CMS Innovation Center releases applications for Advancing American Kidney Health voluntary payment models
The Center for Medicare and Medicaid Innovation has released a request for application for the Kidney Care Choices model, a proposal that offers new payment incentives for nephrologists who care for patients with nondialysis-dependent chronic kidney disease in stage 4 and stage 5 and those on dialysis with ESKD.
The KCC model contains four options:
- Kidney Care First (KCF);
- Comprehensive Kidney Care Contracting (CKCC) graduated model;
- CKCC professional model; and
- CKCC global model.
The KCC model will test “whether a model of care in which a single set of health care providers with aligned incentives are responsible for a patient’s care from the later stages of CKD to and through dialysis, transplantation or end of life care will improve overall quality of care and reduce the cost of care for beneficiaries with kidney disease,” CMS wrote in the request for application document.
Physician practices that are part of the KCF model will receive a CKD quarterly capitation payment for providing care to patients in stage 4 through stage 5 CKD, an adjusted monthly capitation payment and a kidney transplant bonus. These groups must maintain a population of at least 500 patients with CKD and 200 patients with ESRD.
The KCF option will be a merit-based incentive payment system alternative payment model and an advanced alternative payment model beginning in 2021.
Groups that participate in the CKCC models must include nephrologists or physician practices and transplant providers — a transplant center, transplant surgeon, transplant nephrologist and/or organ procurement organization — and can include other providers and suppliers, including dialysis providers, that help to coordinate the care for beneficiaries with advanced CKD and ESRD.
“[These groups] will focus on improving the quality of care, reducing total cost of care, delaying the progression of kidney disease and increasing the transplant rate,” CMS wrote in the request for application.
In all three CKCC options — graduated, professional and global — the health care providers will receive adjusted capitated payments for managing care for beneficiaries with CKD stages 4 and 5, and ESRD. The participating group will select a payment option and will be accountable for quality outcomes.
The 84-page RFA has been posted at https://innovation.cms.gov/files/x/kcc-rfa.pdf. More details about the Kidney Care Choices model are available at https://innovation.cms.gov/initiatives/kidney-care-choices-kcc-model/
The deadline to apply is through Jan. 22, 2020, CMS said.