A New Way to Get More Kidneys to the People Who Need Them
Getting a kidney transplant in the United States has often felt like a slow and confusing process. Thousands of people wait for years, while many kidneys that could save lives end up being thrown away. To fix this, the government and the National Kidney Foundation are backing a new plan called the IOTA Model. This program aims to change the rules so that more patients get their second chance at life sooner.
What is the IOTA Model?
The Increasing Organ Transplant Access (IOTA) Model is a six-year project from the Centers for Medicare and Medicaid Services (CMS). It officially started in 2025, but new updates this week show how it is already changing the system. Instead of just paying hospitals for each surgery, this plan gives them financial rewards if they successfully transplant more kidneys and keep their patients healthy afterward.
About 100 hospitals across the country are part of this mandatory program. If a hospital does a great job of finding matches and reducing wait times, they can earn a bonus of up to $15,000 per transplant. If they fall behind or are too slow to accept available organs, they might have to pay a penalty. This creates a strong reason for hospitals to be more efficient and proactive.
Stopping the Waste of Life-Saving Organs
One of the biggest problems in the current system is the “discard rate.” Right now, nearly 30% of kidneys recovered from donors are never used. Sometimes this happens because a kidney is not “perfect” or because the hospital takes too long to decide. For a person on the waiting list, a kidney that is slightly older or less than perfect is often a much better choice than staying on dialysis for another five years.
The IOTA Model encourages “shared decision-making.” This means doctors and patients talk openly about the risks and benefits of different organs. Instead of a hospital rejecting a kidney on behalf of a patient, the patient gets to help decide. This change is vital because roughly 14 people die every single day while waiting for a transplant.
Why the National Kidney Foundation is On Board
The National Kidney Foundation (NKF) recently shared its support for the transparency parts of this new policy. They believe that patients deserve to know exactly how the system works and where they stand on the list. Kevin Longino, the CEO of the National Kidney Foundation, has been a vocal supporter of these improvements.
“There are some major wins in the just passed FY2026 Federal Budget for the 37 million Americans living with kidney disease and the thousands more waiting for a second chance at life through transplantation,” Longino said.
He also pointed out that the new rules make it easier for living donors to give the gift of life without worrying about the costs. By removing financial barriers and making the process more open, the goal is to make the system fairer for everyone, regardless of their background or income.
Comparing the Old System to the IOTA Model
To understand why this matters, it helps to see how the rules are shifting.
| Feature | The Old Way | The IOTA Model Way |
| Focus | Volume of surgeries | Quality, efficiency, and equity |
| Organ Usage | High discard rates for “imperfect” kidneys | Incentives to use every viable organ |
| Patient Role | Doctors often decide which organs to skip | Shared decision-making between patient and doctor |
| Hospital Rewards | Standard fee-for-service | Bonuses for high performance and better care |
This policy is not just about numbers or money. It is about the thousands of families who are waiting for a phone call that says a match has been found. By making the transplant process more transparent and encouraging hospitals to take fewer risks with perfectly good organs, the IOTA Model is designed to save lives.
For those living with kidney disease, this shift offers a sense of hope. It moves the focus away from just managing the disease with dialysis and toward the real goal: getting a transplant and returning to a normal life. As the program continues through 2031, it could set a new standard for how all organ transplants are handled in the United States.
Disclaimer: The information provided in this article is for general informational and educational purposes only. It is not intended to be a substitute for professional medical advice, diagnosis, or treatment. While the details regarding the IOTA Model and federal policies are based on official government reports and statements from the National Kidney Foundation as of February 2026, medical regulations and healthcare policies are subject to change.
