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As CKCC nears its sunset, kidney care leaders urge CMS to preserve a dedicated, nephrologist-led accountable care model for advanced kidney disease.
In 2027, Medicare will enter an important transition in its continued evolution toward accountable care. The Long-term Enhanced Accountable Care Organization Design (LEAD) Model will begin a 10-year test intended to make accountable care more stable, inclusive, and responsive to patients with complex needs.
Additionally, next year the Comprehensive Kidney Care Contracting (CKCC) Model, Medicare’s principal accountable care model for people with advanced kidney disease, is scheduled to sunset. The Centers for Medicare & Medicaid Services (CMS) has not announced whether accountable kidney care will continue through an extension, a successor model, or a defined specialty track within LEAD.
The parallel timing of LEAD and CKCC allows CMS to preserve and strengthen accountable kidney care, just as LEAD builds on lessons from nearly 15 years of primary care–based accountable care models. As CMS designs the next generation of accountable care, it must preserve a dedicated model for kidney care. The clinical improvements achieved through CKCC, combined with CMS’s recent financial reforms, make a strong case for building on the model. Allowing it to end without a successor risks losing the clinical infrastructure and provider investments built over the life of the model.
Patients with advanced chronic kidney disease (CKD) and end-stage renal disease (ESRD) are among Medicare’s most clinically complex beneficiaries. They frequently live with multiple chronic conditions, experience 1.5 hospitalizations per person-year,3 and require intensive care coordination across providers and care settings.