Big Medicare test of kidney dialysis care isn’t working, studies say

A few years in the past, the Facilities for Medicare and Medicaid Providers launched a giant experiment. The company wished to see if monetary incentives and penalties would enhance look after individuals with end-stage kidney illness. Thus far, it hasn’t labored, a brand new research finds.

The Finish-Stage Renal Illness Remedy Decisions (ETC) mannequin is a historic effort, each as a result of it’s the largest such experiment within the historical past of American well being care and since, not like earlier CMS Innovation Heart pilot packages, it’s necessary. About 30% of dialysis suppliers within the nation take part, whereas the opposite 70% are used as a management group. It’s formed like a gold-standard, randomized management trial, and run by the entity that covers nearly all of well being care associated to end-stage renal illness, together with dialysis. 

Annually, suppliers are graded on what number of sufferers they will transfer to residence dialysis, which is extra inexpensive for the well being care system, and the way many individuals go on to obtain kidney transplants, amongst different metrics. In the event that they do nicely, they obtain some more money. Those that don’t do nicely face monetary penalties. Each quantities enhance with annually of the experiment, as much as an 8% bonus or 10% penalty by the top of this system.