New recommendations outline priorities for the future of kidney care payment reform
Washington, D.C. (May 21, 2026)
Accountable for Health (A4H) and the Coalition to Transform Advanced Care (C-TAC) today released a new roadmap for advancing care for people with serious and chronic illnesses. The recommendations come as providers, patients, and other stakeholders look for clarity on an innovative kidney care model, which sunsets at the end of next year, and whether the Center for Medicare and Medicaid Innovation (CMMI) will pursue a successor model focused on coordinated, patient-centered kidney care.
The Comprehensive Kidney Care Contracting (CKCC) model is designed specifically for patients with end-stage renal disease and stages 4 and 5 of chronic kidney disease. The model generated $311 million in gross savings and $155 million in net savings for the roughly 178,000 beneficiaries in 2024 (the most recent year data is available). Since the model launched in 2022, patients are seeing continued improvements in care delivery, including more optimal dialysis starts, greater use of home dialysis, and increased transplant referrals.
A4H, an advocacy organization of more than 60 providers, payers, and innovators founded to champion accountable care, and C-TAC, a coalition dedicated to improving care and quality of life for people impacted by serious illness, urge the CMMI to maintain momentum on payment and delivery system reform for kidney care created by the CKCC model. Their recommendations reflect a growing need to better align care delivery and payment with the realities facing patients living with complex, long-term conditions, ensuring care is more coordinated, supportive, and responsive to what matters most to patients and families.
“CKCC represents an important step forward in improving coordination, accountability, and patient-centeredness in kidney care,” A4H CEO Mara McDermott said. “As policymakers consider the future of the model, stakeholders are sending a clear message that these efforts should continue and evolve, not disappear.”
The A4H and CTAC recommendations outline several principles for an extension or successor model, including:
- Greater model stability and predictability for participants
- Stronger beneficiary engagement and caregiver support
- Better integration of palliative and hospice care
- Earlier, more patient-centered supportive care pathways across the kidney disease continuum
The organizations say future models should place greater emphasis on quality of life, care aligned with patients’ goals, and supportive services for patients navigating complex and long-term illness.
“We have an opportunity to build a kidney care system that treats the whole person, not just the disease,” said Tom Koutsoumpas, co-founder and co-chair of C-TAC. “Future models should advance more coordinated, patient-centered care by incorporating supportive and palliative services earlier, empowering patients and families in decision-making, and improving quality of life throughout the care journey.”
The recommendations also emphasize the importance of providing stability and transparency for model participants to sustain long-term investment and innovation in value-based kidney care.
The full recommendations are available here.
Accountable for Health (A4H) is a 501(c)(4) national advocacy and policy analysis organization accelerating the adoption of sustainable, effective accountable care that improves health care quality and outcomes and lower costs. We represent a broad, diverse group of accountable care stakeholders working to improve the way health care is delivered to people across the county, across various payers, programs, and delivery models. A4H provides advocacy, research, and education to improve outcomes and patient experiences while lowering costs.
The Coalition to Transform Advanced Care (C-TAC) is dedicated to improving care and quality of life for people impacted by serious illness, particularly those who are underserved and under-resourced. We work alongside policymakers, regulators, advocates, health care leaders, and funders to advance equitable, person-centered policies that improve access to comprehensive care and support for patients, families, and unpaid caregivers. As a nonprofit, nonpartisan organization, C-TAC is recognized as a trusted, unbiased source of expertise on serious illness care and a respected convener of more than 190 member organizations committed to transforming the health care system to better honor the needs, goals, and dignity of every person. Learn more about our work and membership at TheCTAC.org
Contact:
Mara McDermott, CEO of Accountable for Health
mmcdermott@accountableforhealth.org
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