ESRD Treatment Choices (ETC) Model Implementation: Home Dialysis Payment Adjustment (HDPA) & Waiver of the Kidney Disease Education (KDE) Benefit
Section 1115A of the Social Security Act (the Act) authorizes the Innovation Center to test innovative payment and service delivery models expected to reduce Medicare, Medicaid, and Children’s Health Insurance Program (CHIP) expenditures while preserving or enhancing the quality of care furnished to the beneficiaries of such programs. The End-Stage Renal Disease (ESRD) Treatment Choices Model (ETC Model) will be a mandatory payment model focused on encouraging greater use of home dialysis and kidney transplants, in order to preserve or enhance the quality of care furnished to Medicare beneficiaries while reducing Medicare expenditures. The ETC Model adjusts Medicare payments on certain dialysis and dialysis-related claims for participating ESRD facilities and clinicians caring for beneficiaries with ESRD—or Managing Clinicians—based on their rates of home dialysis transplant wait listing, and living donor transplants. We believe that these two models will test ways to further our goals of reducing Medicare expenditures while preserving or enhancing the quality of care furnished to beneficiaries.
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: October 30, 2020
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