CMS Seeks Second Cohort for Kidney Care Choices Model
The Centers for Medicare & Medicaid Services (CMS) is seeking applications for a second cohort of its Kidney Care Choices (KCC) alternative payment model. The new cohort will begin participation on Jan. 1, 2023.
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 Comprehensive End Stage Renal Disease Care 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.
In January 2022, CMS listed the 30 CMS Kidney Care First (KCF) Practices and 55 Kidney Contracting Entities (KCEs) participating in the first cohort. They are serving beneficiaries in 38 states as well as in the District of Columbia.
The KCC Model Performance Period began on Jan. 1, 2022, and will continue through Dec. 31, 2026. CMS solicited applications for the first cohort of KCC Model participants in October 2019. Healthcare providers interested in participating applied by January 22, 2020. Applicants selected for participation began an Implementation Period in late 2020, to focus on building necessary care relationships and infrastructure. The Implementation Period extended through 2021 to enable model participants to prepare to take on financial and population health accountability starting in January 2022.
CMS invites interested applicants to submit their applications to CMS by March 25, 2022. If selected to participate in the Model, the second cohort of KCC Model participants would begin participation on Jan. 1, 2023, after executing performance period participation agreements that will set forth the terms of the KCF Option or the CKCC Options of the KCC Model, as applicable. The performance period participation agreements for these KCC Model participants will have a term of four Performance Years (2023, 2024, 2025, and 2026). CMS said it does not plan to conduct any further solicitations for KCC Model participants.
