Washington, D.C. (June 23, 2026)

Accountable for Health’s Kidney Care Coalition, representing more than 95% of participants in the CMS Innovation Center’s kidney-focused models, today released two papers making the case for continued support of specialty-focused accountable care models for Medicare beneficiaries with chronic kidney disease (CKD) and End-Stage Renal Disease (ESRD).

The papers demonstrate the Comprehensive Kidney Care Contracting (CKCC) model shows stronger savings potential than early evaluations suggest while delivering significant quality improvements, and calls on CMS to act now to ensure long-term stability for patients and doctors participating in accountable kidney care.

“Medicare beneficiaries with kidney disease are among the most medically complex and costly patients in the program, and they deserve care models designed around their needs,” said Mara McDermott, CEO of Accountable for Health, an advocacy organization of more than 60 providers, payers, and innovators founded to champion accountable care. “The early evidence shows that accountable kidney care is improving quality, and today’s independent analysis shows that the model’s financial story is stronger than headline evaluation results suggest. CMS should continue to build on this important progress.”

The CKCC model has already demonstrated meaningful gains in patient care. An independent CMS evaluation found a 31% improvement in optimal dialysis starts, a 10% increase in home dialysis, and a 69% increase in pre-emptive transplants. These improvements in patient care and quality outcomes will continue to grow over time. However, early evaluations from CMS contractors did not tell the complete story on the cost savings achievements for these models.

A new analysis prepared by Wakely, an independent actuarial firm, found that CKCC is generating cost savings today after updates to the model’s financial terms made in 2026. Had these model changes been adopted earlier, the model would have generated net savings to Medicare of $26 million and $90 million in 2023 and 2024 respectively. Estimated savings could rise to $112 million and $118 million if current model participants were in full-risk tracks.

Furthermore, observers expect that savings will continue to grow as organizations gain experience with the model, and quality outcomes compound cost savings, as has been the case for other accountable care models and programs.

Considering this track record of success in improving outcomes and achieving savings, CKCC model participants are calling on CMMI to create a long-term, stable accountable kidney care model.

The second paper lays out a policy roadmap for stabilizing accountable kidney care beyond 2027. The recommendations call on CMS to ensure there is no gap for beneficiaries once the current model sunsets at the end of next year.

“The question before CMS is whether Medicare should continue to provide a model that is improving kidney care, showing clear savings under their own updated policies, and creating a path away from fragmented fee-for-service care,” Scott Lloyd, chief development and strategy officer at Evergreen Nephrology said. “The answer should be yes.”

• A4H’s Kidney Care Coalition recommends that CMS take several steps to stabilize accountable kidney care, including:
• Reassess early model performance results using the updated 2026 program design features;
• Expanding beneficiary alignment to support earlier intervention for patients with CKD;
• Improving participation rules so more nephrologists and patients can access the model;
• Using risk adjustment and benchmarks that reflect the clinical complexity of kidney disease;
• Preserving incentives for organizations that have already generated savings; and
• Refining quality measures to focus on meaningful, measurable, and actionable outcomes.

A4H is urging CMS to work with kidney care leaders on a stable successor pathway that ensures access to a stabilized, predictable accountable kidney care model.

“Ending CKCC without a clear next step would risk undoing years of provider investment and disrupting care for some of Medicare’s highest-need beneficiaries,” David Pollack, president and chief operating officer at Interwell Health, said. “CMS has an opportunity to preserve momentum, strengthen the model, and give patients with kidney disease continued access to coordinated, accountable care.”

Accountable kidney care models are uniquely positioned to support chronically ill patients through earlier intervention, better dialysis preparation, transplant referrals, home dialysis adoption, medication management, and reduced avoidable utilization. In 2023, the model included more than 100 Kidney Contracting Entities, 4,331 nephrology professionals, 229 transplant professionals, and 1,594 dialysis facilities.

The Wakely paper and policy roadmap are both available on the A4H Kidney Care Coalition page.

Contact:
Mara McDermott, CEO of Accountable for Health
mmcdermott@accountableforhealth.org

About Accountable for Health

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 lowers costs. We represent a broad, diverse group of accountable care stakeholders working to improve the way health care is delivered to people across the country, across various payers, programs, and delivery models. A4H provides advocacy, research, and education to improve outcomes and patient experiences while lowering costs.

For more information, visit https://accountableforhealth.org/. Follow us on LinkedIn and Twitter (@acct4health). ###