Understanding the Kidney Care Choices (KCC) Model
Kidney Care Choices (KCC) is the new set of value based care programs from the Centers for Medicare & Medicaid Services (CMS) Innovation Center that are focused on patients with advanced renal disease. As a part of this program, there are three Comprehensive Kidney Care Contracting (CKCC) Options that incentivize healthcare providers to manage the care of individuals with chronic kidney disease (CKD) and end stage renal disease (ESRD).
By providing specialized education and support services to slow the progression of kidney disease, increase preemptive transplants, and increase planned starts to life-sustaining treatment, this government value based care model enhances the quality of care while reducing cost.
How Does the CKCC KCC Model Work?
CKCC offers two-sided, total cost of care for Medicare patients with both end stage renal disease and now the addition of stage 4 and stage 5 CKD. These new offerings will help the CMS determine if a unique payment program can improve outcomes for this patient population while reducing cost.
The KCC Model is made up of three voluntary payment options. The three CKCC Options are designed to reduce Medicare expenses while improving outcomes for patients with CKD and ESRD.
The KCC Model builds on the design of the Comprehensive ESRD Care (CEC) Model. Unlike previous value based kidney care models, the KCC Model addresses both CKD and ESRD patients and aligns patients based on a longitudinal outpatient relationship with a nephrologist, not dialysis treatments.
What Are the CKCC Options?
Kidney Contracting Entities (KCEs) will receive adjusted payments for managing patients with CKD stages 4 and 5 and with ESRD, along with the kidney transplant bonus payment. KCEs take responsibility for the total cost and quality of care for their aligned patients and can receive a portion of the Medicare savings achieved within the following frameworks:
- Graduated Option: Allows participants to begin under a lower-reward, lower-risk model and incrementally phase into greater risk and greater potential reward
- Professional Option: Participants can earn 50 percent of shared savings or be liable for 50 percent of shared losses based on the total cost of care for Medicare Part A and Part B services
- Global Option: Participants take on risk for 100 percent of the total cost of care for all Medicare Part A and Part B services for aligned patients
Who Can Participate in the CKCC Options?
KCEs are required to include nephrologists or nephrology practices and transplant providers, while dialysis facilities and other providers and suppliers are optional participants in KCEs. KCEs will focus on delaying the progression of CKD to ESRD, managing the transition to dialysis, supporting patients through the transplant process, and keeping patients healthy post-transplant. By taking on the responsibility for the total cost and quality of care for these patients, they will in exchange receive a portion of the Medicare savings they achieve depending on which option they choose.
How Are Patients Aligned?
Patients who meet the criteria will be eligible for alignment to these options:
- Medicare patients with CKD stages 4 and 5
- Medicare patients with ESRD receiving maintenance dialysis
- Medicare patients who were aligned to a KCF practice or KCE by virtue of having CKD stage 4 or 5 or ESRD and receiving dialysis who then receive a kidney transplant
Alignment will take into consideration where a patient receives the majority of his or her kidney care. When a patient receives a kidney transplant, he or she will remain aligned to the model for three years following a successful kidney transplant or until the time a kidney transplant fails, at which point the patient could be realigned if he or she meets the requirements for alignment by virtue of his or her ESRD.
How Do Patients Benefit From the Comprehensive Kidney Care Contracting Options?
Patients managed under the CKCC Options will receive kidney disease education. This benefit from Fresenius Medical Care North America’s KidneyCare:365 Care Choice Program is designed to provide education under this government initiative. The program supports people living with late-stage CKD through personalized education, hands-on support, and expanded care coordination activities to help better manage their often complex and chronic comorbidities that may include diabetes, hypertension, and behavioral health issues.
In addition to earlier intervention and prevention, the program provides extensive education about kidney disease and related comorbidities, the importance of seeing a nephrologist, eating well and healthy living with support from dietitians and social workers, and treatment options for kidney failure including transplant and home dialysis.
Get Started Today
Learn more about improving outcomes for patients while reducing cost with value based care options. The KCC Model Performance Period will run through December 31, 2026. Find out more about the application process so your practice can provide the best services to patients through value based care.
