The End-Stage Renal Disease (ESRD) Treatment Choices Model (ETC Model), a mandatory payment model that begins on January 1, 2021, is intended to reduce Medicare expenditures by encouraging greater use of home dialysis and kidney transplants, while also maintaining or improving the patient’s quality of care. One of the goals of the ETC Model is also to give ESRD patients the freedom and choice of ESRD treatment that best works with their lifestyles. The ETC Model will require the Medicare payment adjustments for the selected ESRD facilities and managing clinicians.