September 16, 2022 – Ann Arbor, MI – Arbor Research Collaborative for Health will serve a substantial role on the team selected to carry out the independent evaluation of the End-Stage Renal Disease Treatment Choices Model (ETC) and the Kidney Care Choices Model (KCC). Both models are being conducted by the Medicare & Medicaid Innovation Center. The evaluation will assess the effectiveness of each model’s ability to improve quality of care and reduce expenditures for Medicare beneficiaries with End-Stage Renal Disease (ESRD) by providing incentives to use home dialysis and kidney transplantation (the ETC Model) and to improve care for beneficiaries with Chronic Kidney Disease and ESRD (the KCC Model).
Arbor Research will focus on the ETC Model, serving as a subcontractor to the Lewin Group, while providing key subject matter expertise on the KCC Model. Other partners on the six and a half year evaluation project include the University of Michigan Kidney Epidemiology and Cost Center and ICF.
Established by the Centers for Medicare & Medicaid under the 2019 Advancing American Kidney Health Executive Order, the mandatory ETC model encourages greater use of home dialysis and kidney transplantation among Medicare beneficiaries with ESRD and preemptive kidney transplantation among Medicare beneficiaries who have not yet initiated dialysis. The model establishes financial incentives for participating dialysis facilities and managing clinicians to encourage the use of home dialysis and kidney transplantation for the treatment of kidney disease, both of which offer potential advantages related to independence and quality of life. By increasing the use of these treatment options, the ETC Model is intended to reduce Medicare expenditures while preserving or enhancing the quality of care for Medicare beneficiaries. Another important feature of this model is that it is also designed to promote greater equity in the use of home dialysis and kidney transplantation.
“There are valuable opportunities with these models to increase the use of healthcare options for kidney disease that may allow patients to be more independent and have a better quality of life. This evaluation will provide timely information to policymakers on whether this can be accomplished in a way that is equitable and whether there are certain advantages or disadvantages for patients”, says Dr. Marc Turenne, Scientific Director of the Health Policy & Practice Program at Arbor Research Collaborative for Health.
The KCC Model was designed to delay the onset of End-Stage Renal Disease (ESRD), better prepare beneficiaries for dialysis, coordinate care across settings, and incentivize kidney transplantation. The key design features of the KCC Model include voluntary provider participation, a range of payment incentives and levels of risk and creates a structure under which providers (nephrologists, transplant providers, dialysis facilities and others) can voluntarily come together to provide care to Medicare fee-for-service (FFS) kidney disease patients. The KCC is composed of two payment options, Kidney Care First (KCF) and Comprehensive Kidney Care Contracting (CKCC).