CMS delays start of financial performance year for Kidney Care Choices until 2022

A patient receives hemodialysis
The Centers for Medicare & Medicaid Services has announced a delay of one year to the performance year for the Kidney Care Choices model until 2022. (Getty/Mailson Pignata)

The Biden administration delayed the start date of the first performance year for the Kidney Care Choices model by a year to January 2022.

The model’s financial accountability start date, when participants would have to take on financial risk, was originally set for Jan. 1, 2021. It is the latest unannounced update by the Center for Medicare and Medicaid Innovation to a financial model, after a decision to pause and review the controversial Geographic Direct Contracting model.

The model was first announced in 2019 to incentivize better kidney disease management. The goal is to improve care for a patient through the treatment of chronic kidney disease, kidney transplantation and post-transplant care.

The Centers for Medicare & Medicaid Services (CMS) did not immediately return a request for comment on the reason for the change.

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Officials asked for applications for the model back in fall of 2019, and participants were selected last year. CMS had an implementation period in 2020 that enabled providers to install “necessary care relationships and infrastructure,” according to CMS’ website.

Providers were supposed to take on financial accountability under the model on Jan. 1, 2021. Now, the implementation period will stretch through the rest of this year.

Participating providers will get quarterly capitated payments for “managing care of aligned beneficiaries” with late-stage renal disease and adjusted monthly capitated payments for all dialysis patients.

“These payments will be adjusted on the basis of health outcomes and utilization compared to both the participants’ own experience and national standards, and also performance on quality measures,” the agency said.

The model included three frameworks for how to be financially accountable for kidney care episodes. The frameworks range from a lower-risk, one-sided financial model to one where a provider takes on 100% of financial risk for total cost of care for all Medicare Part A and B services for the aligned beneficiary.