The Increasing Organ Transplant Access (IOTA) Model Evaluation
Kidney transplantation is widely recognized as the best treatment for patients with end-stage renal disease (ESRD). Unfortunately, there are far more patients awaiting transplants than available organs. Many patients experience long wait times or die before receiving a transplant, and approximately a third of transplantable kidneys recovered annually are discarded.
The Centers for Medicare & Medicaid Services (CMS) launched the Increasing Organ Transplant Access (IOTA) Model to address long-standing challenges in kidney transplantation and improve outcomes for patients with ESRD.
This six-year, mandatory model began on July 1, 2025. IOTA provides performance-based financial incentives for selected transplant hospitals to:
- Increase kidney transplant volume;
- Improve efficiency (such as kidney offer acceptance); and
- Enhance quality of care.
By giving IOTA transplant hospitals flexibility in how they respond to incentives, the model is expected to generate a wide range of innovative strategies to expand access and improve care delivery. To support a rigorous evaluation, CMS randomized approximately half of the country to participate in IOTA, creating a strong foundation for evaluating the model’s impacts.
For questions about the IOTA evaluation or if you’re interested in contributing insights, please contact AIR.
The IOTA Model Evaluation identifies model evidence of what works, for whom, and how to achieve lasting improvements in patient outcomes. CMS awarded the task of evaluating the IOTA Model to AIR and partner Hennepin Healthcare Research Institute (HHRI).
AIR and subcontractor HHRI will conduct a mixed-methods evaluation integrating quantitative analysis with on-the-ground insights from stakeholders in both IOTA and non-IOTA areas, including organ procurement organizations, transplant centers, clinicians, and patients.
