VIDEO: RPA concerned that nephrologists may leave CKD demonstration over payment cuts
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Key takeaways:
- Changes in risk care arrangements to the Comprehensive Kidney Care Contracting model may lead to an exodus of nephrology practices.
- Letters have been sent to Congress and HHS asking for changes.
Nephrology groups are concerned that a reduction in payments to nephrology practices in the Comprehensive Kidney Care Contracting models may lead to a drop in participation, according to Robert Blaser.
“These are the voluntary payment models that Congress and the Trump administration created to advance kidney care in a value-based manner, which is different than the current fee-for-service and the Medicare fee schedule,” Blaser, the director of public policy for the Renal Physicians Association, told Healio.
“But there are a lot of concerns with [the models] now,” Blaser said. “At the moment, there are payment cuts that are expected to be 8% to 12% over a 2-year period and that is just not sustainable for the nephrology practices that are participating in these models.”
As Healio has previously reported, the RPA and the American Society of Nephrology sent letters to Medicare and HHS officials outlining the potential impact of the cuts, along with a letter to congressional leaders asking them to intervene.
The Comprehensive Kidney Care Contracting (CKCC) option of the Kidney Care Choices model, which offers capitated payments to nephrologists to manage patients with CKD stages 4 to 5, requires nephrology practices to take on greater financial risk for patient care in exchange for greater shared savings with Medicare.
The payment changes, called the retroactive trend adjustment, are based on lower utilization of dialysis services during the COVID-19 pandemic. “We are trying to work with the Administration to get them to reduce the impact of the cuts if at all possible,” Blaser told Healio, “but it’s not a great time to do that right now ... We are going to keep up the fight throughout the summer,” he said.
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