Federal Kidney Care Payment Reforms and Transplant Policy Changes Shape 2026 Coverage Landscape

CMS is overhauling kidney care through transplant system modernization, new organ procurement standards, and the mandatory IOTA Model launched in mid-2025, while simultaneously sunsetting underperforming value-based care models like ESRD Treatment Choices. The piece examines how federal payment reforms, emerging xenotransplant technology, and refined Kidney Care Choices models are reshaping the dialysis and transplant ecosystem. While primarily Medicare-focused, these structural changes affect Medicaid managed care plans covering dual-eligible populations and states with integrated care models for members with end-stage renal disease.

Managed Care · Finance

This is outside commentary from Avalere, not part of Medicaid Monitor's independently scored news coverage.

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