Medicare’s experiment to fix kidney failure to end early

Isabella Cueto covers the leading causes of death and disability: chronic diseases. Her focus includes autoimmune conditions and diseases of the lungs, kidneys, liver (and more). She writes about intriguing research, the promises and pitfalls of treatment, and what can be done about the burden of disease. You can reach Isabella on Signal at isabellacueto.03.

The Centers for Medicare and Medicaid Services will cut short a big experiment to try and change the way dialysis is done in the U.S. The agency, led by Mehmet Oz, will end its End-Stage Renal Disease Treatment Choices model on Dec. 31, according to a final rule published in the Federal Register last week.

The trial, run by the CMS Innovation Center, was testing whether giving financial incentives to providers would move more patients with end-stage kidney disease onto home dialysis and through the transplant process. It was the largest such experiment in the history of American health care, and required 30% of the country’s dialysis providers to participate. 

However, ETC hasn’t proven that approach works. An analysis after the first year, 2021, showed no impact on home dialysis or transplantation. A study last summer found a similar result. Providers participating in the new payment model weren’t getting more patients onto home dialysis or to transplant than those in the control group, the paper reported.