The Centers for Medicare & Medicaid Services (CMS) anticipates a delayed start date for the Increasing Organ Transplant Access (IOTA) Model, originally slated to start Jan. 1, 2025, because the agency is still working on the final rule.
The proposed mandatory model aims to increase access to kidney transplants for individuals living with end-stage renal disease, improve the quality of kidney transplant care, reduce disparities among kidney transplant patients, and increase the efficiency of selected transplant hospitals.
Selected transplant hospitals would be eligible for upside or downside risk payments based on a final performance score calculated on metrics in three proposed domains:
- Achievement (number of adult kidney transplants)
- Efficiency (organ offer acceptance rate ratio)
- Quality (post-transplant outcomes)
Participation would be mandatory for nonpediatric transplant hospitals within selected donor service areas (DSAs) with an active kidney transplant program that performed 11 or more kidney transplants annually over a three-year period. CMS has stated that DSAs will be selected at random but has not yet selected DSAs. Out of 257 transplant hospitals, 90 (35 percent) of hospitals must participate. Transplant hospitals not selected would serve as a comparison group for evaluation purposes.
The association submitted comments to CMS in July on the proposed IOTA Model rule, urging the agency to consider the unique role that essential hospitals play in providing transplant care to underserved populations.
Contact Director of Policy Rob Nelb, MPH, at rnelb@essentialhospitals.org or 202.585.0127 with questions.
Author