The Centers for Medicare and Medicaid Services (CMS) recently announced the premature end of the End-Stage Renal Disease Treatment Choices (ETC) model, a pioneering experiment aimed at revolutionizing dialysis care in the United States. The decision to terminate the program, scheduled for December 31, comes after an evaluation of its effectiveness and impact on patient outcomes.
Led by Mehmet Oz and administered by the CMS Innovation Center, the ETC model sought to incentivize healthcare providers to transition more patients with end-stage kidney disease to home dialysis and facilitate the transplant process. This ambitious initiative involved the participation of 30% of the country’s dialysis providers, making it the largest experiment of its kind in American healthcare history.
Despite high hopes and significant investments, the ETC model failed to demonstrate tangible benefits in its initial phase. Data analysis conducted after the first year of implementation revealed no significant increase in the number of patients opting for home dialysis or undergoing transplant procedures. Subsequent studies conducted last summer reaffirmed these findings, indicating that providers enrolled in the new payment model did not achieve higher rates of home dialysis or transplantation compared to their counterparts in the control group.
The decision to terminate the ETC model underscores the challenges and complexities involved in transforming dialysis care delivery and improving patient outcomes. While the experiment’s objectives were noble and its scope unprecedented, the lack of demonstrable impact raises questions about the efficacy of financial incentives in driving meaningful change in the dialysis landscape.
Moving forward, stakeholders in the healthcare industry must reflect on the lessons learned from the ETC model and explore alternative strategies to enhance dialysis care and promote patient well-being. By leveraging innovative technologies, fostering interdisciplinary collaborations, and prioritizing patient-centered approaches, the healthcare community can strive towards a future where individuals with end-stage kidney disease receive optimal care and support throughout their treatment journey.

