How payment incentives affect access to home dialysis and kidney transplant
Official title: Impact of Randomized Payment Incentives on Disparities in Home Dialysis and Kidney Transplantation
Funded at Brown University · NIH-11242046 · Data updated 2026-11-12
This project looks at whether changing how dialysis centers are paid helps more patients—especially Black, Hispanic, Native American, and low-income people—get home dialysis or kidney transplants.
Quick facts
| Grant type | R01 grant |
|---|---|
| Study type | NIH-funded research |
| Funding institution | Brown University NIH-funded |
| Lab location | 1 site (Providence, United States) |
| Project start | February 9, 2022 |
| Project end | November 30, 2026 |
| Funding year | 2026 |
| Award (this year) | $613,551 |
| NIH project number | 5R01MD017080-05 |
| Project ID | NIH-11242046 on NIH RePORTER |
Who could benefit from this research
✓Could help
Ideal candidates are U.S. adults with kidney failure who receive care at dialysis centers affected by the CMS payment program, especially Black, Hispanic, Native American, and low-income patients.
✕Less likely to help
Patients not treated at U.S. dialysis centers subject to the CMS program (for example, those entirely outside Medicare) or people without kidney failure are unlikely to be directly affected.
What this research studies
As a patient with kidney failure, this project compares dialysis centers that were randomly given extra payment incentives to those that were not. Researchers will use national Medicare and clinical data to see whether more people start home dialysis or receive kidney transplants where incentives were offered. The team will focus on whether these payment changes reduce racial and income-related gaps in who gets home dialysis or transplants. They use statistical methods designed to separate the effect of the payment policy from other factors that might influence care.
Why it matters
Potential benefit: If successful, the work could guide payment policies that increase use of home dialysis and transplants and help reduce racial and socioeconomic disparities in kidney failure care.
How similar studies have gone: Observational studies suggest payment incentives can raise home dialysis rates, but randomized, causal evidence on overall effects and impacts on disparities is limited.
Where this research is happening
-
Brown University
Providence, United States Active
Researchers
- Principal investigator: Trivedi, Amal N. — Brown University
- Study coordinator: Trivedi, Amal N.
Related research
Other NIH-funded projects on the same topics.
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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.
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Effects of payment incentives on access to home dialysis and kidney transplants
This study is looking at how offering financial rewards to dialysis centers and doctors can help more people, especially those from disadvantaged backgrounds, get access to home dialysis and kidney transplants when they have kidney failure.
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Understanding challenges and supports for home dialysis and kidney transplants in young people
This study is looking at what makes it easier or harder for teens and young adults to get home dialysis and kidney transplants from living donors, so we can find ways to improve their care and help more young people get the treatment they need.
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Strategies for HIV-to-HIV kidney transplants to increase organ donations
This project looks at making HIV-to-HIV kidney transplantation more common to help people with HIV get transplants faster by boosting organ donation and changing practice.
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Biomarker-guided Immunosuppression in Kidney Transplant Patients
A multicenter study in kidney transplant recipients is testing whether a biomarker score from HLA-DR/DQ can guide changes in immunosuppression to reduce rejection risk and drug toxicity.
-
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This project will try giving specially treated donor B cells alongside immune-sparing medicines to teach the immune systems of kidney transplant patients without prior antibodies to accept the new kidney.
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.