Alex Azar on VBC, Carilion-UVa, TransMedics Allegations, JPM Takeaways, Ozempic, Vafseo, & More...

Welcome back, we’ve missed you. This is our first update of 2025, and it’s a fun one. A new year means new funding, new research, new jobs, and even a new look for us here at Signals HQ. There are two changes you can expect from our recaps going forward: they’ll be more consistent (Sundays, not anydays), and they’ll be more to the point (five or ten minutes, not fifty).

To support these changes, we’re tidying up our format. We’ll focus on the 2-3 stories you should know about and why they matter, followed by curated lists of headlines, research, community updates and open roles across the Kidneyverse.

As always, we’d love to hear from you. Leave a comment or join us in Signals Slack to let us know what you think of the new format, cadence, and branding.

Let’s light this candle, shall we?

Please note: This is a preview of my full post on the Signals website. Access the full post (for free) and join conversations on kidney-focused topics with your peers here.

In this issue

• Alex Azar and “pulling the band-aid” on VBC
• Carilion makes its case for kidney transplant
• Fraud allegations against TransMedics
• How CMS builds evidence-based care models
• Why dietitians should take charge of renal nutrition
• A petition for patients to know about organ offers
• SGLT2 prescription patterns by specialty (2015-20)
• Studying the gut-kidney-PKD axis in Cameroon
• Open roles around the Kidneyverse
• & more…

Updates

ICYMI: We just re-launched our data room with new resources and formats (PDF, PNG, XLSX), and made it a bit easier to navigate. Going forward, you’ll be able to find all our visuals, one-pagers, and databases there. We also added the direct link in our navigation bar on the Signals homepage so it’s easy to find when you need it.

We’re also opening up the Slack #general channel so you can join the conversation and see the magic firsthand. I’m loving the back and forth questions, discussions, and candor you just can’t get on social media. People helping people. Paid subscribers get full access to all channels like #transplant, #dialysis, #VBC, #policy, #jobs, #questions and more.

“Time to Rip the Band-Aid Off”: Alex Azar on Value-Based Care's Future

Summary: At the 2024 Fierce Health Payer Summit, former HHS Secretary Alex Azar urged the healthcare industry to fully commit to value-based care, citing progress in kidney care models as a foundation for broader reform. He highlighted data showing improved patient outcomes and cost savings from government and commercial kidney value-based programs, including increases in home dialysis, depression screening, and transplant waitlisting. Azar argued that kidney care's holistic approach makes it an ideal testing ground for pay-for-performance models and called for large-scale adoption across the healthcare system. Despite progress, Azar noted persistent challenges, including aligning incentives, improving clinician buy-in, and addressing gaps in data sharing and interoperability. He stressed the need for reliable government support and better data tools, such as predictive analytics for identifying high-risk patients. Looking ahead to 2025, Azar remains optimistic, emphasizing that the time has come for the healthcare system to stop experimenting and fully embrace value-based payment models to achieve transformative change.

Thoughts: Three calls to action here: align incentives, improve clinician buy-in, and enhance data sharing. The first two make sense to me: they take time and move at the speed of trust. The third I still struggle with as far as whether access to “good” data is a limitation of policy or technology. The latter seems unlikely. Either way, I think a bit more accountability and transparency in VBC performance (and stable goalposts) would be a great thing. And it’s “good” timing for a spark, given the recent blog from CMMI and kidney-friendly leadership changes headed to Washington this week. When I think about alternative payment models, particularly a second-gen model like Kidney Care Choices (KCC), I think about reach. My last (unofficial) count is in the ballpark of 1 million lives served across 11 providers, but I’ll be sharing that full breakdown here soon enough.

What do you think it will take to get to a full embrace of VBC? What would that even look like? For patients? For providers? For policy makers?

...To continue reading about Carilion's case for opening Roanoke Kidney Transplant Center and fraud allegations against TransMedics, visit and subscribe to the Signals newsletter website here (it's free to get started).

News

• Novo’s Ozempic, Wegovy Targeted in Second Round of IRA Drug Price Negotiations [BioSpace]
• At JPM, biotech industry expresses excitement — and some anxiety — about therapies from China [STAT]
• With a major patent cliff coming, will JPM play host to some serious deal-making? [STAT]
• Maze Therapeutics looks for IPO lodestar to guide kidney disease assets through clinical trials [FierceBiotech][S-1]
• Metsera files IPO just 9 months after emerging [FierceBio][S-1]; also announces positive results in newest Phase IIa GLP-1RA [Clinical Trials Arena]
• Trump administration will likely kill the FTC’s controversial noncompete rule [Healio]
• Patient care technicians are key in dialysis but are often not fairly recognized [Healio] (H/t Paul Gordon)

Research

• Lived Experiences of Patients Hospitalized With Acute Decompensated Heart Failure and Kidney Dysfunction [JAMA]
• The survival of B cells is compromised in kidney disease [Nature]
• Vafseo trial update: more than 750 patients have now been enrolled in the VOICE study [U.S. Renal]
• Immunogenomic determinants of exceptional response to immune checkpoint inhibition in renal cell carcinoma [Nature Cancer]
• Gut microbiota and kidney function in autosomal dominant polycystic kidney disease participants in Cameroon: a cross-sectional study [BMC Nephrology]
• Belzutifan plus cabozantinib as first-line treatment for patients with advanced clear-cell renal cell carcinoma (LITESPARK-003): an open-label, single-arm, phase 2 study [Lancet]

Community

• Policy: Successor Models, Scaling Pathways, and the CMS Innovation Center [CMS Blog] (H/t Miriam Godwin)
• Petition: Patients Deserve To Know (about organ offers)! [NKF]
• Industry: #FutureFresenius Presentation at JPM [Fresenius]
• Industry: The 34 Lives team presented The First Dedicated Normothermic Rescue Center for Unused Renal Grafts [LinkedIn]
• Perspective: Dietitians should take the lead in weight management for patients with kidney disease [Healio]
• Public: New undergraduate organization provides free kidney disease screenings [Virginia Tech]

Jobs

• Transplant - Hepatology at Piedmont Transplant Institute
• Director, Product Strategy Lead - Renal at Novartis
• Director of Product and Strategy at Monogram Health
• VP, Business Development at Breakthrough T1D
• Account Executive, Healthcare at Stepful
• Senior Program Manager at Diality
• Find your next role or key hire with Signals

Made Possible By

Signals is made possible with the generous support of our sponsors. We are grateful to partner with organizations committed to advancing kidney care and innovation. This post was made possible by Roivios and 3ive Labs. Thanks team!

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