February 18, 2013
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DaVita won't participate in renal ACO without changes to program

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News from the kidney care community

DaVita executives said during an investor conference call Feb. 14 that the dialysis provider would not participate in the Centers for Medicare & Medicaid Services' new renal accountable care organization demonstration unless the agency makes changes to some of its rules.

(Related: CMS to hold second open door forum on renal ACOs)

"The ACO proposal is incomplete," executives said during the call. They called the CMS proposal issued Feb. 4 "sufficiently negative to make the program unattractive." But they also said they were hopeful that the agency would make changes to the proposal.

The DaVita executives broke down what they called the shortcomings of the new kidney care ACO model:

  1. Methodology penalizes dialysis providers who have had better outcomes in the past
  2. The benchmark methodology appears to be flawed in a way that doesn't work in kidney care
  3. There is not enough time to make an investment and see return before the ESRD bundle rebasing begins
  4. There are explicit economic penalties for larger dialysis organizations. "This doesn't make philosophical sense," DaVita said.

(Related: Acing the renal Accountable Care Organization)


DaVita noted that after 10 years of working on models for providing comprehensive care to kidney disease patients, they would be  "very bummed out" if changes are not made to the proposal. -by Rebecca Zumoff

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