toward more synchronized care. Palecek echoed his counterparts about the many challenges that lie ahead, including broadening physician networks and simplifying practice workflows.

“I think at this point the momentum is very clear,” Palecek said. “We have to move from fee-for-service to value-based care. We need to do better.”

Each panelist—including Palecek—focused on a simple and effective message: Value-based care is a journey toward better care for patients.

According to Palecek, value-based care provides the right environment to enhance chronic disease management. Palecek cited a personal experience about traditional health care models failing his brother. Without cohesive and collaborative care and communications, Palecek’s brother was compromised by a fragmented care plan.

His brother’s experience helped drive Palecek’s passion for improving the overall care experience for patients and their families.

“When I look out into this audience, there’ve been a lot of partners we’ve been on this journey for a long time with and I know the passion that many of you have to improve care,” he said. “I think the train has left the station, and we’re all going to do better for our patients. And that makes me very excited.”

To facilitate this vision, Palecek also underscored the need to move upstream and place more attention on CKD patients by better understanding their disease progression and having intentional conversations around best treatment modality options. Integrated kidney care and the emphasis on a results-driven model, he explained is vital to improving the intention placed on modality selection.

“If 50% of patients crash into dialysis, that is unacceptable in American health care,” Palecek said. “As we move upstream, I think over the next couple of years you’re going to see a dramatic reduction in the number of patients who find out their kidneys are failing for the first time in an acute setting in a hospital.”

When asked about how new nephrology business models will mitigate the looming physician workforce shortage, Palecek pointed to the benefit of machine learning and predictive algorithms to focus resources on the most complex patients. By having nephrologists focus more on complex patients and care teams support lower-risk patients, he believes this approach will help support nephrologists—allowing them to deliver high-quality care while managing a larger patient population.

He again emphasized the need to reimagine kidney care and identified value-based care models as the clear path to a better future and more positive patient outcomes.

“I have no doubt that by partnering with nephrologists, hospitals and payors, we’ll be able to slow the progression of CKD and we’ll be able to get more patients on home, more optimal starts, and dramatically reduce hospitalizations,” Palecek said. “It couldn’t be a more exciting time to be putting these tools and capabilities together with [you] to help patient care.”