Erica Maltby, Vice President of Physician Solutions
On Friday, March 5th, the Center for Medicare and Medicaid Innovation (CMMI) delayed the start of value-based kidney care models within Kidney Care Choices (KCC), including Kidney Cares First (KCF) and Comprehensive Kidney Care Contracting (CKCC) from April 1, 2021 to January 1, 2022.
The current Implementation Period will be extended to December 31, 2021. This news came just a few weeks prior to the intended start of the program, creating some frustration and many questions throughout the kidney care community.
CKD and ESRD patients were disproportionately impacted by the pandemic, causing both a strain on resources as well as changes to standard processes. For example, some CKD patients were wary of coming into clinics, forcing many to delay routine care or leverage telehealth services. Delaying the program until January will likely allow for a return to routine care.
It is also important to note that CMS is not changing the benchmark years for the program. We saw in our own data that COVID-19 was frequently a top-3 admit code for practices, which would drive costs up or artificially down due to a delay in care. The unchanged benchmark paired with the delayed start will be a truer reflection of nephrology groups’ performance.
Despite a delay in the Model, CMS has indicated that the program’s future is not at risk. The program will be extended for an additional year, signaling their long-term commitment. Additionally, the model is a direct reflection of the results we’ve seen from other value-based models; physician-led models perform 7x better than facility-based models. In that sense, KCC models are a great step forward for value-based kidney care.
The nephrology community is highly supportive of the KCC Models and is excited to see them move forward on a concrete timeline. Some practices have already made significant investments by hiring resources in anticipation of the April 1st launch; this is an added financial strain on practices for the next nine months. Many practices anticipated Advanced Alternative Payment Model (AAPM) bonuses from their participation in KCC in 2021 – now they will need to do Merit-based Incentive Payment System (MIPS) reporting this year instead.
Despite these frustrations, the excitement and anticipation for the KCC models to go live is strong among nephrologists. The challenge is more about how to manage new people, processes, and technologies in 2021.
By extending the Implementation Period, CMS will continue to provide data and guidance on the models. Participants should continue to refine workflows as more data is released, to better prepare for the first performance year. We also expect CMS to release benchmark year data, which will help all participants better project their financial opportunity in the models.
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