Author Interviews, Cost of Health Care, JAMA, Kidney Disease, Transplantation / 01.07.2024
Brown University Study Finds No Increase in Home Dialysis or Kidney Transplantation with Government’s Pay-For-Performance Program
MedicalResearch.com Interview with:
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Prof. Trivedi[/caption]
Amal Trivedi, MD, MPH
Professor of Health Services, Policy & Practice
Brown University School of Public Health
MedicalResearch.com: What is the background for this study?
Response: On January 1st, 2021, the Centers for Medicare & Medicaid Services (CMS) launched the mandatory End-Stage Renal Disease Treatment Choices (ETC) Model, which randomly assigned approximately 30% of U.S. dialysis facilities and managing clinicians to financial incentives to increase the use of home dialysis and kidney transplantation. The program is set to run through 2027, with financial incentives and penalties increasing as the model progresses.
Our study sought to assess the ETC’s effect on these outcomes of interest in the first two years, as well as to examine outcome changes by race, ethnicity and socioeconomic status.
Prof. Trivedi[/caption]
Amal Trivedi, MD, MPH
Professor of Health Services, Policy & Practice
Brown University School of Public Health
MedicalResearch.com: What is the background for this study?
Response: On January 1st, 2021, the Centers for Medicare & Medicaid Services (CMS) launched the mandatory End-Stage Renal Disease Treatment Choices (ETC) Model, which randomly assigned approximately 30% of U.S. dialysis facilities and managing clinicians to financial incentives to increase the use of home dialysis and kidney transplantation. The program is set to run through 2027, with financial incentives and penalties increasing as the model progresses.
Our study sought to assess the ETC’s effect on these outcomes of interest in the first two years, as well as to examine outcome changes by race, ethnicity and socioeconomic status.
Dr. Wong[/caption]
Susan P. Y. Wong, MD MS
Assistant Professor
Division of Nephrology
University of Washington
VA Puget Sound Health Care System
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Very little is known about the care and outcomes of patients who reach the end stages of kidney disease and do not pursue dialysis. We conducted a systematic review of longitudinal studies on patients with advanced kidney disease who forgo dialysis to determine their long-term outcomes.
We found that many patients survived several years and experienced sustained quality of life until late in the illness course. However, use of acute care services was common and there was a high degree of variability in access to supportive care services near the end of life.








