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Previously, most Medicare beneficiaries with ESRD were only permitted to enroll in traditional Medicare. The purpose of our study was to determine how MA plans responded to this policy change. We conducted 48 interviews with representatives from MA plans, dialysis provider organizations, and chronic kidney disease (CKD) care management companies. One major theme that emerged from our interviews was MA plans partnered with CKD care management companies to manage the care of ESRD patients. Plans partnered because they had little experience with and were wary of the costs of this population, and sought to improve the value and quality of services. MA plans varied in how they contracted with these organizations, and the CKD care management companies employed several methods for managing patients. 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