CMMI Releases Revised ESRD Seamless Care Organization RFA, In Attempt to Further Stimulate Provider Participation
Summary
On April 15, CMS released a revised version of the ESRD Seamless Care Organizations (ESCOs) Request for Application (RFA).
Please note: This is an archived post. Some of the information and data discussed in this article may be out of date. It is preserved here for historical reference but should not be used as the basis for business decisions. Please see our main Insights section for more recent posts.
The revised RFA includes major adjustments to the ESCO model based on feedback from dialysis providers and other constituents, including:
- The nephrologist and/or nephrology practice does not need to be an independent entity from the owner dialysis facility.
The guaranteed discount for large dialysis organization (LDO) ESCOs only applies to non-dialysis FFS Medicare Parts A and B spending.
CMS is no longer offering two risk track options for non-LDOs, limiting these providers to a one-sided (upside-only) risk track.
The benchmark will not be rebased in years four and five, although the ESCO contract period remains a three-year agreement with an optional fourth and fifth year.
CMMI initially intended to approve 10-15 ESCO applications for participation in Year 1 of the program, but encountered high levels of reluctance from dialysis organization due to concerns over some of the specific provisions. The revised RFA represents the Agency’s most recent attempt to further stimulate provider participation in the ESCO program, Medicare’s first disease-specific shared savings initiative.
Letters of Intent and completed applications are due on June 23 for LDO applicants and Sept. 15 for non-LDO applicants.
Rare Disease Day Webinar: Voices that move systems
Access the webinar replay offering actionable, cross-geography insights on how patient and caregiver voices can improve diagnosis, engagement, and outcomes.
Replay