CommercialAdministrativeMedium impact
Chronic kidney disease program aims to avoid the “crash”
Blue Cross Blue Shield of Rhode Island·RI · Nephrology, Family Medicine, Internal Medicine·Provider Update
We identified it
Jun 19, 2026
Summary
BCBSRI has implemented a Chronic Kidney Disease program for commercial and Medicare Advantage members with CKD stages 4-5 and ESRD, partnering with nephrology groups to provide coordinated care management. The program incentivizes nephrology groups for every member who begins outpatient dialysis and includes dedicated care teams to help avoid hospitalization and 'crash' dialysis situations.
Action Required
Billing teams treating BCBSRI commercial and Medicare Advantage members with CKD stages 4-5 or ESRD should coordinate with nephrology groups participating in this care management program. Ensure proper referrals to nephrology specialists for early intervention and document coordination with assigned care teams including nurse care managers and pharmacist support to support program goals.