Skip Ribbon Commands
Skip to main content
Home Administrative Billing & Reimbursement BlueCard® Health and Wellness Medical PEAR portal Pharmacy Products Quality Management

Kidney care measures for the nephrology pay for value (NeP4V) program

December 2, 2020

​As previously communicated in a Partners in Health UpdateSM article, effective January 1, 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.

Program incentives

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 the kidney care measures outlined below.

Kidney care measures

The kidney care measures are based on services provided during the reporting period (January through December of the measurement year, unless otherwise noted). Accurate encounter and claims submissions are important to document these services.

The kidney care measures for measurement year 2021 are:

  • at-home dialysis therapy for ESRD members
  • emergency room/department and inpatient utilization for CKD 4, CKD 5, and ESRD members
  • optimal ESRD starts
  • transplants per year when member remains dialysis free at 12 months post-transplant

NeP4V program prerequisites

A complete list of the program prerequisites is outlined in the NeP4V program manual.

One requirement is that nephrology practices must be enabled to use PEAR Analytics & Reporting (formerly IndexProTM), our practice reporting tool accessed through the Provider Engagement, Analytics & Reporting (PEAR) portal, to view all NeP4V program-related reports in addition to other valuable value-based data. Learn more on how to enroll for access to the PEAR portal here.    

Learn more

Review the NeP4V program manual, available on our value-based program page, to learn more about the program. If you have questions, please email us at NeP4V@ibx.com.

 

This content was prepared for the Provider News Center and may not be reproduced in any way without the express written permission of Independence Blue Cross. Independence Blue Cross is an independent licensee of the Blue Cross and Blue Shield Association.
Connect with us     Facebook     Twitter     Flickr     YouTube     Walk the Talk    Independence Pinterest    Independence LinkedIn    Independence Instagram Site Map        Anti-Fraud        Privacy Policy        Legal        Disclaimer
© 2023 Independence Blue Cross.
Independence Blue Cross is an independent licensee of the Blue Cross and Blue Shield Association, serving the health insurance needs of Philadelphia and southeastern Pennsylvania.