The Trump Administration has announced a number of policy goals and innovation models that seek to “improve the lives of Americans suffering from kidney disease, expand options for American patients, and reduce healthcare costs,” according to the Department of Health and Human Services (HHS). The broad policy framework was outlined in an executive order on “Advancing American Kidney Health” signed by President Trump on July 10, 2019. The executive order includes as federal priorities: preventing kidney failure whenever possible through better diagnosis, treatment, and incentives for preventive care; expanding affordable treatment alternatives for end stage renal disease (ESRD); encouraging the development of artificial kidneys, and updating the organ transplant system.

HHS is launching five new Medicare ESRD innovation models to jump-start the Advancing American Kidney Health initiative. One model, a proposed ESRD Treatment Choices Model, would be mandatory for dialysis providers in randomly-selected geographic areas that account for about 50% of adult ESRD beneficiaries. This model promotes home dialysis and kidney transplants by adjusting ESRD prospective payment system (PPS) payments upward or downward based on home dialysis and transplant rates, and increasing certain payments for home dialysis services. This model is subject to a public comment period through September 16, 2019. CMS also announced four optional models: the Kidney Care First (KCF) Model, and three Comprehensive Kidney Care Contracting (CKCC) Models. These models include incentives for coordinating care for beneficiaries with chronic kidney disease or ESRD and reducing total care costs, and for successful transplants. Details about these models are available here.