The Comprehensive ESRD Care (CEC) Model was designed to identify, test, and evaluate new ways to improve care for Medicare beneficiaries with End-Stage Renal Disease (ESRD). Through the CEC Model, CMS partnered with health care providers and suppliers to test the effectiveness of a new payment and service delivery model in providing beneficiaries with person-centered, high-quality care. The Model was built on Accountable Care Organization experience from the Pioneer ACO Model, Next Generation ACO Model, and the Medicare Shared Savings Program to test Accountable Care Organizations for ESRD beneficiaries.
In the CEC Model, dialysis clinics, nephrologists and other providers joined together to create an ESRD Seamless Care Organizations (ESCO) to coordinate care for matched beneficiaries. ESCOs were accountable for clinical quality outcomes and financial outcomes measured by Medicare Part A and B spending, including all spending on dialysis services for their aligned ESRD beneficiaries. This model encouraged dialysis providers to think beyond their traditional roles in care delivery and supports them as they provide patient-centered care that address beneficiaries’ health needs, both in and outside of the dialysis clinic.
The CEC Model began October 2015 and ended March 31, 2021. ESCOs had the option to end December 31, 2020 or extend until March 31, 2021. The CEC Model conducted a solicitation in 2016 to add more ESCOs. These ESCOs started in Performance Year (PY) 2 of the model on January 1, 2017.
The Public Use Files (PUFs) include summary data on the characteristics of the population attributed to an ESCO and the providers affiliated with an ESCO without disclosing sensitive identifiers. It also provides summary data on financial performance including the baseline and benchmark expenditure of each ESCO and the shared savings (or loss). These files do not contain Personally Identifiable Information (PII) or Protected Health Information (PHI) in order to protect beneficiary confidentiality. Data dictionaries are provided in the PUF.
For more information, please visit the CEC Model website at https://innovation.cms.gov/innovation-models/comprehensive-esrd-care.
Questions about the Comprehensive ESRD Care Model can be sent to ESRD-CMMI@cms.hhs.gov.