The Centers of Medicare & Medicaid Services (CMS) has consistently stated that it does not anticipate approving specialty accountable care organizations.  Thus it is no surprise that CMS has been reluctant to call the new ESRD Seamless Care Organization (ESCO) a "renal ACO" or "renal accountable care organization" and in many ways the new program does differ from the ACO shared savings program.   Like many U.S. healthcare sectors, various players within the continuum of care are exploring ways to affiliate to lower costs and enhance quality.  The ESCO is surely an option that dialysis companies and nephrologists will investigate, although it remains to be seen how viable the program truly is.

In a recent publication, our McGuireWoods colleagues Jim Riley, Jason Greis and Scott Downing, describe the ESCO and the new CMS pilot program to test the renal coordinated care concept.