CMS has proposed five new experimental ESRD and CKD payment models:
- Four models will be voluntary:
- The KCF (Kidney Care First) Model would capitate and incentivize payments to nephrology practices for care of CKD and ESRD patients.
- Three different CKCC (Comprehensive Kidney Care Contracting) Models would allow the creation of Kidney Contracting Entities (KCEs), which would take full responsibility for the cost and quality of care for ESRD patients in return for capitated payments, with a share of any cost savings rebated. KCEs would consist of nephrology practices, transplant providers, dialysis providers, and other healthcare providers.
- These programs would run for four to six years, beginning January 1, 2020. Find more information on the KCF and CKCC Models at https://www.cms.gov/newsroom/fact-sheets/kidney-care-first-kcf-and-comprehensive-kidney-care-contracting-ckcc-models.
- The fifth model, the ETC (ESRD Treatment Choices) Model, would be mandatory in randomly selected geographic areas that would cover fifty percent of the US, and run for six and a half years beginning January 1, 2020. It would incentivize transplants and home dialysis, and interact with the current ESRD PPS and QIP in yet-to-be-determined ways. Find more information on the ETC Model at https://www.cms.gov/newsroom/fact-sheets/proposed-end-stage-renal-disease-treatment-choices-etc-mandatory-model and https://innovation.cms.gov/initiatives/esrd-treatment-choices-model/. The ETC Model is part of a draft Proposed Rule that can be found at https://www.hhs.gov/sites/default/files/CMS-5527-P.pdf.