CMS is launching a new accountable care organization model to improve care coordination for patients with kidney failure and control costs for end-stage renal disease treatments.
The 1.1 percent of Medicare beneficiaries with ESRD accounted for 5.6 percent of Medicare spending in 2012, according to CMS. This is because ESRD requires life-sustaining dialysis treatments several times per week and ESRD patients often suffer from other chronic conditions.
In an effort to provide better care for these complex patients and create more alternative payment opportunities for providers, CMS called for applications to the dialysis ACO last April.
Here are five things to know about the ACO model and the participating organizations.
1. The model, called the Comprehensive ESRD Care Model, is based off CMS' experience with other programs, such as the Pioneer ACO and Medicare Shared Savings Program.
2. Under the CEC Model, nephrologists and other providers team up with dialysis facilities to create ESRD Seamless Care Organizations, which function like ACOs. The model is meant to prompt providers to support patients both in and out of the dialysis facility.
3. ESCOs are at risk for Medicare Part A and B spending, dialysis services and quality outcomes of their assigned beneficiaries.
4. There are two financial arrangements for ESCOs, based on the size of the participating dialysis facility. Large dialysis organizations, or those with 200 or more facilities, are eligible to share in savings and share in losses. Small dialysis organizations, or those with fewer than 200 facilities, are eligible to share in savings, but do not go at risk for losses.
5. The following 13 ESCOs have been selected to participate in the program, 12 large dialysis organizations and one small.
Small dialysis organization ESCO
- Rogosin Kidney Care Alliance (New York City)
Large dialysis organization ESCOs
- Liberty Kidney Care Alliance (Newark, N.J.)
- Palmetto Kidney Care Alliance (Spartanburg, S.C.)
- Music City Kidney Care Alliance (Nashville, Tenn.)
- Phoenix-Tucson Integrated Kidney Care (Phoenix)
- South Florida Integrated Kidney Care (Miami)
- Philadelphia - Camden Integrated Kidney Care (Philadelphia)
- Fresenius Seamless Care of San Diego (San Diego)
- Fresenius Seamless Care of Chicago (Chicago)
- Fresenius Seamless Care of Charlotte (Charlotte, N.C.)
- Fresenius Seamless Care of Philadelphia (Philadelphia)
- Fresenius Seamless Care of Columbia (Columbia, S.C.)
- Fresenius Seamless Care of Dallas (Dallas)
More articles on accountable care:
8 accountable care, shared savings agreements in September
3 keys for Medicare ACO survival
Study: Pioneer ACO program reduces low-value services