Healio Special Report: Health Care and Politics

Healio Special Report: Health Care and Politics

September 18, 2020
2 min read

CMS finalizes ESRD Treatment Choices model, estimates $23 million in savings

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CMS released the final version of its ESRD Treatment Choices payment model today, aimed at incentivizing dialysis providers to place more patients with end-stage renal disease on home dialysis or refer them for a kidney transplant.

“President Trump is tackling a longstanding problem for people with kidney disease because they deserve better than a system that perpetuates costly care and poor outcomes,” CMS Administrator Seema Verma, said in a press release. “He challenged us to deliver a new model that focuses on prevention and better quality of life for our Medicare beneficiaries, so they can spend less time in dialysis centers and more time living fuller lives.”

Source: Adobe Stock

According to the release, the ESRD Treatment Choices payment model is value-based, which places special focus on the quality of care received by patients. More specifically, the model will test the impact of shifting Medicare payments from traditional fee-for-service payments to those in which providers are financially incentivized for encouraging home dialysis and transplantation.

In a press release, advocacy group Kidney Care Partners said while the reduction in the scope of the demonstration – from 50% of the ESRD population in the proposed rule to 30% in the final rule – was a positive step, there were still concerns about patient choice.

“While we appreciate the decision to reduce the scope of the model from the proposed 50[%] to 30 [%], we remain concerned over fears voiced by patient organizations and providers about patients who do not select home dialysis being disadvantaged by the model ... While the model would expand the kidney disease education benefit, we know that early education before patients enter the dialysis facilities is essential to helping patients understand and adopt home dialysis modalities. Yet, the waivers provided do not include dialysis facilities and their multi-disciplinary care teams, which is something that members of Congress have specifically sought to do in The Chronic Kidney Disease Improvement in Research & Treatment Act.”

Alex Azar

HHS Secretary Alex Azar commented on the administration’s efforts to improve care for patients living with kidney disease, as well as on how the ESRD Treatment Choices model can play a role in the initiative.

“Over the past year, the Trump administration has taken more action to advance American kidney health than we’ve seen in decades,” he said. “This new payment model helps address a broken set of incentives that have prevented far too many Americans from benefiting from enjoying the better lives that could come with more convenient dialysis options or the possibility of a transplant.”

CMS received more than 300 comments on the proposed rule for the ESRD Treatment Choices Model when it was released in July 2019. Initially, the demonstration, which is mandatory, was to start in Jan. 2020.

CMS projects the model could lead to an estimated savings of $23 million for 5.5 years and is now set to be implemented on Jan. 1, 2021.

For more information, view the ESRD Treatment Choices model fact sheet here: https://www.cms.gov/newsroom/fact-sheets/end-stage-renal-disease-treatment-choices-etc-model-fact-sheet