Medicare Kidney Failure Trial Ends Early
- The Centers for Medicare and Medicaid Services (CMS) will cut short its End-Stage Renal Disease Treatment Choices (ETC) model, a significant experiment designed to reshape dialysis care in...
- Launched by the CMS Innovation Center, the ETC model aimed to incentivize providers to increase the number of patients receiving dialysis at home and undergoing kidney transplantation.
- Despite its scale, the ETC model did not achieve its intended outcomes.
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CMS Ends Landmark Dialysis Experiment – ETC Model
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What Happened: The End of the ETC Model
The Centers for Medicare and Medicaid Services (CMS) will cut short its End-Stage Renal Disease Treatment Choices (ETC) model, a significant experiment designed to reshape dialysis care in the U.S. The agency, led by Mehmet Oz, announced the termination in a final rule published in the Federal Register last week.
Launched by the CMS Innovation Center, the ETC model aimed to incentivize providers to increase the number of patients receiving dialysis at home and undergoing kidney transplantation. It was the largest such experiment in the history of American health care, requiring participation from 30% of the nation’s dialysis providers.
Why the ETC Model Failed: Lack of Impact on Key Metrics
Despite its scale, the ETC model did not achieve its intended outcomes. Initial analysis following the first year, 2021, revealed no discernible impact on rates of home dialysis or kidney transplantation. A subsequent study conducted last summer corroborated these findings.
The study found that providers participating in the new payment model weren’t getting more patients onto home dialysis or to transplant than those in the control group. This suggests that the financial incentives offered by the ETC model were insufficient to overcome existing barriers to these treatment options.
Barriers to Home Dialysis Adoption
- Patient Suitability: Not all patients are medically suitable for home dialysis due to health conditions or lifestyle factors.