BeWell360-CKD Model Targets Whole-Person Kidney Care Transformation

Key Clinical Summary

• Chronic kidney disease (CKD) affects over 37 million Americans and is associated with high costs and fragmented, biomedical-focused care delivery.
• The BeWell360-CKD model integrates Minimally Disruptive Medicine (MDM), Lifestyle Medicine (LM), and Integrative Medicine and Health (IMH) to reduce treatment burden and improve patient engagement.
• Incorporating digital health, multidisciplinary teams, and patient-centered metrics may support scalable, value-based kidney care across health systems.

CKD continues to drive substantial morbidity, mortality, and health care spending in the United States, yet care delivery remains fragmented and heavily focused on biomedical targets. A newly proposed BeWell360-CKD model aims to address these gaps by integrating whole-person care principles into nephrology practice, with a focus on reducing treatment burden and improving patient-centered outcomes.

Study Findings 

The BeWell360-CKD model combines 3 complementary frameworks: MDM, Lifestyle LM, and IMH. The model was developed through a multidisciplinary collaboration involving clinicians, behavioral scientists, implementation experts, and patient advisory groups.

Current CKD care often emphasizes surrogate clinical measures such as blood pressure and dialysis access, while underaddressing psychosocial, behavioral, and contextual factors that influence adherence and outcomes. These gaps contribute to disease progression, hospitalizations, and disparities, particularly among socioeconomically disadvantaged populations.

The proposed model addresses these shortcomings by aligning treatment intensity with patient capacity through MDM, promoting behavior-based risk reduction through LM, and incorporating IMH modalities such as mindfulness, yoga, and symptom-focused therapies to improve quality of life.

A central feature of the model is the focus on activation, self-efficacy, and resilience (A-S-R), which are linked to improved clinical and patient-reported outcomes. Interventions such as health coaching, peer support, and care navigation are highlighted as underutilized but critical components of effective CKD management.

Implementation strategies include development of multidisciplinary care teams, integration of electronic health record–based tools for risk stratification, and use of telehealth and digital platforms to extend care delivery. Artificial intelligence may further support identification of high-risk patients and personalization of care pathways.

Clinical Implications

For managed care stakeholders, the BeWell360-CKD model represents a shift toward value-based, patient-centered nephrology care. Traditional reimbursement structures often prioritize pharmacologic and procedural interventions, while underrecognizing lifestyle, behavioral, and supportive services that influence long-term outcomes.

By integrating nonpharmacologic interventions and caregiver support into care pathways, the model may reduce treatment burden, improve adherence, and enhance quality of life. Early-stage CKD intervention is emphasized as a key opportunity to delay progression and reduce downstream costs associated with end-stage kidney disease.

The model also highlights the importance of addressing social determinants of health and incorporating patient-reported outcomes into quality measurement frameworks. Adoption may require investment in care redesign, workforce training, and digital infrastructure, as well as alignment of payment models to support these services.

Conclusion

The BeWell360-CKD model offers a comprehensive, scalable framework for modernizing kidney care by integrating whole-person approaches with data-driven strategies. Future research will be needed to evaluate clinical and economic outcomes, but the model provides a pathway toward more sustainable, equitable, and patient-centered CKD management.

Reference

Dabrh AMA, Chebib FT,  Hickson LJ. Reframing kidney care: toward whole person, integrative, and minimally disruptive healthcare delivery. BMC Nephrol. 2026;27(34). doi:10.1186/s12882-025-04651-w