CMS launches Comprehensive ESRD Care, accountable care model for kidney care

The Centers for Medicare and Medicaid Services on Tuesday launched a new accountable care model for kidney care companies, linking dialysis facilities, nephrologists, and other providers in more than a dozen ACOs that will share in the risk associated with treating Americans with end-stage renal disease.

According to CMS, the program was modeled after the Pioneer and Medicare Shared Savings accountable care models, where participating providers will either receive a portion of any savings they achieve or may have to pay penalties if costs spiral above benchmarks.

Patients on dialysis already pose a cost problem for the government. CMS said more than 1 percent of the total Medicare population is undergoing dialysis but the segment accounts for nearly 6 percent of Medicare spending.

[Also: See how Pioneer ACOs performed in 2014 (Data)]

The new model, dubbed the Comprehensive ESRD Care program, creates "seamless care organizations" comprised of dialysis providers and other participants. These ESCOs will be held accountable for spending and will track health outcomes to measure the quality of care, much as Medicare ACOs do.

"This new ACO model represents a paradigm shift in care for beneficiaries with end-stage renal disease; it promotes a patient-centered approach to their dialysis and non-dialysis care needs that will help accomplish our delivery system reform goals of better care, smarter spending, and healthier people," said Acting CMS Deputy Administrator Patrick Conway in the announcement.

[Also: See which shared savings ACOs earned payments in 2014 (Data)]

The program will split large dialysis providers and small ones, with the larger participants of more than 200 facilities sharing risk in the form of potential payments or possible penalties.

Meanwhile, the smaller ESCOs will be eligible for payments but won't initially be on the hook for shared losses.

Here is the list of organizations and the companies that are anchoring them:

Large ESCOs

• DCI -- Liberty Kidney Care Alliance, LLC; Newark, New Jersey
• DCI -- Palmetto Kidney Care Alliance LLC; Spartanburg, South Carolina
• DCI -- Music City Kidney Care Alliance, LLC; Nashville, Tennessee
• DaVita -- Phoenix-Tucson Integrated Kidney Care; Phoenix
• DaVita -- South Florida Integrated Kidney Care; Miami
• DaVita -- Philadelphia- Camden Integrated Kidney Care; Philadelphia
• Fresenius -- Fresenius Seamless Care of San Diego, LLC; San Diego
• Fresenius -- Fresenius Seamless Care of Chicago, LLC; Chicago
• Fresenius -- Fresenius Seamless Care of Charlotte, LLC; Charlotte, North Carolina
• Fresenius -- Fresenius Seamless Care of Philadelphia, LLC; Philadelphia
• Fresenius -- Fresenius Seamless Care of Columbia, LLC; Columbia, South Carolina
• Fresenius -- Fresenius Seamless Care of Dallas, LLC; Dallas

Small ESCO

• Rogosin Institute -- Rogosin Kidney Care Alliance; New York
   

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