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# CMS proposes CY2027 ESRD payment rate above $299 for the first time
- URL: https://members.americanhealthintel.com/2026-07-27-serviceline/
- Published: 2026-07-27T21:04:22.000Z
- Updated: 2026-07-27T21:04:22.000Z
- Description: Plus: Kidney Care Choices practices lose $15,000 transplant bonus. The day's rules, money, and enforcement, sourced and tiered below.
- Author: American Health Intel

Plus: Kidney Care Choices practices lose $15,000 transplant bonus. The day's rules, money, and enforcement, sourced and tiered below.

| American Health Intel Rules · Money · Medicine · Decoded daily The Service Line Monday, July 27, 2026 CMS proposes CY2027 ESRD payment rate above $299 for the first time Plus: Kidney Care Choices practices lose $15,000 transplant bonus. The day's rules, money, and enforcement, sourced and tiered below. ![](https://americanhealthintel.com/email/pulse-divider.png) Rule Confidence: High CMS, the Medicare agency, just proposed raising the dialysis payment rate to $299.55 a treatment for 2027, the first time it has climbed above $299, while reshaping how facilities get paid for new drugs. The proposal raises home dialysis training pay and adds a new post-drug-add-on payment category, projecting a 1.1% overall payment increase for dialysis facilities. Comments close August 24, 2026. Why it matters Medicare pays for the vast majority of dialysis treatments, so this rate sets the baseline economics for the whole industry; watch whether the 1.1 percent bump survives to the final rule this fall. Sources: [CMS](https://www.cms.gov/newsroom/fact-sheets/calendar-year-cy-2027-end-stage-renal-disease-esrd-prospective-payment-system-proposed-rule?ref=members.americanhealthintel.com) · [Federal Register](https://www.federalregister.gov/documents/2026/06/26/2026-12925/medicare-program-cy-2027-changes-to-the-end-stage-renal-disease-esrd-prospective-payment-system?ref=members.americanhealthintel.com) Rule Confidence: High Nephrology groups in Medicare's Kidney Care Choices model, a value-based kidney care program, just lost the $15,000 bonus they earned for every successful kidney transplant. CMS's innovation center also cut quarterly chronic kidney disease payments 50% and added a 1% benchmark discount, after the model posted $304 million in net losses model-wide. Why it matters This is a real cut to a Medicare value based kidney care program that lost money; watch how many nephrology practices stay in the model through 2027 versus shifting to MSSP ACOs. Sources: [Jonesday](https://www.jonesday.com/en/insights/2025/07/cms-updates-kidney-care-choices-model?ref=members.americanhealthintel.com) · [Hcinnovationgroup](https://www.hcinnovationgroup.com/policy-value-based-care/alternative-payment-models/news/55293311/cmmi-extends-kidney-care-choices-but-lowers-some-payments?ref=members.americanhealthintel.com) Also today California vascular access doctor settles for $6.73M [Read](https://americanhealthintel.com/editions/2026-07-27-serviceline/?utm%5Fsource=newsletter&utm%5Fmedium=email&utm%5Fcampaign=edition#serrano-vascular-access-settlement) Dialysis facility closures outpace openings for first time this decade [Read](https://americanhealthintel.com/editions/2026-07-27-serviceline/?utm%5Fsource=newsletter&utm%5Fmedium=email&utm%5Fcampaign=edition#dialysis-facility-closures) GLP-1s slow kidney decline as Medicare shifts transplant incentives to hospitals [Read](https://americanhealthintel.com/editions/2026-07-27-serviceline/?utm%5Fsource=newsletter&utm%5Fmedium=email&utm%5Fcampaign=edition#glp1-iota-transplant-incentive-tension) $1.8 billion: the operator metric for nephrology alignment deals [Read](https://americanhealthintel.com/editions/2026-07-27-serviceline/?utm%5Fsource=newsletter&utm%5Fmedium=email&utm%5Fcampaign=edition#strive-health-operator-metric) 277Records$19.0BEnforcement10Deadlines87Rules [Read this issue + the trackers](https://americanhealthintel.com/editions/2026-07-27-serviceline/?utm%5Fsource=newsletter&utm%5Fmedium=email&utm%5Fcampaign=edition) Pick your field on the site and every story tells you what it means for you. Reply to this email and tell us what you want covered. We read everything. We show our work. We score our own calls. [Track record](https://americanhealthintel.com/ledger/?utm%5Fsource=newsletter&utm%5Fmedium=email&utm%5Fcampaign=edition) · [Calendar](https://americanhealthintel.com/calendar/?utm%5Fsource=newsletter&utm%5Fmedium=email&utm%5Fcampaign=edition) · [Enforcement](https://americanhealthintel.com/enforcement/?utm%5Fsource=newsletter&utm%5Fmedium=email&utm%5Fcampaign=edition) · [X](https://x.com/amhealthintel?ref=members.americanhealthintel.com) · [LinkedIn](https://www.linkedin.com/company/american-health-intel?ref=members.americanhealthintel.com) News and analysis, not legal, medical, coding, or investment advice.You subscribed at americanhealthintel.com · [Unsubscribe](%%{unsubscribe%5Furl}%%) |
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