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Value-based care interventions and management of CKD progression
Melissa Feeney, Joseph Mehltretter, Tammy Cheung
1Strive Health, 1125 17th St #1000, Denver, CO 80202.
The American Journal of Managed Care
|October 27, 2025
Summary
Value-based care (VBC) interventions significantly slowed chronic kidney disease (CKD) progression. Patients experienced reduced estimated glomerular filtration rate (eGFR) decline, preserving kidney function in advanced stages.
Area of Science:
- Nephrology
- Health Services Research
- Value-Based Care
Background:
- Chronic kidney disease (CKD) affects millions globally, necessitating effective interventions to slow progression.
- Estimated glomerular filtration rate (eGFR) is a key biomarker for assessing kidney function and disease progression.
Purpose of the Study:
- To evaluate the effectiveness of value-based care (VBC) interventions in mitigating the progression of CKD.
- To assess the impact of VBC on the rate of eGFR decline in patients with stage 3b and 4 CKD.
Main Methods:
- Retrospective cohort study of 623 patients with stage 3b or 4 CKD from 2017-2023.
- Linear regression and mixed-effects models analyzed eGFR trajectories pre- and post-VBC intervention.
- Compared rates of eGFR decline before and after VBC enrollment.
Main Results:
- VBC interventions led to a significant reduction in the rate of eGFR decline across all CKD stages.
- Median eGFR decline reduced by 77.2% in stage 3b and 65.2% in stage 4 CKD (P < .001).
- Patients in VBC had higher median eGFR post-enrollment compared to expected values without intervention.
Conclusions:
- VBC models demonstrate a statistically significant impact on slowing CKD progression.
- Interventions are particularly effective in advanced stages of CKD (stage 3b and 4).
- VBC shows promise in preserving kidney function and improving patient outcomes.
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