[Federal Register Volume 78, Number 25 (Wednesday, February 6, 2013)]
[Notices]
[Pages 8535-8536]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2013-02194]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[CMS-5506-N]
Medicare Program: Comprehensive End-Stage Renal Disease Care
Model Announcement
AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS.
ACTION: Notice.
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SUMMARY: This notice announces a request for applications from
organizations to participate in the testing of the Comprehensive End-
Stage Renal Disease (ESRD) Care Model, a new initiative from the Center
for Medicare and Medicaid Innovation (Innovation Center), for a period
beginning in 2013 and ending in 2016, with a possible extension into
subsequent years.
DATES: Letter of Intent Submission Deadline: Interested organizations
must submit a non-binding letter of intent on or before March 15, 2013.
Application Submission Deadline: Applications must be received on
or before May 1, 2013.
FOR FURTHER INFORMATION CONTACT:
Daniel Farmer, (410) 786-5497 or Email [email protected].
SUPPLEMENTARY INFORMATION:
I. Background
The Center for Medicare and Medicaid Innovation (Innovation
Center), within the Centers for Medicare & Medicaid Services (CMS), was
created to develop and test innovative health care payment and service
delivery models that show promise of reducing program expenditures,
while preserving or enhancing the quality of care for Medicare,
Medicaid, and Children's Health Insurance Program (CHIP) beneficiaries.
We are interested in identifying models designed to improve care
for specific populations. One population is beneficiaries with end-
stage renal disease (ESRD). This population has complex health care
needs, typically with comorbid conditions and disease complications,
which require extensive care coordination services. To promote seamless
and integrated care for beneficiaries with ESRD, a comprehensive care
delivery model would emphasize coordination of a full-range of clinical
and non-clinical services across providers, suppliers, and settings.
This may be best achieved through the establishment of an
interdisciplinary care team that is led by a nephrologist, comprised of
dialysis facilities, health care professionals, paraprofessionals, and
non-traditional health providers.
Through the Comprehensive ESRD Care Model, we seek to identify ways
to improve the coordination and quality of care for this population,
while lowering total per-capita expenditures to the Medicare program.
We anticipate that the Comprehensive ESRD Care Model would result in
improved health outcomes for beneficiaries with ESRD regarding the
functional status, quality of life, and overall well-being, as well as
increased beneficiary and caregiver engagement, and lower costs to
Medicare through improved care coordination.
II. Provisions of the Notice
Section 1115A of the Social Security Act (the Act), as added by
section 3021 of the Affordable Care Act, authorizes the Innovation
Center to test innovative payment and service delivery models that
reduce spending under Medicare, Medicaid or CHIP, while preserving or
enhancing the quality of care. Under this authority, we seek to test
whether establishing new incentives for dialysis facilities,
nephrologists, and other healthcare providers and suppliers to improve
the care delivered to Medicare beneficiaries living with ESRD will
result in better outcomes through the implementation of the
Comprehensive ESRD Care Model.
Under the Comprehensive ESRD Care Model, CMS will enter shared
financial risk arrangements through ``Participation Agreements'' with
organizations comprised of dialysis facilities, nephrologists, and
other Medicare providers and suppliers. Participating organizations
will be clinically and financially accountable for care provided to a
group of beneficiaries with ESRD that will be attributed to these
organizations based on the beneficiaries' historical and ongoing care
patterns. Those organizations that are successful in improving
beneficiary outcomes and lowering per capita Medicare Parts A and B
expenditures will be able to share in Medicare savings generated.
However, those organizations that do not improve outcomes and lower
costs may be subject to losses. Final shared savings amounts and shared
loss amounts will be based on the organization's performance on
specified quality measures.
Organizations interested in applying to participate in the testing
of the Comprehensive ESRD Care Model must submit a non-binding letter
of intent and an application. Applications will not be accepted from
organizations that did not submit a letter of intent. The letter of
intent and application must be received by the dates specified in the
DATES section of this notice.
For additional information on the Comprehensive ESRD Care Model and
how to apply, click on the Request for Applications located on the
Innovation Center Web site at: innovation.cms.gov/initiatives/comprehensive-ESRD-care.
III. Collection of Information Requirements
Section 1115A(d)(3) of the Act, as added by section 3021 of the
Affordable Care Act, states that Chapter 35 of title 44, United States
Code (the Paperwork Reduction Act of 1995), shall not apply to the
testing and evaluation of models or expansion of such models under this
section. Consequently, it need not be reviewed by the Office of
Management and Budget under the authority of the Paperwork Reduction
Act of 1995.
[[Page 8536]]
(No. 93.773 Medicare--Hospital Insurance Program; and No.
93.774, Medicare-Supplementary Medical Insurance Program)
Dated: January 25, 2013.
Marilyn Tavenner,
Acting Administrator, Centers for Medicare & Medicaid Services.
[FR Doc. 2013-02194 Filed 2-4-13; 4:15 pm]
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