Improve Patient Outcomes and Increase Your Earnings

Physicians who participate in Kenji can expect to see a meaningful increase in their earned income for providing care to the same number of Medicare beneficiaries and dual eligibles that they provide care to today. The increase is primarily caused by two factors:

In a risk-bearing program like Kenji’s, physicians benefit from savings versus benchmark for all aspects of Medicare spending, not just Part B spending. According to CMS, today physicians receive only 7% of the total care dollars. As a result, Kenji physicians now have the potential to benefit from savings in the other 93% of care dollars. Based on detailed data analysis of historical claims data, Kenji believes that savings of 30% versus benchmark are attainable while improving the quality of care delivered and the patient experience.

Kenji expects to provide participating physicians with new care-related revenue opportunities and investment opportunities. Some of the ways savings are achieved are by:

• Shifting care to less costly, but clinically appropriate settings.

• Optimizing primary care, preventive care and chronic care to reduce need for acute care.

• Connecting all involved in patient care to enable better collaboration and coordination.

Here’s an example of how savings are generated:

A typical Medicare patient has COPD. A physician participating in Kenji REACH chooses the patient’s home as a clinically appropriate care setting and assigns a distributed care team for the patient because doing so is as effective as, and less costly than, caring for the patient in a hospital that is often followed by a nursing home stay.

The patient wins by receiving effective care in a preferred location (their home) while also saving $1,600 in out-of-pocket hospital deductible.

Kenji REACH–and the physicians who participate in and own it–also win because Part A (hospital costs) savings are realized.

Typically, the potential savings associated with a COPD case are $4,500, or 50%. Similarly, Orthopedic cases moved to ambulatory surgical settings can typically save over $6,000 per case.

In addition, participation in Advanced Alternative Payment Models (APMs) automatically qualifies physicians for the Medicare Quality Payment (QPP) program where physicians can earn up to 9% of your traditional Medicare claims as a bonus based on your MACRA / MIPS score.

Two ways Medicare beneficiaries will be aligned to you:

Based on the percentage of primary care services those beneficiaries receive from you as compared to those received from other providers. In addition, other patients may voluntarily choose a physician as their provider of record.