Chronic kidney disease (CKD) and end-stage renal disease (ESRD) are both very costly and impact a significant portion of the U.S. population. Approximately 15% of adults in the United States have CKD, and ESRD treatment accounts for over 7% of Medicare spending despite affecting only 1% of Medicare beneficiaries.

The Comprehensive Kidney Care Contracting (CKCC) program is intended to reduce Medicare expenditures and improve the quality of care received by eligible Medicare beneficiaries. These beneficiaries include those with CKD stage 4 or 5 or who have ESRD and are receiving maintenance dialysis.
In this paper, we discuss the options and current landscape of the CKCC, as well as examine the key challenges faced by participating Kidney Contracting Entities (KCEs).