CMS has made changes to its Comprehensive ESRD Care (CEC) Initiative to encourage greater participation by both large dialysis organizations (LDOs) and non-LDOs. The goal of the CEC initiative is to improve outcomes for Medicare beneficiaries with ESRD while reducing expenditures by creating financial incentives for dialysis facilities, nephrologists, and other Medicare providers to effectively collaborate on caring for the complex ESRD beneficiary population. In particular, CMS has made changes to the participant owner requirements, the financial risk arrangement, and the financial calculation options. In light of these changes, CMS has reopened the application period; for details on submission dates and additional information, see the CMS web site.