November 26, Centers for Medicare and Medicaid Services (CMS) Confirmed the Increase in organ transplant access (IOTA) modelsaims to increase access to kidney transplants for patients living with end-stage renal disease (ESRD). This six-year model was originally scheduled to begin on January 1, 2025, but was postponed to July 1, 2025 to give participating hospitals and other stakeholders time to prepare. . This model replaces the previous Centers for Medicare and Medicaid Innovation model (i.e. ESRD treatment selection and Kidney care choices Model) aims to improve the care of patients with kidney disease, and specifically aims to:
- Improving the quality of care before, during, and after transplantation.
- Make the most of deceased donor kidneys.
- Identify more living donors and assist potential living donors through the donation process.
- Improving access to kidney transplants by addressing social determinants of health and other barriers to care.
- Improving care coordination and patient-centeredness in the kidney transplant process. and
- Reduce Medicare spending.
CMS selected half of the contributing service areas (DSAs) and all eligible kidney transplant hospitals within those regions. 103 hospitals— Participate in a mandatory model in which the other half of the DSA acts as a comparison group. The selected hospitals are non-pediatric transplant hospitals that have performed an average of 11 or more kidney transplants per year in the three years prior to the start of the model.
Participating hospitals are being provided support to provide better care coordination, improve quality of care, and address the health-related social needs (HRSN) of patients awaiting transplant. In addition, hospitals are eligible to receive incentive payments based on their performance scores in three areas: achievement, efficiency, and quality. This model uses one-sided risk in the first performance year and introduces two-sided risk in the second performance year.
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