NNH Interactive is funded by the practice that publishes it and by value-based care revenue from a CMS payment model. No other funding source currently supports the work.
This page describes the current funding sources in detail, the additional categories of support currently being explored, and the editorial guardrails that govern all of it. The principle is straightforward: funding sources do not control editorial content.
No funding source has editorial review of any module before publication. No funding source can require coverage of a topic, prevent coverage of a topic, or approve language within a topic. No module carries funder branding, funder messages, or funder-supplied content within its body. Funding relationships are disclosed publicly on this page; no funding relationships are private.
These rules apply to every current funding source and to every category of support being explored. They are not negotiable on a funder-by-funder basis.
NNH Interactive is currently funded by two sources, both originating within the kidney care system rather than from external commercial interests. The combined funding is sufficient to develop and publish the current module library and to support ongoing maintenance.
Northern Nephrology & Hypertension pays a license fee to NNH Interactive for the right to embed the modules in the practice's own patient education workflow. This is the founding funding source and the most independent of the streams: it is the practice paying its own publishing arm, with no external party able to exert influence on content decisions.
Northern Nephrology & Hypertension participates in Integrated Kidney Care of Lake Erie, a Kidney Contracting Entity in the CMS Kidney Care Choices model. The practice earns shared-savings and quality-bonus revenue based on the cost and quality of care its attributed CKD and dialysis patients receive. A portion of this revenue is allocated to NNH Interactive.
This is not payment in exchange for content. It is value-based care revenue earned through clinical performance, redirected toward patient education that the practice believes contributes to that performance. The relationship to CMS, to the KCE, and to the KCE's partners (VillageHealth and DaVita Integrated Kidney Care) is a clinical performance relationship, not an editorial one.
Two additional categories of support are currently being explored. The criteria are described here so that any future funding relationship can be evaluated against published guardrails rather than negotiated case by case.
Unrestricted educational grants from manufacturers of CKD-relevant therapeutics, including SGLT2 inhibitors, GLP-1 receptor agonists, nonsteroidal mineralocorticoid receptor antagonists, and other disease-state-relevant categories, fit the model under the following conditions: the grant is unrestricted in fact, not just in label; the funder has no review of module content before publication; no module discusses a funder's specific product by brand name within the module body; the relationship is disclosed publicly on this page; and the funder's support is for disease-state education broadly, not for content about any particular medication.
Manufacturer support for disease-state patient education is a well-established mechanism in medical education. The guardrails above are what make it acceptable in the context of this project.
Foundation grants for the development of specific modules, for example a module on a particular CKD complication or a module designed for a specific patient population, fit the model when the foundation's mission aligns with patient education in nephrology and the grant terms allow editorial independence on clinical content.
Foundation support is the most flexible category and the most natural fit for the publishing model: foundations typically fund content development and accept publication of the resulting work as the deliverable, which matches how the modules are produced and distributed.
The modules are published under a Creative Commons Attribution-NonCommercial-NoDerivatives license (CC BY-NC-ND 4.0). Any nephrology practice, CKD-serving organization, health system, or non-commercial educational program may embed the modules in their own patient-facing environments at no cost.
The license permits free embedding and use. It does not permit modification of module content, repackaging the modules as part of a commercial product, or removing attribution. Practices embedding the modules retain full control over the patient-facing context the modules appear in. The modules are designed to embed cleanly into existing portals, websites, and clinical workflows without imposing branding or design requirements.
Organizations interested in embedding the modules, or in discussing any of the support categories described above, can reach NNH Interactive at churwitz@northernnephrology.com.
Editorial independence is not a posture. It is a set of operational rules that govern how NNH Interactive works day to day.
Module topics are chosen by the clinician-author based on clinical priorities and patient needs, not by funders. Module content is written and reviewed within NNH Interactive, not by funders. Funders receive no advance copies of modules and have no opportunity to suggest changes before publication. Funder relationships are listed on this page and updated as they change.
If a funding relationship would require any of the above to bend, the funding relationship does not happen. The work being independent is the point of the work being valuable.