# Impact of the ESRD Treatment Choices Model on Home Dialysis Uptake and Disparities

> **NIH AHRQ K08** · WEILL MEDICAL COLL OF CORNELL UNIV · 2022 · $153,876

## Abstract

PROJECT SUMMARY/ABSTRACT
 Dr. Sri Lekha Tummalapalli is a nephrologist and health services researcher whose long-term goal is to
become a leading national expert studying healthcare policies and delivery system interventions to optimize
the quality and equity of care for patients with kidney disease. If awarded, this K08 mentored career
development award will provide Dr. Tummalapalli with the necessary protected time and training to develop
into an independent physician-investigator. Dr. Tummalapalli will be mentored primarily by Dr. Lawrence
Casalino, the Livingston Farrand Professor of Population Health Sciences and an expert in alternative payment
models and the organization of the healthcare delivery system. Under the guidance of a multidisciplinary
mentorship team, Dr. Tummalapalli will engage in a rigorous training and career development plan in the
following 3 areas: (1) qualitative research for evaluating healthcare delivery systems (Dr. Lawrence Casalino),
(2) quasi-experimental research designs (Dr. Yuhua Bao) and advanced epidemiologic methods (Dr. Michelle
Estrella), and (3) the use of large claims databases to examine quality and equity of care (Dr. Sumit Mohan,
Dr. Said Ibrahim). Dr. Tummalapalli will conduct her research and training in the outstanding environment of
Weill Cornell Medicine’s Department of Population Health Sciences, surrounded by internationally recognized
experts in health services research, health economics, epidemiology, and biostatistics.
 End-stage renal disease (ESRD) requiring dialysis causes an enormous clinical and economic burden,
affecting over 550,000 Americans and costing ~$49 billion annually. Home dialysis is a preferred treatment for
ESRD, offering better quality of life than in-center hemodialysis at reduced cost. Yet, uptake of home dialysis is
low and there are stark racial/ethnic and socioeconomic disparities in uptake. There is limited understanding of
organizational structures and processes that lead to higher home dialysis uptake and reduced disparities. This
proposal applies rigorous health services research techniques to examine the ESRD Treatment Choices (ETC)
Model, a randomized alternative payment model that incentivizes home dialysis uptake. Leveraging qualitative
interviews and national large claims databases, this research aims to (1) Identify changes in structures and
processes of care in response to the ETC Model; (2) Identify facility and practice structures and processes of
care associated with home dialysis uptake; and (3) Assess the impact of the ETC Model on socioeconomic and
racial/ethnic disparities in home dialysis uptake. The knowledge gained in this project is highly likely to
influence healthcare policy and the delivery of kidney disease care on the national scale by revealing effective
structures of care, processes of care, and policy levers that increase home dialysis uptake and reduce
disparities. This work will equip Dr. Tummalapalli with the skills and research exper...

## Key facts

- **NIH application ID:** 10525495
- **Project number:** 1K08HS028684-01A1
- **Recipient organization:** WEILL MEDICAL COLL OF CORNELL UNIV
- **Principal Investigator:** Sri Lekha Tummalapalli
- **Activity code:** K08 (R01, R21, SBIR, etc.)
- **Funding institute:** AHRQ
- **Fiscal year:** 2022
- **Award amount:** $153,876
- **Award type:** 1
- **Project period:** 2022-08-01 → 2027-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10525495

## Citation

> US National Institutes of Health, RePORTER application 10525495, Impact of the ESRD Treatment Choices Model on Home Dialysis Uptake and Disparities (1K08HS028684-01A1). Retrieved via AI Analytics 2026-05-27 from https://api.ai-analytics.org/grant/nih/10525495. Licensed CC0.

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