CMS penalized clinics in ESRD demonstration with patients at greater social risk


A study found that dialysis clinics treating patients with high social risk faced higher financial penalties in the ESRD Treatment Choices model. CMS levied fines for poor performance in the first year of its ESRD Treatment Choices model against dialysis clinics with higher proportions of patients at social risk. The model includes dialysis facilities and clinicians who receive performance-based payment adjustments based on increasing the number of patients using home dialysis and transplants. This could create an imbalance in facilities treating patients with and without social risks, raising concerns about social inequities and financial penalties for clinics caring for marginalized populations. The study suggests adding the area deprivation index to the performance payment model to promote facility-level reimbursement equity.

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