Podcast - Voices from RPA Shaping the Future of Nephrology

This special episode of Kidney Health Connections includes exclusive highlights from the 2025 Renal Physicians Association (RPA) Annual Meeting, where nephrology professionals gathered to discuss innovation, collaboration, and the future of kidney care. From value-based kidney care models to the role of AI technology in combating clinician burnout to the importance of culture in building successful nephrology practices, this episode is packed with actionable insights and forward-thinking perspectives from the leaders on the frontlines of kidney care.

Transcript

Welcome to Kidney Health Connections, a podcast exploring the future of kidney health and the rapid shift of value-based care where you can learn about the latest innovations that are helping patients live healthier, more fulfilling lives. Here's your host, Dr. George Hart.

Dr. George Hart: Hello! We recently got back from the Renal Physicians Association Annual Meeting, commonly known as the RPA, which was held in Las Vegas this year.

The RPA is the premier event focused on the practice of kidney care. With so many leaders in nephrology under one roof, we thought: What better place to record an episode of Kidney Health Connections?

We asked esteemed experts from across the country to share their perspectives on what’s working, what’s changing, and what’s on the horizon in the field of nephrology.

Now, let’s jump right into it. We’ll start with Dr. Shika Pappoe, CEO and founder of Mitokohn Advisors, as she shares her takeaways from this year’s event.

Dr. Shika Pappoe: Hello, my name is Shika Pappoe and I am the CEO and co-founder of Mitokohn Advisors. We are a social impact design and innovation firm, and we work with organizations throughout the healthcare system to help them build sustainable, equitable, and scalable care delivery models. And I am also a nephrologist, and it has been incredible to be here at RPA.

I will say my three highlights. Number one is being able to connect with colleagues in the kidney space and make new friends and just to share the excitement around all the great work that we're doing here together to advance the cause of our patients.

The second highlight has been just a conversation around value-based care. There has been a lot of energy in that space, but I also see a lot of controversy as to whether or not it has been impactful—so a lot of the discussions, a lot of data presented to help clarify where we are. I will say that I remain very optimistic and it's going to be great to see how that that framework evolves in time.

And then my third highlight has been learning about the various technologies that are out there to support clinicians, nephrologists, and other providers. And particularly around the AI scribes, because we know that there is tremendous burnout among providers, and so it’s exciting to see some of these solutions that will allow clinicians just to have more time on their hands to spend with patients and solutions that will create more efficiencies for practices.

Dr. George Hart: Dr. Pappoe’s optimism about the future of value-based care and her excitement over new technologies resonates deeply with what we heard from many attendees at this year’s event.

To dive deeper into the future of value-based models, we’ve asked Rob Blaser, RPA director of public policy, to share his perspective on the future of CMS’s value-based Kidney Care Choices Model.

Rob Blaser: Hi, I'm Rob Blaser. I'm RPA's director of public policy reporting from the RPA Annual Meeting.

I was asked to make some observations about what's going on with the kidney care models that are out there right now. This is in the wake of the conclusion of the mandatory payment model, the ETC Model, but there's questions about the voluntary models, and would they possibly be concluded, and I don't think that's the case.

I think there's a lot of support for the voluntary models. They've been successful. I think the current CMMI leadership is very knowledgeable about the models, and I think it’s recognized that they've worked—largely worked, not perfect, but largely worked. And I think there's a commitment to make sure that they continue.

So, you know, much more to be seen, we're in an unpredictable environment, but I think we're so far, so good and I would think we're going to be okay.

Dr. George Hart: Of course, as nephrologists look to adopt value-based models, they face unique challenges. Next, we’ll hear from Dr. Vidooshi Maru of Nephrology Associates of Michigan on the collaborative approach she has employed to improve her practice’s performance on a key quality measure: optimal starts.

Dr. Vidooshi Maru: This is Vidooshi Maru. I am lead nephrologist for Nephrology Associates of Michigan. We practice in the metropolitan Ann Arbor, Detroit area.

