For providers managing patients with chronic kidney disease (CKD), the complexity of care is undeniable. You balance clinic visits, dialysis schedules, medication reconciliation, comorbidities, and lifestyle interventions, all while navigating a fragmented healthcare system. Traditional care models often fall short in supporting the long-term needs of these patients.

The Kidney Care Choices (KCC) Model, introduced by CMS, was designed to address these challenges. It promotes greater care coordination, earlier treatment interventions, and expanded patient options, including home dialysis and kidney transplantation.

Unlike one-size-fits-all care, KCC emphasizes collaboration between nephrologists, dialysis organizations, and health systems—rewarding practices that deliver higher-quality, patient-centered care.

Why CMS Created the KCC Model

Kidney disease remains one of the highest-cost and most burdensome chronic conditions in Medicare. The KCC Model was created to:

• Encourage earlier-stage CKD management before patients reach dialysis.  
• Expand access to kidney transplants and home dialysis options.  
• Improve patient quality of life while reducing costly hospitalizations.  
• Incentivize nephrologists and health systems for outcomes, not volume.

For providers, the model directly ties financial rewards to quality metrics, cost containment, and care coordination success.

How Does the Kidney Care Choices Model Work?

The program organizes care delivery under Kidney Contracting Entities (KCEs). These groups—composed of nephrologists, dialysis clinics, hospitals, and transplant centers—share accountability for the outcomes and costs of attributed patients.

Here’s how it works:

1. Providers Sign Up
   Practices, hospitals, and dialysis partners collaborate under the KCE structure. This requires shared responsibility and data transparency across all care team members.  

2. Patients Are Assigned
   Medicare attributes eligible patients with CKD stage 4–5 or ESRD to KCEs automatically, ensuring consistent alignment with participating providers.  

3. Care Coordination Happens
   With the growing role of digital health, platforms like TelliHealth make it easier for patients to stay connected to their care teams remotely. Patients receive access to a dedicated care manager, along with support from nutritionists, transplant educators, and digital health tools like remote monitoring platforms. The goal is to reduce complications and empower patients with proactive care.  

4. Financial Incentives Kick In
   Unlike fee-for-service, the KCC Model rewards providers for improved outcomes. Shared savings are generated when patients avoid hospitalizations, transition successfully to home dialysis, or receive kidney transplants.  

5. Patient-Centered Care is Delivered
   The outcome is team-based, proactive, and individualized care that prevents complications, enhances quality of life, and aligns with value-based goals.

Benefits of the KCC Model

For Patients:

• Greater education on CKD progression and treatment options.  
• More choices, including home dialysis and transplant pathways.  
• Better continuity of care, avoiding fragmented management.  
• Improved quality of life through fewer emergency visits and hospitalizations.

For Providers:

• Financial Rewards – Shared savings tied directly to clinical performance.  
• Team-Based Collaboration – Physicians, nurses, and specialists work together seamlessly.  
• Cost Reduction – Avoiding costly complications and unplanned hospitalizations.  
• Patient Trust and Satisfaction – Coordinated care leads to stronger provider-patient relationships.

Challenges Providers Should Consider

The KCC Model presents opportunities, but also operational challenges:

• Complexity – Coordinating across multiple organizations, payers, and care teams can be demanding.  
• Provider Readiness – Smaller clinics may lack infrastructure for reporting and compliance.  
• Patient Awareness – Many patients need education about program benefits.  
• Financial Risks – Providers share downside risk if quality and cost outcomes are not achieved.  
• Cultural Shifts – Moving from dialysis-centered to prevention-first care requires mindset and workflow change.

Why the KCC Model Matters for Providers

Kidney disease is often a “silent” condition, with many patients diagnosed late, when little can be reversed. By shifting incentives toward prevention, earlier intervention, and patient choice, the KCC Model transforms how nephrology practices approach care.

For providers, it represents:

• A path to stronger value-based performance.  
• Opportunities for financial growth tied to outcomes.  
• Improved patient adherence, satisfaction, and trust.

While the model carries complexity, its direction is clear: kidney care is moving toward proactive, coordinated, value-based delivery. For nephrology practices, participation in KCC offers a chance to lead this transformation and deliver better outcomes for patients.