Table 2.

Key elements of a proposed shared accountability model for ESRD health care delivery

Patient PopulationGeographic RegionsOutcome MeasuresHealth Care ProvidersRegulatory Agencies
All patients with ESRDESRD network regionsAll-cause mortalityDialysis centersHHS
Patients with ESRD and age limits (e.g., <70 yr old)UNOS regionsHospitalization ratesPrimary providersCMS
Patients with ESRD without objective contraindications to transplantationDonor service areasPatient-reported outcomesKidney transplant centersUNOS
Neighborhoods with regional divisions to be determinedCost-effectiveness/value of careOrgan procurement organizationsHRSA
Time to placement on a waiting list or transplantationPrivate payers
Time to transplantation
  • HHS, Health and Human Services; UNOS, United Network for Organ Sharing; CMS, Centers for Medicare and Medicaid Services; HRSA, Health Resources and Services Administration.