a A few years ago, the Centers for Medicare and Medicaid Services launched a large-scale experiment: They wanted to see whether financial incentives and penalties would improve care for patients with end-stage renal disease. So far, the experiment has been ineffective, a new study finds.
The End-Stage Renal Disease Treatment Choice (ETC) model is a historic initiative. The biggest experiment This is a milestone in U.S. health care history, and it's different from previous CMS Innovation Center pilot programs because it's mandatory. About 30 percent of the nation's dialysis providers will participate, with the remaining 70 percent used as a control group. It's run by an organization that covers the vast majority of care related to end-stage renal disease, including dialysis, in a format similar to a gold-standard randomized controlled trial.
Each year, providers are evaluated on a variety of criteria, such as how many patients they transition to home dialysis, which is less costly for the health care system, or how many patients they get kidney transplants. If they perform well, they're paid extra; if they perform poorly, they're fined. Both amounts increase with each year of the experiment, up to a maximum of an 8% bonus or 10% penalty at the end of the program.
