The U.S. Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), has finalized a mandatory six-year model called the Increasing Organ Transplant Access (IOTA) Model .   This model,  finalized by the Biden-Harris administration,  is designed to address critical challenges in the nation’s kidney transplant system and significantly improve access to kidney transplants.  IOTA Model background  CMS has implemented various initiatives to improve care for patients living with kidney disease and address access to kidney transplantation. The IOTA Model builds on these efforts, enhancing organ availability and providing better education for patients, their families and caregivers.   The model aligns with previous CMS initiatives like the ESRD Treatment Choices (ETC) Model, launched in 2021, which emphasizes the use of home dialysis and increased access to kidney transplantation to improve the quality of...

On Nov. 25, the Centers for Medicare and Medicaid Services (CMS) released Performance Year (PY) 2022 evaluation findings for the Kidney Care Choices (KCC) voluntary model. The evaluation of the first performance year revealed mixed outcomes.  Kidney Care Choices model evaluation findings for PY 2022  Participation: 30% of Medicare fee-for-service beneficiaries with chronic kidney disease or end-stage renal disease eligible for the model are aligned with a KCC participating entity.    Encouraging trends: CMS reported , “The KCF model option increased the proportion of patients with ESRD dialyzing at home (20%). Home dialysis training increased in CKCC (32%). Both model options increased peritoneal dialysis, the primary modality for home dialysis (KCF: 26% and CKCC: 8%).”  Stable measures: Most quality measures showed no significant changes.  Financial outcomes: There was no measurable impact on overall Medicare costs, savings or losses.  The road a...

In this edition of DataGen Insights, we look at how alternative payment model participants can ensure their processes and workflows are optimally set up for success. To help, DataGen listed the top three strategies all providers participating in APMs can employ and created a handy checklist to enable maximum returns and reduce financial risk. Please explore our website to learn more about our  products and services .  Download DataGen Insights today .  We hope you enjoy!

Are you up to date with the latest on alternative payment models?  This summer, catch up on all that you might have missed! Check out this list of must-reads from the last few months on APMs like Primary Care First, Kidney Care Choices, and more. Alternative Payment Models (General) Top challenges providers face in alternative payment models [Physician’s Practice] What to expect from CMS’ second decade of APM programs Primary Care First Start the year off right: DataGen answers your Primary Care First questions Three Steps to Successfully Participate in Primary Care First INFOGRAPHIC: 3 Strategies for PCF Success Why you must consider leakage for Primary Care First Kidney Care Choices Crucial rules and deadline guidance for Kidney Care Choices INFOGRAPHIC: 3 Strategies for KCC Success Critical Tools for Kidney Care Choices Success Oncology Care Model Lessons Learned from the Oncology Care Model If you have any questions or would...

The Kidney Care Choices Model is welcoming a new cohort of participants in January 2023. KCC is a voluntary model for nephrology practices, nephrology professionals and kidney contracting entities.  KCC provides financial incentives to help providers improve the quality and reduce the cost of care for patients with late-stage chronic kidney disease and end-stage renal disease. The program’s main goals are to delay the progression of CKD to ESRD, effectively manage the transition onto dialysis, support beneficiaries through the transplant process and keep them healthy post-transplant. In addition to announcing Cohort 2, CMS shared more information on the incentive structure and quality measures current and future participants must understand. Successful participation in the program will drive: reduction in total cost of care; comprehensive and coordinated care delivery; and improved access to care. Participants can achieve these benefits through three strate...