A plan to launch the first round of the Comprehensive ESRD Care Initiative, or renal ACO demonstration, in January with large dialysis providers has been postponed until July, when the agency was set to start round 2 of the project with small dialysis organizations.

CMS released the details of the demonstration to the renal community two years ago, on Feb. 5, 2013 with an original launch date of January2014. By July 2013 it had granted three extensions for applications after dialysis providers raised concerns about the financial risk and the size of the patient population needed by small providers to participate. CMS agreed to loosen some of the restrictions on organizing the ESRD Seamless Care Organizations, the entities that would participate in the demonstration, and released a new set of applications in January of last year. A final round of deadlines took place last July for large dialysis organizations and in September for small dialysis providers.

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