Health Affairs August 1, 2024
On May 8, 2024, the Centers for Medicare and Medicaid Services (CMS) proposed the Increasing Organ Transplant Access (IOTA) model: a six-year mandatory payment model designed to expand equitable access to kidney transplantation—the preferred treatment option for kidney failure (that is, end-stage renal disease [ESRD]) over dialysis given the higher survival rates and quality of life at lower costs. The IOTA model shares key design aspects with other ongoing CMS kidney payment models, such as the ESRD Treatment Choices (ETC) model: a seven-year mandatory payment model designed to increase home dialysis and kidney transplant waitlisting. Unlike other voluntary kidney payment models—such as the Kidney Care Choices (KCC) model and the Comprehensive ESRD Care model—both the ETC and IOTA models randomize...
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