Cohort Selection
ESRD
RENAL, ESRD, KIDNEY FAILURE, END STAGE RENAL DISEASE
In this cohort study, we used data from the US Renal Data System to identify adults (age ≥18 years) who initiated dialysis treatment between January 1, 2016, and June 30, 2022, based on information from the End Stage Renal Disease (ESRD) Medical Evidence Report (Form CMS 2728). We excluded patients with a prior kidney transplant or missing dialysis facility zip code. We further excluded patients being institutionalized or receiving dialysis in a skilled nursing or long-term care facility as the primary dialysis setting. The study was reviewed by the Advarra Institutional Review Board and was exempt from review and the requirement for informed consent according to 45 CFR 46.104. This report follows the Strengthening the Reporting of Observational Studies in Epidemiology (The ETC payment model was proposed in July 2019, but the federal government did not release further information about the model until finalizing its specifications in September 2020, at which time participating markets were announced. Health care was disrupted by the COVID-19 pandemic in 2020. Implementation of ETC was thus delayed, and there was a transient but substantial decrease in all incident patients with kidney failure.