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Centers for Medicare & Medicaid Services

 



*ESRD Treatment Choices (ETC) Model Measurement Year (MY) 4 Data*

Today, the Center for Medicare and Medicaid Innovation (Innovation Center) is releasing performance information and results for Measurement Year 4 (MY4) of the End Stage Renal Disease (ESRD) Treatment Choices (ETC) Model.

The ETC Model is intended to encourage greater use of home dialysis and kidney transplants for Medicare beneficiaries with ESRD, while reducing expenditures while preserving or enhancing the quality of care furnished to beneficiaries with ESRD. The ETC Model began on January 1, 2021, and will run through June 30, 2027. Measurement Year 4 concluded on June 30, 2023. The Innovation Center assesses performance during MYs to determine ETC Participants’ payment adjustments during the respective Performance Payment Adjustment (PPA) Period, which begin 6 months following the end of the MY. The PPA Period for MY4 began on January 1, 2024, and concluded on June 30, 2024.

Aggregation group-level results from MY4, including home dialysis rates, transplant rates, and PPA amounts, are now available on the ETC Model website [ https://innovation.cms.gov/innovation-models/esrd-treatment-choices-model ]. These performance data are being published on the ETC Model website in three formats: at-a-glance results, summary results, and detailed results.

_MY4 PPA Highlights_:

For MY4, 2,428 ESRD facilities and 2,996 Managing Clinicians are receiving PPAs. The average home dialysis and transplant rates for ETC Participants who are ESRD facilities were 16.31% and 15.92%, respectively. The average home dialysis and transplant rates for ETC Participants who are Managing Clinicians were 14.89% and 16.70%. The majority of ETC Participants in MY4 received either 0% or +2.5% adjustment to claims. 30% of ETC Participants who were ESRD facilities had 0% adjustment to the PPS base rate. 30% had a +2.5% adjustment to the PPS base rate. 41% of ETC Participants who were Managing Clinicians had a +2.5% adjustment to the Monthly Capitation Payment (MCP). 29% had 0% adjustment to the MCP.

This information is intended to inform the public about the cost and quality of care and about ETC Participants’ performance in the ETC Model as discussed in the CY 2023 ESRD Prospective Payment System final rule [ https://www.govinfo.gov/content/pkg/FR-2022-11-07/pdf/2022-23778.pdf ] (87 FR 67280). The release of these MY4 data supplement the annual evaluation reports that CMS is required to conduct and release to the public under section 1115A(b)(4) of the Act. Evaluation reports for the ETC Model may be found on the ETC Model website [ https://www.cms.gov/priorities/innovation/innovation-models/esrd-treatment-choices-model ].

For more information, please visit https://innovation.cms.gov/innovation-models/esrd-treatment-choices-model. You can also contact the model team at ETC-CMMI@cms.hhs.gov.

 

 

Centers for Medicare & Medicaid Services (CMS) has sent this ESRD Treatment Choices (ETC) Model Update. To contact Centers for Medicare & Medicaid Services (CMS) go to our *contact us [ http://www.cms.gov/About-CMS/Agency-Information/ContactCMS/index.html ] *page.

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