The Centers for Medicare & Medicaid Services announced on Jan. 18 that it had accepted 24 new End-Stage Renal Disease Seamless Care Organizations (ESCOs) into its five-year Comprehensive ESRD Care Demonstration––including applications from three medium-sized providers.

The demonstration began in September 2015 aimed at showing whether integrated care could help improve kidney treatment and save money for the Medicare program. Based on a provider’s choice of risk model, savings shown by providers are shared between Medicare and the providers.

After getting 13 ESCOs approved in the first round with only one––Rogosin Institute––considered a small provider, CMS re-opened the application process in an effort to attract smaller- to medium-sized dialysis companies.

The 24 new sites approved by CMS to be part of the demonstration bring the number of sites in total to 37, include new ESCOs from:

  • The Centers for Dialysis Care, Cleveland (The Northeast Ohio Renal Alliance, LLC)
  • Atlantic Dialysis, New York, NY (The Gotham City Kidney Care ESCO, LLC)
  • Northwest Kidney Centers, Seattle (Northwest Kidney Care Alliance)

The remaining 21 new ESCOs are divided between Fresenius Medical Care and Dialysis Clinic Inc., with Fresenius now at 24 sites, DaVita at three sites, and DCI now with 6 sites (see list below).

Expanding payment models

Identifying the new CEC applications from the dialysis provider community was part of a CMS announcement on Jan. 18 touting the 359,000 clinicians confirmed to participate in four of CMS’s Alternative Payment Models (APMs) in 2017. “By listening to physicians and engaging them as partners, CMS has been able to develop innovative payment reforms that bring physicians back to the core practice of medicine––caring for the patient,” said Acting Administrator Andy Slavitt.


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“By reducing regulatory burden and paying for quality, CMS is offering solutions that improve the quality of services our beneficiaries receive and reduce costs, to help ensure the Medicare program is sustainable for generations to come.”

Other APMs that receive Medicare funding include The Medicare Shared Savings Program (Shared Savings Program), Next Generation Accountable Care Organization Model, and the Comprehensive Primary Care Plus (CPC+) Model. In 2017, CMS estimates that there will be:

  • Over 359,000 clinicians participating in APMs
  • More than 12.3 million Medicare and/or Medicaid beneficiaries served
  • 572 ACOs across the Shared Savings Program, Next Generation ACO Model and CEC Model
  • 131 ACOs in a risk-bearing track, including in the Shared Savings Program, Next Generation ACO Model and CEC Model
  • 2,893 primary care practices participating in CPC+

The 37 organizations participating in the ESRD Care Model

Additional information on the ACO model can be found at https://innovation.cms.gov/initiatives/comprehensive-esrd-care/

Large Dialysis Organizations (LDOs):

Participating Dialysis

Provider

ESCO Name Location
Dialysis Clinic Inc. Music City Kidney Care Alliance, LLC Nashville, TN
Dialysis Clinic Inc. Palmetto Kidney Care Alliance LLC Spartanburg, SC
Dialysis Clinic Inc. Metropolitan Kidney Care Alliance, LLC Newark, NJ
Dialysis Clinic Inc. Heart of America Kidney Care Alliance, LLC Kansas City, MO
Dialysis Clinic Inc. Independence Kidney Care Alliance, LLC Pittsburgh, PA
Dialysis Clinic Inc. Georgia Pines Kidney Care Alliance, LLC Albany, GA
Fresenius Medical Care Fresenius Seamless Care of Philadelphia, LLC Philadelphia, PA
Fresenius Medical Care Fresenius Seamless Care of San Diego, LLC San Diego, CA
Fresenius Medical Care Fresenius Seamless Care of Chicago Chicago, IL
Fresenius Medical Care Fresenius Seamless Care of Columbia Columbia, SC
Fresenius Medical Care Fresenius Seamless Care of Dallas, LLC Dallas, TX
Fresenius Medical Care Fresenius Seamless Care of Charlotte, LLC Charlotte, NC
Fresenius Medical Care Fresenius Seamless Care of Louisiana Baton Rouge, LA
Fresenius Medical Care Fresenius Seamless Care of Indianapolis Indianapolis, IN
Fresenius Medical Care Fresenius Seamless Care of Minneapolis Minneapolis, MN
Fresenius Medical Care Fresenius Seamless Care of Portland Portland, OR
Fresenius Medical Care Fresenius Seamless Care of Michigan Detroit, MI
Fresenius Medical Care Fresenius Seamless Care of Atlanta Decatur, GA
Fresenius Medical Care Fresenius Seamless Care of Massachusetts Springfield, MA
Fresenius Medical Care Fresenius Seamless Care of Houston Houston, TX
Fresenius Medical Care Fresenius Seamless Care of Central Texas San Antonio, TX
Fresenius Medical Care Fresenius Seamless Care of Central Alabama Birmingham, AL
Fresenius Medical Care Fresenius Seamless Care of Gulf Shore Mobile, AL
Fresenius Medical Care Fresenius Seamless Care of Las Vegas Las Vegas, NV
Fresenius Medical Care Fresenius Seamless Care of Erie Valley Cleveland, OH
Fresenius Medical Care Fresenius Seamless Care of New York New York, NY
Fresenius Medical Care Fresenius Seamless Care of Maryland Bethesda, MD
Fresenius Medical Care Fresenius Seamless Care of Central North Carolina Raleigh, NC
Fresenius Medical Care Fresenius Seamless Care of Delaware Wilmington, DE
Fresenius Medical Care Fresenius Seamless Care of Central Illinois Bloomington, IL
DaVita Inc. Phoenix-Tucson integrated Kidney Care Phoenix, AZ
DaVita Inc. South Fla. Integrated Kidney Care Miami, FL
DaVita Inc. Philadelphia-Camden Integrated Kidney Care Philadelphia, PA

 

Non-Large Dialysis Organizations (Non-LDOs)

 

Company ESCO Name      Location
Rogosin Rogosin Kidney Care Alliance, LLC   New York, NY
Centers for Dialysis Care (CDC) Northeast Ohio Renal Alliance, LLC   Cleveland, OH
Atlantic Dialysis The Gotham City Kidney Care ESCO, LLC    New York, NY
Northwest Kidney Centers Northwest Kidney Care Alliance    Seattle, WA