Why 360° care matters
People with kidney disease can feel overwhelmed by the complexity of their treatment plan, medication list, lifestyle restrictions, and more. That's where Interwell 360 comes in, with wraparound care that includes personalized, continuous support that makes them more engaged and better prepared for their next steps. It also means their providers can focus more resources on delivering high-quality care.
Delivered by a dedicated, interdisciplinary care team
Patients are connected with an interdisciplinary care team that includes nurses, social workers, advanced practice providers, dietitians, and care coordination specialists. Working with nephrologists and primary care providers, the team creates individualized care plans then engages patients in-person, by phone, at home, online, at the dialysis center, and in the nephrologist’s office.
Support
- Comorbidity management for patients with health risks, including diabetes, hypertension, and heart failure
- Coordinated care services from finding a nephrologist to appointment scheduling and transportation
- Connections with community resources, counseling, and outpatient behavioral health referrals
Education
- Kidney health and treatment education to empower patient decision making
- Guidance for diet and lifestyle choices that can help manage or improve kidney health
- Medication and prescription management to avoid adverse interactions
Timely interventions
- Using proprietary algorithms and predictive models to take a proactive approach to care
- Preventing hospital readmissions and slowing the progression of kidney disease
- Preparing patients for an optimal start when dialysis is required
Opinions that matter
A specialized program for CKCC members
As the largest participant in the Comprehensive Kidney Care Contracting (CKCC) model, Interwell Health offers a specialized program for CKCC-specific patients. Developed by the Centers for Medicare & Medicaid Services (CMS), this model aims to improve patient outcomes and reduce costs by aligning financial incentives for chronic kidney disease (CKD) and end-stage kidney disease (ESKD) care management.