CMS announces changes to dialysis ACO application

The Centers for Medicare & Medicaid Services Innovation Center held an Open Door Forum on Aug. 1 to announce some modifications to the application for the Comprehensive ESRD Initiative, or renal-specific Accountable Care Organization demonstration.

The agency said it plans to launch the demonstration in January, shortly after approving the applications for the project. The agency recently extended the application deadline to August 30.

Other updates to the application include:

CMS now requires that only an independent nephrologist or nephrology group practice join a dialysis facility to create a legal participating entity. Previously, an additional Medicare provider or supplier would have been required for an application.
CMS made changes to the risk arrangement for large dialysis organizations. The guaranteed discount for those participants is 0% in year one, 1% in year two, 2% in year three, and 3% in year four and beyond.
CMS also made changes to the rebasing methodology, which takes place in the fourth payment year. Rebasing will now consider an average of total annual expenditures for the three previous years as a base.
CMS clarified that waivers granted in this demonstration will apply to all participating organizations.

CMS officials are in the process of developing quality measures for the ESRD program. Over the next few months, contractors will be developing Technical Expert Panels to aid CMS in these efforts. The measures are expected to be finalized before participants are required to sign a participation agreement.

CMS will be uploading a new FAQ document to their website in the near future as well, based on the changes outline at the Aug. 1 open door forum.

A replay of the open door forum is available by dialing 855. 859.2056 and entering the code 14927067.