Posting a brief statement online, the Centers for Medicare & Medicaid Services (CMS) has said it is delaying the start of the Kidney Care Choices (KCC) Model’s first performance year until Jan. 1, 2022.
KCC is a voluntary alternative payment model, and its core goal is to incentivize nephrologists, dialysis facilities and end stage renal disease (ESRD) healthcare practices to focus on the total care of their patients. According to the CMS, more than 430,000 Medicare fee-for-service ESRD beneficiaries spend an average of 12 hours a week receiving dialysis at a center, so the KCC model is structured to encourage participating practices to delay the onset of dialysis and instead focus on transplants.
The model builds upon the existing Comprehensive End Stage Renal Disease (ESRD) Care (CEC) Model structure, in which dialysis facilities, nephrologists, and other healthcare providers form ESRD-focused accountable care organizations (ACOs) to manage care for beneficiaries with ESRD. The goal is to this by adding strong financial incentives for providers to manage the care for Medicare beneficiaries with chronic kidney disease (CKD) stages 4 and 5 and ESRD, to delay the onset of dialysis and to incentivize kidney transplantation, CMS has outlined.
The five-year KCC model has four payment options: CMS Kidney Care First (KCF) Option, Comprehensive Kidney Care Contracting (CKCC) Graduated Option, CKCC Professional Option, and CKCC Global Option. In the highest-risk option, the provider takes on 100 percent of financial risk for the total cost of care for all Medicare Part A and B services for aligned beneficiaries.
Back in July 2019, then-President Trump signed an executive order called the Advancing American Kidney Health Initiative, which had some lofty goals in terms of improving the care of patients with kidney disease. As a result of that initiative, there were two models proposed by the Center for Medicare and Medicaid Innovation (CMMI), one of them being the Kidney Care Choices program.
The KCC program was scheduled to start Jan. 1 of this year before being delayed to April 1 due to the COVID-19 pandemic. CMS said the “implementation period will extend through 2021 to enable model participants to prepare to take on financial and population health accountability starting in January 2022.” The agency did not provide further updates.
