"Fistula First" as a CMS breakthrough initiative: improving vascular access through collaboration.

The arteriovenous fistula is the "gold standard" for ESRD vascular access, and, after the initial success of the ESRD Network national vascular access improvement initiative, CMS adopted "Fistula First" as a formal CMS Breakthrough Initiative. A formal coalition has been formed from members of the renal stakeholder community, and five task force groups are currently addressing various issues and aspects of the health care system surrounding successful arteriovenous fistula placement.