CMS launches new payment model to improve kidney transplant outcomes

CMS launches new payment model to improve kidney transplant outcomes

A new final rule issued this week by the Centers for Medicare and Medicaid Services and the U.S. Department of Health and Human Services for a mandatory alternative payment model called the Increasing Organ Transplant Access (IOTA) model aimed to increase the number of life-saving kidney transplants for patients whose kidneys have failed. The new rule will examine whether performance-based upward or downward risk payments at a select subset of kidney transplant hospitals improve access to kidney transplants for patients with end-stage renal disease while maintaining or improving quality of care and reducing Medicare costs.

Kidney failure affects more than 800,000 people in the United States, and care for patients diagnosed with kidney failure is covered by the U.S. Medicare End-Stage Renal Disease Program. Patients can be treated with either a kidney transplant or dialysis. Transplantation is the optimal treatment option for patients and is more cost-effective than the alternative treatment option: dialysis. However, there are nearly 100,000 people on the kidney transplant waiting list and about 3,000 new patients are added every month, but only about 25,000 kidney transplants are performed each year. More than 30 percent of deceased donor organs procured for transplant each year go unused, and an average of 13 patients die each day while waiting for a transplant.

Studies conducted by Regenstrief Institute and Indiana University School of Medicine researchers: Rachel Patzer, PhD, MPH; Katie Ross-Driscoll, PhD, MPH; and Adam Wilk, PhD; were repeatedly cited in the CMS final rule issued by the Centers for Medicare and Medicaid Services on November 26, 2024, effective July 1, 2025.

Dr. Patzer, a research fellow at the Center for Health Services Research and president and CEO of the Regenstrief Institute, is currently leading a research study funded by the National Institute on Minority Health and Health Disparities, part of the National Institutes of Health, focused on government payment models for kidney disease and is a leading expert on the barriers and facilitators to improving access to kidney transplantation. She is also a member of the Policy and Advocacy Committee of the American Society of Nephrology, whose mission is to advance policies through federal laws and regulations to promote kidney health, increase access to transplantation, and eliminate disparities in kidney disease and transplantation.

In the past, kidney transplant centers have been encouraged to focus on improving survival and outcomes of transplanted patients, but have ignored the patient population that has not yet been successfully transplanted. The IOTA model seeks to change this by encouraging transplant centers to focus on improving not only transplant outcomes, but also access to transplants for patients with kidney failure.”

Dr. Rachel Patzer, PhD

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