Benesch Keynote Address 2025: What in the world is going on here?
Presented by:
KEITH BELLOVICH, DO
Immediate Past President, Renal Physicians
Association
Chief Medical Officer, Henry Ford St. John Hospital
Presentation Overview
Dr. Keith Bellovich delivered a fast-paced and highly relevant overview of the federal policy and legislative environment impacting kidney care. The session covered economic realities, legislative gridlock, CMMI model changes, and the importance of physician advocacy-all within the context of the current political climate.
Key Takeaways
- Federal Budget and Deficit Pressure is Shaping
Healthcare Policy
With $36 trillion in national debt and growing entitlement costs, Congress is aggressively seeking cost containment. Healthcare— especially Medicare and Medicaid—remains a prime focus for spending cuts. - Kidney-Focused Legislative Priorities Are Being
Sidelined
Provisions supporting the APM bonus, transplant incentives, and comprehensive CKD policy packages have been deprioritized in current negotiations. The focus remains on deficit reduction and partisan fiscal strategy. - Medicare Payment Cuts and Model Rollbacks are
Accelerating
CMS is trimming capitation payments and ending transplant bonuses under CKCC and other CMMI models like KCF and ETC are being sunset. These changes could impact financial sustainability for nephrology practices engaged in VBC. - Administrative, Judicial, and Regulatory Forces Are in
Flux
Beyond Congress, CMMI is pivoting its leadership and model portfolio; the judiciary may soon play a larger role in healthcare litigation, especially regarding federal workforce, access, and payer regulations. - Physician Advocacy and Engagement Are More Important
Than Ever
With kidney priorities getting lost in the legislative shuffle, nephrologists must step up. Participation in advocacy days (like October 10 in Washington, D.C.) and strong response to valuation surveys are critical to protecting fair reimbursement and advancing patient care priorities.
Benesch continues to monitor these fast-moving developments and supports clients in navigating both the legal and strategic implications of federal kidney health policy.
Healthcare Private Equity Investment: Happy Days or Headwinds
Presenters:
SCOTT KREMEIER, Managing Director, Piper Sandler
DOUG SIMPSON, President, Panoramic Health
PRABIR ROY-CHAUDHURY MD, PhD, FASN
Drs. Ronald and Katherine Falk Eminent Professor and Co-Director,
UNC Kidney Center
President, American Society of Nephrology ROBERT
PROVENZANO, MD, CEO, Innocura
Moderator:
JASON GREIS, Partner, Benesch Healthcare+
Panel Overview
This dynamic discussion gathered clinical, financial, and policy leaders to explore the evolving role of private equity (PE) in nephrology and dialysis. The panel highlighted the strategic, operational, and cultural implications of PE partnerships and offered practical guidance to practices considering PE engagement.
Key Takeaways
- PE Can Offer Capital, Scale, and Strategic
Support—When Aligned Properly
PE partnerships can bring infrastructure, analytics, and shared services that many small- to mid-sized nephrology practices can't afford alone. However, alignment on vision, incentives, and autonomy is essential to long-term success. - Data is the Currency of Modern Medicine—and PE is
Investing Heavily
PE-backed platforms are pouring capital into data analytics, dashboards, predictive modeling, and benchmarking tools. These capabilities allow practices to track clinical outcomes, improve operations, and better engage in value-based care (VBC). - VBC in Nephrology Faces Unique Behavioral and
Operational Challenges
Patient behavior, disease complexity, and adherence issues make VBC harder to succeed in nephrology than in primary care. Panelists emphasized realistic expectations, strong patient education, and careful cost modeling for sustainable outcomes. - Physician Satisfaction Hinges on Operational Relief,
Not Loss of Control
Contrary to common fears, PE firms generally aim to relieve physicians of back-office burdens (scheduling, HR, IT) so they can focus on care. Transparency, trust, and setting clear expectations around clinical autonomy are key. - Every Deal Is Unique-Success Depends on Fit and
Follow-Through
Not all PE outcomes are positive. Practices should carefully assess PE groups' healthcare experience, track record, exit timelines, and alignment with long-term goals. Open and early conversations among physician partners are critical before any engagement.
Benesch remains a trusted advisor in guiding healthcare practices through complex investment, partnership, and growth decisions in a rapidly consolidating kidney care landscape.
Research Opportunities in Nephrology and Dialysis
Presenters:
BERNARD V. FISCHBACH, MD, CCRP, Dallas Nephrology
Associates
JAN WALTER, President, Frenova
NANCY CIPPARRONE, Director of Research,
Nephrology Associates of Northern Illinois and
Indiana
Moderator:
LAURI COOPER, Counsel, Benesch Healthcare+
Panel Overview
This expert panel explored the current renaissance in nephrology clinical research and provided a practical roadmap for nephrology practices seeking to launch or expand clinical trial programs. With perspectives from a a physician lead research practice leader, global dialysis facility research strategist and a large nephrology research executive, the conversation highlighted the operational, clinical, and financial foundations of a successful clinical research strategy.
Key Takeaways
- It's a New Era for Kidney Innovation and the Time
to Engage is Now
Breakthrough therapies and real-world evidence initiatives are reshaping kidney care. Research participation offers early access to cutting-edge treatments and enables practices to contribute directly to improved patient outcomes and care standards. - Clinical Research Can and Should Be Embedded in Private
Practice
Community nephrology groups like NANI and Dallas Nephrology are leading the way by operationalizing research within day-to-day workflows. Success requires robust internal coordination and dedicated roles for both clinical and operational leads. - Building Infrastructure is Key: Teams, Systems, and
Budgets Matter
Establishing a thriving program demands up-front investment, especially in study coordinators, data tools, and leadership engagement. Developing realistic compensation models and allocating protected time are vital to long-term sustainability. - Partnership Models Offer Flexibility and
Scalability
Organizations like Frenova provide flexible pathways from advisory support to joint venture site models. These collaborations can support start-ups or help scale mature research programs with operational resources, contracting support, and data services. - Recruitment, Startup Speed, and Reputation Drive
Growth
Sponsors prioritize sites that move quickly through startup and reliably enroll patients. Strong recruitment planning, EHR integration, and transparent forecasting on patient fit (especially in rare disease trials) are critical to securing repeat study opportunities.
Benesch proudly supports innovation and research integration in community kidney care and remains a trusted partner in navigating the operational, legal, and contractual complexities of clinical trial engagement.
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