The Kidney Transplant Collaborative (KTC), a leader in transforming access to kidney transplants through national advocacy and education regarding the Increasing Organ Transplant Access (IOTA) Model, applauds the Centers for Medicare and Medicaid Innovation’s (CMMI) 2025 Strategy to Make America Healthy Again, and for their continued commitment to value based care and model improvement. This is particularly the case with regards to CMMI’s efforts to address America’s ongoing End-Stage Renal Disease (ESRD) crisis. 

CMMI recently announced the elimination of the Kidney Care Choices (KCC) Model’s bonus for attributed beneficiaries receiving a functioning kidney transplant. While this change marks a shift in incentives structure, KTC firmly believes it is essential to spotlight the opportunity now available via the IOTA model, a more recent, mandatory CMMI model scheduled to begin imminently on July 1, 2025. The IOTA model encourages selected Transplant Centers to form partnerships with key providers in their service area to include referring nephrologists. These are referred to as IOTA Collaborators in the model and allow the selected providers to partner with the Transplant Center to help them achieve their Performance Payment goals which is driven by increasing kidney transplants. KTC urges nephrologists and transplant centers who are able to operate under the IOTA model to pursue such partnerships.

“We thank CMMI for laying the groundwork through both the KCC and IOTA models. As incentives shift, IOTA provides a strong path forward for transplant centers and nephrologists to work together in expanding access to transplants,” said Dr. Andy Howard, MD, FACP, Chairman of the Kidney Transplant Collaborative. “This model builds on past progress and provides an opportunity for both transplant centers and nephrologists to take an active role in advancing transplant care.”

The IOTA model focuses on transplant centers and provides meaningful financial incentives such as the transplant center’s Positive Performance Payments bonuses. The model is primarily driven by increasing kidney transplants. CMMI is paving the way for kidney transplant program innovation by placing these incentives in both their prior KCC model and the new IOTA model. 

The KCC model demonstrated extraordinary success in the first two payments years through 2023, having seen an increase in preemptive kidney transplants by 69% and increasing all living donor transplants by 22%¹. Now, the IOTA model is in place to build upon this extraordinary success, and with the KTB ending in the KCC model after January 1, 2026, it presents a timely and important opportunity for nephrologists to align with transplant centers to drive better outcomes and receive meaningful incentives.

¹Centers for Medicare & Medicaid Services. Kidney Care Choices (KCC) Model: Payment Year 2023 Final Evaluation Report. The Lewin Group, 2024. Available at: CMS.gov – KCC Model

About the Kidney Transplant Collaborative

The Kidney Transplant Collaborative (KTC) is a 501(c)(4) nonprofit organization dedicated to increasing kidney transplants and eliminating financial and logistical barriers for kidney patients, donors, and their families. Unlike other initiatives, KTC is specifically focused on increasing the number of living donor transplants in the United States through policy advocacy, education, and community organizing. For more details, visit www.kidneytransplantcollaborative.com.