This bill creates a voluntary Medicare demonstration program to reward health insurance plans that successfully prevent kidney disease from progressing to end-stage renal disease, or ESRD. The program, running for ten years starting January 2027, allows participating insurance plans—including commercial, Medicaid, and Medicare Advantage plans—to share in the Medicare savings they generate by keeping kidney disease patients healthier and out of expensive ESRD treatment. Participating plans must provide free kidney disease screening to all enrollees, cover kidney disease treatments with minimal out-of-pocket costs, and report detailed data on their kidney disease patients' health outcomes. If a plan's kidney disease patients progress to later disease stages at lower rates than a Secretary-established benchmark, the plan can receive up to 25 percent of the estimated Medicare savings it generates. The bill allocates $5 million annually from 2026 through 2038 for program administration and requires the Secretary to report to Congress on program results within three and six years of implementation.