The Kidney Care Coalition is a group of organizations committed to improving care for Medicare beneficiaries with chronic kidney disease and end-stage renal disease through accountable, specialty-focused care models. We support policies that strengthen care coordination, expand access to patient-centered kidney care, improve outcomes, and ensure long-term stability for value-based kidney care.
Members
Issue Statement
Medicare beneficiaries with chronic kidney disease (CKD) and end-stage renal disease (ESRD) represent one of the most medically complex and costly populations in the Medicare program, requiring intensive, specialty-driven care coordination that traditional fee-for-service payment does not adequately support.
The Kidney Care Coalition supports specialty-focused accountable care models because they improve outcomes for patients with kidney disease while strengthening the sustainability of the Medicare program.
Given the promising results and significant provider investment in transforming kidney care delivery, CMS and the Innovation Center should ensure long-term stability and continuity for accountable kidney care models beyond the current CKCC model period.
Results Show Cost Savings and Improved Care
Specialty-focused accountable care models help improve care coordination, delay disease progression, expand transplant access, reduce avoidable hospitalizations, and support more patient-centered kidney care.
Early results from the Comprehensive Kidney Care Contracting (CKCC) model show:
Independent analysis found CMS’s 2026 CKCC model changes could have generated approximately $90 million in Medicare savings in 2024.
Resources
A4H’s Kidney Care Coalition outlines a roadmap to strengthen and sustain specialty-focused kidney care models in Medicare. The paper offers policy recommendations to improve stability, expand participation, strengthen accountability, and ensure continued access to value-based kidney care beyond 2027.
A4H’s Kidney Care Coalition partnered with independent actuaries at Wakely to reassess the early financial performance of Medicare’s Comprehensive Kidney Care Contracting Model. The analysis found the model could have generated meaningful net Medicare savings under CMS’s 2026 policy changes, with savings expected to grow as providers gain experience and care transformation efforts mature.
A4H’s Kidney Care Coalition released new resources showing that accountable kidney care is improving outcomes and has stronger savings potential than early evaluations suggest. With the CKCC Model set to end in 2027, CMS should build on this progress by creating a stable, long-term pathway for kidney care providers to continue delivering coordinated, patient-centered kidney care.
Accountable for Health and the Coalition to Transform Advanced Care drafted recommendations that would strengthen the Comprehensive Kidney Care Contracting model and offer a broader roadmap for advancing care for people with serious and chronic illnesses.
Kidney-focused accountable care models align incentives around proactive, coordinated, whole-person care. Early results show meaningful gains, including more optimal dialysis starts and increased home dialysis use, demonstrating that better care and lower costs can go hand in hand.
A4H submitted a statement for the record to the U.S. House Ways and Means Health Subcommittee for the hearing on improving kidney health. A4H urges Congress to consider our recommendations to improve kidney health through better prevention, earlier intervention, and the advancement of innovative, accountable care models.
Medicare’s accountable care models have demonstrated that, when properly structured and supported, they can improve care experiences, expand access, and lower costs. CMMIs work must continue without undue interference and any legislative strategies should focus on expanding its role in transforming care delivery rather than contracting it.
The Accountable for Health Institute, in conjunction with the West Health Policy Center, identified a need for more standardized core competencies to identify accountable care. This tool and the surrounding content lay out key capabilities of accountable care providers and create a framework for future measurement activities.
When Rex, a 70-year-old retired construction worker in Utah, lost his kidney transplant after 24 years, he faced a familiar and daunting reality: a return to in-center dialysis.