IOTA
Increasing Organ Transplant Access Model
The Increasing Organ Transplant Access (IOTA) Model aims to increase access to life-saving kidney transplants for patients living with end-stage renal disease (ESRD). It incentivizes kidney transplant hospitals to improve their care delivery capabilities and efficiency, and supports greater care coordination in the organ transplant waitlist process.
Innovation
Implements performance-based payments separate from standard Medicare IPPS/OPPS payments, utilizing upside and downside risk based on achievement, efficiency, and quality domains.
The Problem
Kidney transplantation is the best treatment for most patients with chronic kidney disease and ESRD, but there are far more people in need of a kidney than there are organs available. Many people die every day while waiting for a kidney transplant.
The Solution
The IOTA Model provides incentives for kidney transplant hospitals to increase the number of kidney transplants, by maximizing the use of deceased donor kidneys and facilitating more transplants from living donors and improving the process and quality of care for people awaiting treatment.
Expected Outcomes
Improving the transplant system helps patients with chronic kidney disease access life-saving, high quality treatment resulting in optimal long-term health outcomes and reducing Medicare spending.
Strategy
The IOTA Model demonstrates the critical impact of receiving high value care to promote healthier living and drive down long-term medical expenses.
Model Goals
- Encouraging transplant hospitals to use more available kidneys
- Reducing the number of discarded kidneys
- Supporting and educating potential living donors
- Improving care coordination and patient-centered care
- Enhancing the quality of care before, during, and after receiving a transplant
Patient Eligibility
Patients 18 years of age or older who are registered on a kidney transplant waitlist or who receive a kidney transplant from an IOTA participant.
- Alive at the time CMS conducts attribution
- 18 years of age or older
- Registered on a kidney transplant waitlist or receives a kidney transplant from an IOTA participant
Provider Eligibility
Kidney transplant hospitals located in selected donation service areas (DSAs) that meet a minimum volume threshold.
- Located in one of the selected donation service areas (DSAs)
- Performed 11 or more kidney transplants for patients aged 18 years or older in each of the baseline years
Care Categories
Organ Transplantation
CMS Benchmarks & Thresholds
eligibility
financial
operational
population
quality
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