The Centers for Medicare & Medicaid Services (CMS) Innovation Center announced Monday it is extending three tracks within the Kidney Care Choices (KCC) Model through 2027.
Starting in performance year 2026, the model’s financial methodology and participation options will be modified to “improve model sustainability,” the agency said. However, one KCC Model track will be shuttered a year early at the end of December.
The KCC Model has 93 participants, and implementation first began in January 2022. The most recent participants were announced Jan. 15.
“In the first two years of the model, the KCC Model has improved quality across several important outcomes, including increased Optimal [End-Stage Renal Disease] Starts, rates of homes dialysis, and preemptive and living donor transplants,” the CMS said in an update posted on its website. ”Despite these gains, the model resulted in statistically significant net losses of approximately $304 million to Medicare in performance year (PY) 2023."
The CMS has intended to help patients needing a kidney transplant or suffering from chronic kidney disease or end-stage renal disease. Nephrologists and other kidney practices work together to provide care, including dialysis and end-of-life care.
The model has four tracks. The Kidney Care First option gives nephrology practices capitated payments for managing care and bonus payments from beneficiaries receiving kidney transplants. This option was canceled.
Three options are available under the Comprehensive Kidney Care Contracting umbrella: graduated, professional and global. Capitated payments to kidney contracting entities (KCEs) are similarly offered, but KCEs must include nephrologists, practices or transplant providers. Dialysis facilities and other providers or suppliers are optional participants in KCEs.
“KCEs take responsibility for the total cost and quality of care for their patients, and in exchange, can receive a portion or all of the Medicare savings they achieve,” explains the CMS.
As part of the changes, more U.S. territories will be able to host eligible participants in the model. Participants will also have a 1% discount for chronic kidney disease benchmarks. Currently, global risk track participants have a discount for end-stage renal disease benchmarks. Global participants have a 100% risk for total cost of care in Part A and B services.
In the professional track, there will now be 1% discounts for chronic kidney disease and end-stage renal disease benchmarks. Participants in the professional track can earn 50% of shared savings or be liable for half of shared losses.
Model participants will no longer receive $15,000 per successful transplant over three years, and capitated payments to participants will be reduced.
The CMS Innovation Center has undergone a makeover under the Trump administration, remaking the office into a Make America Healthy Again test tube.
Last week, the CMS released new updates for the ACO REACH program, but the program’s long-term future is still in question.