CMS NEWS
FOR IMMEDIATE RELEASE Contact: CMS Media Relations Group
February 4, 2013 (202) 690-6145
CMS Announces New Initiative to Improve End-Stage Renal Disease Care
New
model will support providers and suppliers in testing innovative ways
to improve care for beneficiaries with End-Stage Renal Disease
The
Centers for Medicare & Medicaid Services (CMS) today announced a
new initiative designed to identify, test, and evaluate new ways to
improve care for Medicare beneficiaries with End-Stage Renal Disease
(ESRD). Through the Comprehensive ESRD Care initiative, CMS will partner
with health care providers and suppliers to test the effectiveness of a
new payment and service delivery model in providing these beneficiaries
with patient-centered, high-quality care.
“This
initiative puts Medicare beneficiaries living with End-Stage Renal
Disease at the center of their care,” said CMS Acting Administrator
Marilyn Tavenner. “Through enhanced care coordination, these
beneficiaries will have a more patient-centered care experience, which
will ultimately, improve health outcomes.”
Those
with ESRD have significant health care needs. These beneficiaries
constituted 1.3% of the Medicare population and accounted for an
estimated 7.5% of Medicare spending, totaling over $20 billion in 2010.
These high costs are often the result of underlying disease
complications and multiple co-morbidities, such as coronary artery
disease and hypertension, which often lead to high rates of hospital
admission and readmissions, as well as a mortality rate that is much
higher than the general Medicare population.
Through
the Comprehensive ESRD Care Initiative, CMS will enter into agreements
with groups of health care providers and suppliers called ESRD Seamless
Care Organizations who will work together to provide beneficiaries with a
more patient-centered, coordinated care experience. Participating
organizations must include at least a dialysis facility, a nephrologist,
and one other Medicare provider or supplier. This initiative is being
run through the CMS Innovation Center, which was created by the
Affordable Care Act to test new models of delivering health care that
can potentially lower costs and improve patient care.
Participating
organizations will assume clinical and financial responsibility for a
group of beneficiaries with ESRD, based on where these beneficiaries
receive services. Beneficiaries will retain the right to see any
Medicare provider they choose and these organizations will be evaluated
on their performance on quality measures, which include beneficiary
health and experience. Those organizations successful in improving
beneficiary health outcomes and lowering the per capita cost of care for
beneficiaries will have an opportunity to share in Medicare savings
with CMS.
This
initiative was developed through consultation with advocates and
beneficiaries living with ESRD, health care providers, and nonprofit
organizations, among others.
To
provide more information about the model, CMS will host an Open Door
Forum on Tuesday, February 5 at 1:00 PM EST. Information about how to
participate is available at innovation.cms.gov/ initiatives/comprehensive- ESRD-care.
Interested
applicants are required to file non-binding letters of intent, which
are due on March 15, 2013. Applications to participate in the model are
due May 1, 2013. For more information, and to see the request for
application, visit innovation.cms.gov/ initiatives/comprehensive- ESRD-care.
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