Signals Brief: What To Know About The Increasing Organ Transplant Access (IOTA) Model

Hi friends and fellow explorers,

We're back to our regularly scheduled Sunday morning Signals! With the NKF spring clinical meeting coming up this week and ATC just 3 weeks away, I know these next few Sundays will be filled with packing, traveling, and a fair amount of screentime. Here's a full list of 2024 conferences we're tracking.

Wherever you're headed, and whoever you're meeting at these events, I've got you covered. Some might say we are the "Dunkin' of kidney-themed media companies" in a lot of ways. The Kidneyverse runs on Signals. ???

Speaking of which, it turns out Signals is making waves in boardrooms, slack channels, investor diligence, and across the conference circuit. This is music to my ears??. So, if you want your company to pay for full access to every Signal and our data room, we put together this email template to help you ask your manager to expense a subscription for $4 per month. It's a great investment in you, and clear ROI for your company.

Without further ado, let's get on with this week's update.

Reading time: 6 minutes.

Background

On Wednesday, the Centers for Medicare & Medicaid Services (CMS) announced the Increasing Organ Transplant Access (IOTA) Model. The proposed model aims to increase access to kidney transplants for all people living with end-stage renal disease (ESRD), improve the quality of care for people seeking kidney transplants, reduce disparities among individuals undergoing the process to receive a kidney transplant, and increase the efficiency and capability of transplant hospitals selected to participate.

This proposed model would build on the Biden-Harris Administration’s priority of improving the kidney transplant system and the collaborative efforts between CMS and the Health Resources and Services Administration (HRSA) to increase organ donation and improve clinical outcomes, system improvement, quality measurement, transparency, and regulatory oversight. HRSA is taking transformational steps to modernize the critical organ matching technology while increasing transparency and accountability by issuing new data reporting requirements to better address pre-waitlist and organ procurement practices, which will help address inequities in the transplant waitlist process by reducing racial and ethnic variation both in patient referrals and in organ procurement.

The IOTA model also aligns with the HHS Organ Transplant Affinity Group’s initiatives to increase transplantation access through payment, quality, and regulatory efforts.

Model Aims

The model would be implemented by the CMS Innovation Center and run for six years, beginning January 1, 2025, with the aim to:

• Increase access to kidney transplants for people living with end-stage renal disease.
• Improve the quality of care for people seeking kidney transplants.
• Reduce disparities in kidney transplantation.
• Increase the efficiency and capability of transplant hospitals selected to participate.

Transplant hospitals assigned to participate in the model would be assessed on how well they increase the number of transplants, improve equity in the transplant process, increase organ acceptance rates, and improve post-transplant outcomes.

An Unmet (and Growing) Need

Kidney transplantation is the best treatment for most individuals with ESRD, a condition that occurs when the kidneys are no longer able to function properly. People with ESRD who receive transplants have better outcomes than people who receive dialysis, improvements in quality of life, and are freed from lengthy and burdensome dialysis treatments.

However, the scarcity of organs, particularly for kidney transplants, leads to increased patient mortality and a significant gap between demand and supply. Despite this scarcity, approximately 30% of donor kidneys go unused annually, highlighting gaps in procurement, distribution, and utilization. Prolonged waiting times, averaging three to five years or more, intensify patient suffering. With just over 28,000 kidney transplants performed in 2023 and more than 90,000 people on a waitlist during that same time, urgent measures are needed to improve the efficacy and efficiency of the system...

...

To continue reading this article and to access my full list of relevant resources, reports, and data, head over to the Signals From [Space] website.

Discussion

This week's Signals Poll asks which VBC outcome you find MOST meaningful when it comes to clinical and financial metrics. It's open all week, so please add your two cents! Here's what people are saying so far:

What are you seeing and hearing in this space right now? We will use the full post and updated VBC graphic (coming soon!) to expand on new additions and momentum changes.

Community Voices

A few posts and conversations to amplify here this week.

First, Amber Paulus, PhD, RN shared several great graphics and posts breaking down the IOTA model, its purpose, and how it compares to existing models like ETC. The graphic below is one example of the type of great content she shares on these topics as a kidney health researcher and thought leader in this space.

For those following the latest VBC and CKCC news, this comment thread is an insightful collection of diverse POVs on what's happening in the space. It includes both high-level guiding wisdom and in-the-weeds candor on what it takes to participate in these models. Thanks to Nishant Jalandhara for starting this conversation.

Want to support my work?

I started writing Signals and organizing the Kidneyverse in hopes of bringing attention to the innovators and investors building the future of kidney care. The updates above are small examples of that mission in action, and seeing it come to life is a source of incredible meaning and joy. Thank you for being a part of it.

• ?? Ask your manager to expense Signals today!
• ?? Share Signals with your friends & network
• ?? Give a gift subscription to fellow innovators
• ?? Share anonymous tips and news with me

Thank you for reading Signals. If this one resonate with you, I'd love to hear from you! Leave a comment below, or join our subscriber-only chat, and let us know what's on your mind and where we should explore next.

— Tim