By Kelly A. Briganti, Editorial Director, G2 Intelligence
The Centers for Medicare & Medicaid Services (CMS) has launched its latest Accountable Care Organization (ACO) model and this time the model focuses on one specific disease. Under the Comprehensive ESRD Care (CEC) ACO Model, dialysis facilities, nephrologists and other providers will collaborate on health care services for end-stage renal disease patients in ESRD Seamless Care Organizations (ESCOs).
There will be two types of ESCOs. For ESCOs involving large dialysis organizations having at least 200 dialysis facilities (called LDOs), both savings and losses will be shared. Smaller dialysis organizations having fewer than 200 facilities (known as non-LDOs) will participate in ESCOs that share in savings but not losses. Currently, 13 ESCOS are participating in the model with locations in more than 10 states. Each ESCO will have at least one dialysis facility and one independent nephrologist or nephrology group and the governing body will include a patient representative and consumer advocate. Participants can include Medicare-enrolled providers of services and supplies except ambulance suppliers, drug/device manufacturers and durable medical equipment, prosthetics, orthotics and supplies (DMEPOS) suppliers.
CMS noted in its announcement of the model’s launch that more than 600,000 Americans suffer from end-stage renal disease and that the disease typically involves multiple health conditions and greater risk for hospitalization and caused 5.6% of total Medicare spending in 2012.