We have been participating in value-based care for quite some time, most recently with the Kidney Care Entity. We've done really well with it. And what I'd like to share that's different and unique, sort of, from our experience with the ESCO, is that the focus on optimal starts has been difficult, and it's required me to really engage hospital administration for help in engaging our surgeons so that they understand the importance of optimal starts in the same way that we do. And it allows us to facilitate earlier AV fistula and graft placements, preemptive, and buried PD catheter placements, and that's really done wonders for our optimal start numbers.

Dr. George Hart: Dr. Maru raised an important point about the need for strong collaboration in nephrology care.

We also heard from nephrologists on the role renal care coordinators play in improving patient care and outcomes. Here’s Dr. Dyer Diskin, a nephrologist at Hypertension & Nephrology Dialysis and Transplantation Clinic in Alabama.

Dr. Dyer Diskin: The addition of a renal care coordinator to our practice has been phenomenal because of how she's able to keep a close eye on the patients, serve as a direct point of contact for a lot of our patients, when they're calling the office they can get a direct line to her, she helps them coordinate their clinic visits.

And our renal care coordinator is a dialysis nurse with 30 years of experience who ran our home program pretty much on her own. So she is incredibly well qualified to explain to them what to expect.

Dr. George Hart: Now, before we wrap up this episode, we need to acknowledge the critical role practice administrators play in keeping our nephrology practices running so that they can better serve patients.

During the RPA practice administrators’ lunch session, we heard from David Fisher, CEO of Eastern Nephrology Associates, on the role of the practice administrator as it relates to success in value-based care.

David Fisher: In reality, what I think it really kind of boils down to, is that we are—as the administrator and the team that helps support the administration of the practice—we really need to be like the assistant coach, the cheerleader, and really one of the biggest advocates for value-based care in the practice. And I think one of the things that we need to be able to do is really break down a lot of the complexities of the operations and the aspect of care that comes with getting into a value-based care organization. Right? We need to kind of hit that easy button, if you guys remember that Staples commercial.

And I think being able to manage the message, and again breaking it down to kind of simple terms, so that everybody understands what's going on. It just can't be me, it just can't be Dr. Taylor, or the physicians that really understand, or the great support staff that I'm really fortunate enough to have in my practice, but the front desk staff need to know why we're doing this. The people that room patients, the MAs, have to understand why. You just can't put an edict out there and say, “From now on, this is how you're going to do it.” Because people don't like change, and they're going to give a lot of push back.

So, being able to break down, make it simple, boil it down to its lowest level. But have a bigger picture of this is why we're doing it, how to tie into your mission, vision, and values within the practice is really important because that also just needs to be top of mind. Because at the end of the day, the ultimate goal of all of this is to make sure that we're taking the best care possible of patients.

And it's our role—even though we don't necessarily interact with patients—our job, as I said earlier, to hit that easy button, make it easy for the doc, make it easier for the APPs, and everybody else that has that interaction with patients. If we can't make it easy, you're not going to be successful.

Culture is very, very hard. You have to make sure that not only are you communicating in an appropriate way, but you also have to have people that are going to be on your team that want to be on your team. You have to be very, very selective in the core people that you bring into an organization. I think that’s really, really critical.

A mentor of mine a number of years ago told me, she said, “Dave, quick to fire, slow to hire.” And that really resonates with me. If you don't have the right people that are willing to get behind your message and what ultimately it is that you're trying to do, you're just not going to be successful. Bringing in the right people, being able to drive that ultimate goal, I think really helps makes accepting the culture of getting into value-based care a lot easier.

Dr. George Hart: Thank you for joining us for today for our special episode from the RPA. We hope you heard an idea or two that you’ll take with you into your own organization or practice.

Catch further insights from the RPA on our blog at interwellhealth.com. And don’t forget to subscribe to Kidney Health Connections for more expert discussions on the future of nephrology and value-based kidney care.