CMS announces new ACO dialysis model

CMS announced the participants for the Comprehensive ESRD Care Model, a new accountable care organization model for Medicare patients with end-stage renal disease (ESRD).  The model brings together dialysis facilities, nephrologists and other providers to form ESRD Seamless Care Organizations (ESCOs) to coordinate care for ESRD beneficiaries and reduce costs. The ESCOs will be financially accountable for quality outcomes and Medicare Part A and B spending for ESRD beneficiaries, including all spending for dialysis services.

More than 600,000 Americans have end-stage renal disease (ESRD), also known as kidney failure, and require life sustaining dialysis treatments several times per week. These individuals typically have many health problems, are at higher risk of hospital readmissions, and suffer from fragmented care. In 2012, ESRD beneficiaries comprised 1.1% of the Medicare population and accounted for an estimated 5.6% of total Medicare spending.  

ACOs are groups of physicians and other health care providers who collectively take on responsibility for the quality and cost of care for a population of patients. The CEC Model is designed specifically for beneficiaries with ESRD and builds on experiences from other models and programs with ACOs, including the Pioneer ACO Model and the Medicare Shared Savings Program.  This model will encourage dialysis providers to think beyond their traditional roles in care delivery and support beneficiaries as they provide patient-centered care that will address beneficiaries’ health needs in and out of the dialysis facility.