Kidney Care Choices (KCC) Model Program Analysis and Operational Support

The current Medicare payment system encourages in-center hemodialysis as the default treatment for patients with end-stage renal disease (ESRD) beginning dialysis. According to the Government Accountability Office, in-center hemodialysis is the most common type of dialysis and used by more than 80 percent of dialysis patients. More than 430,000 Medicare Fee-for-Service beneficiaries with ESRD spend an average of 12 hours a week receiving in-center hemodialysis. Many beneficiaries with ESRD suffer poorer health outcomes, such as higher hospitalization and death rates, often the result of underlying disease complications and multiple co-morbidities.

The Kidney Care Choices (KCC) Model is an accountable care organization (ACO) payment and delivery model that brings together dialysis facilities, nephrologists, and other providers to test innovative payment mechanisms. The Model’s goals include helping providers improve outcomes and reduce cost of care for patients with late-stage chronic kidney disease and ESRD by encouraging home dialysis and kidney transplantation. As a subcontractor to RTI, AIR’s work on the project spans four technical domains: managing model participants, aligning beneficiaries to each ACO, processing and analyzing claims to determine shared savings, and measuring the quality of care that ACOs provide to aligned beneficiaries.