Last week the The Centers for Medicare & Medicaid Services Innovation (CMMI) Center announced that it would be pushing ahead with the new Kidney Care Choices (KCC) payment models, launching April 1, 2021 rather than January 1 as a result of the COVID-19 pandemic. Successful applicants should begin hearing from CMMI in mid-June, and will have the option to delay their start date to January 1, 2022. In parallel, CMMI announced that the Comprehensive ESRD Care Model (ESCO Model) would be extended until March 31, 2021.
CMMI also announced that they would be opening a second window for applications in 2021 for new participants with a start date of January 1, 2022. CMMI is clearly committed to transforming kidney care to be more centered around value and is pressing forward with payment model reforms with only minor delays, as well as indicating ways they will continue to expand the program.
In preparation for the launch of the KCC models, pulseData has built tools to help practices understand how the new KCC model will shape their revenue and where they can expect to stand on the quality and utilization measures.
pulseData has taken the guidance provided in the original Request for Applications to help practices get a clearer picture of the number of patients they could expect might be aligned to their practice.
Using our estimation of the aligned patients to the new model we are able to calculate how revenue will look under the new innovative per beneficiary payment system by calculating prospective income under the Quarterly Capitated Payment (QCP) for aligned CKD Stage 4 and 5 beneficiaries and the Adjusted Monthly Capitated Payment (AMCP) for ESRD beneficiaries. The chart below compares the difference in practice revenue where it being paid under the new capitated payments system or under the existing fee-for-service revenue system. This makes it very clear to practices whether their income might stand to increase or decrease under the new model.
Nephrology practices and kidney care providers already have a substantial reporting burden; a number of agencies that they are required to submit data to that includes CMS, MIPS, AMA, AHRQ and RAND amongst others. The KCC models will similarly ask participating practices to deliver on quality and utilization measures.
The pulseData platform alleviates the reporting burden by equipping practices with the ability to track their performance on specific metrics in real time, allowing them to make adjustments to improve clinical quality outcomes and deliver value based care initiatives.
We are excited about the future of nephrology care. We work alongside nephrologists to build a future that supports more effective and lower cost renal disease management. To arrange a demo of the pulseData platform please email firstname.lastname@example.org.