Background

On July 10, 2019, President Donald Trump signed an Executive Order to launch Advancing American Kidney Health, an initiative to improve the lives of Americans with kidney disease by expanding treatment options and reducing healthcare costs. The initiative proposed various changes, including revising rules to ensure kidneys reach patients quicker, moving more patients into home dialysis, encouraging development of artificial kidneys, increasing the number of kidneys available for transplantation, and changing reimbursement for kidney disease treatment.

As directed by the Executive Order, the U.S. Department of Health and Human Services (HHS) announced the Centers for Medicare & Medicaid Services (CMS), through its Center for Medicare and Medicaid Innovation (CMMI), released a proposed required payment model and four optional payment models to adjust payment incentives to encourage preventative kidney care, home dialysis, and kidney transplants. The Department’s Assistant Secretary for Planning and Evaluation (ASPE) also released a paper entitled Advancing American Kidney Health.

• Advancing American Kidney Health (HHS, 7/10/19)
• HHS To Transform Care Delivery for Patients with Chronic Kidney Disease (CMS Press Release, 7/10/19)
• HHS Marks One-Year Anniversary of Advancing American Kidney Health Initiative (HHS Press Release, 7/10/20)
• HHS Reports Progress on President Trump's 'Advancing American Kidney Health' Initiative (HHS Press Release, 8/17/20)
• Advancing American Kidney Health: 2020 Progress Report (HHS, 8/17/20)

Activities & Implementation

ESRD Treatment Choices (ETC) Model

• Letter from Kidney Care Partners to CMS Regarding CMS–1749–P: ESRD PPS, Payment for Renal Dialysis Services for Individuals with AKI, ESRD QIP, and ETC Model; Focus on ETC Model (8/26/21)
• CMS Proposed Rule: Medicare Program; ESRD PPS, Payment for Renal Dialysis Services Furnished to Individuals With AKI, ESRD QIP, and ESRD Treatment Choices Model (CMS-1749-P) (7/9/21)
• CMS Final Rule: Medicare Program; Specialty Care Models to Improve Quality of Care and Reduce Expenditures (CMS-5527-F) (9/18/20)
• Comparison Chart (Proposed and Final Rules, CMS-5527) ~ outlines recommendations submitted by ANNA to CMS regarding the Proposed Rule and how the Final Rule aligns with those recommendations
• CMS Press Release: CMS Announces Transformative New Model of Care for Medicare Beneficiaries with Chronic Kidney Disease (9/18/20)
• CMS Fact Sheet: ESRD Treatment Choices (ETC) Fact Sheet (9/18/20)
• ANNA Submits Comments to CMS Regarding CMS-5527-P: Medicare Program; Specialty Care Models to Improve Quality of Care and Reduce Expenditures (9/16/19)
• Letter from the Alliance for Home Dialysis to CMS Regarding CMS-5527-P: Medicare Program; Specialty Care Models to Improve Quality of Care and Reduce Expenditures (9/16/19)
• Letter from Kidney Care Partners to CMS Regarding CMS-5527-P: Medicare Program; Specialty Care Models to Improve Quality of Care and Reduce Expenditures (9/15/19)
• CMS Proposed Rule: Medicare Program; Specialty Care Models to Improve Quality of Care and Reduce Expenditures (CMS-5527-P) (7/18/19)
• CMS Fact Sheet: Proposed ESRD Treatment Choices (ETC) Mandatory Model (7/10/19)

Kidney Care Choices Model

• CMS Fact Sheet: Kidney Care Choices Model (12/4/19)
• CMS Fact Sheet: Kidney Care First and Comprehensive Kidney Care Contracting Models (7/10/19)

Organ Donation

• CMS Final Rule: Medicare & Medicaid Programs; Organ Procurement Organization (OPO) Conditions for Coverage Proposed Rule: Revisions to Outcome Measures for OPOs (CMS-3380-F) (11/20/20)
• CMS Fact Sheet: Medicare & Medicaid Programs; Organ Procurement Organization (OPO) Conditions for Coverage Proposed Rule: Revisions to Outcome Measures for OPOs (11/20/20)
• Removing Financial Disincentives to Living Organ Donation (Final Rule, HRSA, 9/22/20)
• Reimbursement of Travel and Subsistence Expenses Toward Living Organ Donation Program Eligibility Guidelines (Final Rule, HRSA, 9/22/20)
• CMS Proposed Rule: Medicare & Medicaid Programs; Organ Procurement Organization (OPO) Conditions for Coverage Proposed Rule: Revisions to Outcome Measures for OPOs (CMS-3380-P) (12/23/19)
• CMS Fact Sheet: Medicare & Medicaid Programs; Organ Procurement Organization (OPO) Conditions for Coverage Proposed Rule: Revisions to Outcome Measures for OPOs (12/17/19)
• Health Resources & Services Administration (HRSA) Proposed Rule: Removing Financial Disincentives to Living Organ Donation (42 CFR Part 121) (12/20/19)

ANNA News & Updates

• ANNA Submits Comments to CMS Regarding CMS-1732-P: Medicare Program; ESRD PPS, Payment for Renal Dialysis Services Furnished to Individuals with AKI, ESRD QIP (9/4/20)
• An Opportunity to Advance Kidney Health Becomes a Responsibility (Nephrology Nursing Journal, July/August 2020)
• Implications of Proposed Changes to Models of Care for Kidney Disease (American Journal of Nursing, July 2020)
• Advancing American Kidney Health – The Time for Nurses to Act Is Now (Nephrology Nursing Journal, November/December 2019)
• Nurses Look at Challenges, Opportunities of Advancing American Kidney Health (Nephrology News & Issues, December 2019)
• An Era of Transformation (Nephrology Nursing Journal, September/October 2019)
• ANNA Submits Comments to CMS Regarding CMS-1713-P: Medicare Program; ESRD PPS, Payment for Renal Dialysis Services Furnished to Individuals with AKI, ESRD QIP (9/25/19)
• ANNA Submits Comments to CMS Regarding CMS-5527-P: Medicare Program; Specialty Care Models to Improve Quality of Care and Reduce Expenditures (9/16/19)

Updated 7/14/21