Home dialysis versus in-center dialysis under Medicare's ETC program
Official title: Leveraging the ESRD Treatment Choices model to understand the benefits of home versus in-center dialysis
Funded at University of Michigan at Ann Arbor · NIH-11090487 · Data updated 2026-11-12
This project looks at whether shifting more people on dialysis to treatment at home instead of at a center improves health and lowers costs.
Quick facts
| Grant type | R01 grant |
|---|---|
| Study type | NIH-funded research |
| Funding institution | University of Michigan at Ann Arbor NIH-funded |
| Lab location | 1 site (Ann Arbor, United States) |
| Project start | July 1, 2023 |
| Project end | May 31, 2027 |
| Funding year | 2025 |
| Award (this year) | $660,010 |
| NIH project number | 5R01DK134406-03 |
| Project ID | NIH-11090487 on NIH RePORTER |
Who could benefit from this research
✓Could help
Ideal candidates are U.S. adults with end-stage kidney disease receiving dialysis, especially Medicare beneficiaries treated in hospital-referral regions affected by the ETC program.
✕Less likely to help
People without kidney failure, those not on chronic dialysis, non-U.S. residents, or patients not captured in Medicare records are unlikely to receive direct benefit from this project.
What this research studies
From a patient's view, researchers are using the ESRD Treatment Choices (ETC) program — a national policy that randomly gave financial incentives to certain U.S. regions — to compare what happens when more people receive dialysis at home versus at dialysis centers. They will analyze Medicare claims and clinical records from patients in ETC-selected regions versus other regions and apply statistical methods to reduce the usual selection bias. Outcomes include survival, hospital stays, transplant rates, quality of life, and health care spending. The work is based on existing patient data and does not require individual enrollment in a new drug or device trial.
Why it matters
Potential benefit: If successful, this work could support wider access to home dialysis and lead to better health outcomes and lower costs for dialysis patients.
How similar studies have gone: Previous observational studies have suggested home dialysis is linked with better survival and lower costs but are limited by selection bias, and randomized policy-level experiments like ETC are a newer approach.
Where this research is happening
-
University of Michigan at Ann Arbor
Ann Arbor, United States Active
Researchers
- Principal investigator: Shahinian, Vahakn B — University of Michigan at Ann Arbor
- Study coordinator: Shahinian, Vahakn B
Related research
Other NIH-funded projects on the same topics.
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How dialysis facility growth affects care for people with end-stage kidney disease
New research will examine whether the spread of dialysis centers and new treatment technologies benefit patients with end-stage kidney disease, and whether benefits reach all communities.
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MOVE Trial: Tailored motivational support to help African Americans stick with dialysis
A study tests a customized motivational interviewing approach to help African American dialysis patients stay adherent to their treatment, aiming to reduce hospitalizations and improve health.
-
Blood sugar monitoring for people on maintenance dialysis
This project tests how continuous glucose monitoring can better track blood sugar in people on dialysis to improve diabetes care and prevent complications.
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Quality of life for people on home dialysis and their family caregivers
This grant studies how living with home dialysis affects daily life and the well-being of patients and their family caregivers.
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Patient-provider conversations and unequal access to home dialysis and kidney transplant
This project explores how conversations between doctors and patients affect why some Black and Hispanic people with kidney disease don’t get home dialysis or preemptive kidney transplants as often as White or Asian patients.
-
CHOOSE Home: Using community health workers to boost home dialysis and social care in CKD
A real-world trial tests adding community health workers to an interdisciplinary CKD clinic to help patients access home dialysis options.
About this research
- This is an active NIH-funded research project — typically early-stage science, not a clinical trial accepting patient enrollment.
- Some NIH-funded labs run parallel clinical studies or seek volunteers for related work. To check, contact the principal investigator or institution listed above.
- For full project details, budget, and progress reports, visit the official NIH RePORTER page.