End Stage Renal Disease Treatment Choices Model – Overview of Final Rule - McDermott+Consulting

End Stage Renal Disease Treatment Choices Model – Overview of Final Rule

On September 18, 2020, the Centers for Medicare and Medicaid Services (CMS) released the details on the End Stage Renal Disease Treatment Choices (ETC) Model. This model was released in conjunction with the Radiation Oncology Model in the Specialty Care Models to Improve Quality of Care and Reduce Expenditures Final Rule. The Administration proposed both models in July 2019.

  • The Specialty Care Models Final Rule is available here.
  • The press release is available here.
  • The fact sheet is available here.
  • Additional details on the ETC model are available here.

Model Purpose

CMS intends to determine whether adjusting the current Medicare fee-for-service (FFS) payments for dialysis services will incentivize managing clinicians—i.e., end stage renal disease (ESRD) facilities and clinicians managing adult Medicare FFS beneficiaries with ESRD—to work with their patients to achieve increased rates of home dialysis utilization and kidney transplantation, and as a result improve or maintain the quality of care and reduce Medicare expenditures.

CMS estimates that the model in this final design will save approximately $23 million over the life of the model.

Model Overview

The table below outlines several key policies in the finalized ETC Model.

 


For more information, contact Deborah Godes, Mara McDermott or Jessica Roth.