Dialysis Bundling | Medicare Payments for Dialysis to be Bundled
"Bundling" is the term used by the Centers for Medicare & Medicaid Services payments for new single payment for all services related to an outpatient dialysis session. The rule would establish a base bundled payment rate and adjust it for case-mix factors such as the patient's age, gender, body size and time on dialysis.
Additional adjustments would be made for co-existing medical conditions and high-cost cases, as well as geographic differences in labor costs and low-volume facilities. The new payment system would apply to dialysis services provided to Medicare beneficiaries with end-stage renal disease effective Jan. 1, 2011.
The rule also proposes three quality measures and a conceptual model for a quality incentive program for dialysis services and providers beginning in calendar year 2012.
Hemodialysis.com will provide ongoing abstracts and articles related to bundling issues with links to the references below.
Medicare Bundling Payments for Hemodialysis and Dialysis
J Am Soc Nephrol. 2012 Jun 7. [Epub ahead of print]
Vanholder R, Davenport A, Hannedouche T, Kooman J, Kribben A, Lameire N, Lonnemann G, Magner P, Mendelssohn D,Saggi SJ, Shaffer RN, Moe SM, Van Biesen W, van der Sande F, Mehrotra R; on behalf of the Dialysis Advisory Group of the American Society of Nephrology
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CMS Releases ESRD PC Pricer
Section 1881 (b)(12) of the Social Security Act, as amended by section 623 of the Medicare Prescription Drug Improvement and Modernization Act of 2003, establishes the End Stage Renal Disease (ESRD) composite rate payment method for most dialysis related services provided by renal dialysis facilities to Medicare beneficiaries with end stage renal disease.
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EXTON, Pa., May 23, 2012 (BUSINESS WIRE) -- BioTrends Research Group, one of the world's leading research and advisory firms for specialized biopharmaceutical issues, announces the release of its 2012 ChartTrends(R): Bone and Mineral Metabolism in Dialysis (U.S.) report, the seventh in an ongoing annual series. The study was conducted with 226 U.S. nephrologists who completed detailed chart reviews for 1,061 dialysis patients. This is also the second ChartTrends report published since the dialysis bundle legislation was implemented in January 2011.
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CMS ANNOUNCES STRONGER INCENTIVES TO IMPROVE ESRD TREATMENT OUTCOMES
FINAL RULE UPDATES POLICIES AND PAYMENT RATES FOR DIALYSIS FACILITIES IN 2012
November 01, 2011The Centers for Medicare & Medicaid Services (CMS) today issued a final rule that updates Medicare policies and payment rates for 5,503 dialysis facilities paid under the End Stage Renal Disease (ESRD) Prospective Payment System (PPS) that was first implemented in calendar year (CY) 2011 |
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DOPPS Practice Monitor Website – First Data Update
13 May 2011The Dialysis Outcomes and Practice Patterns Study (DOPPS) has implemented the first update to the DOPPS Practice Monitor (DPM), a public website (http://www.dopps.org/DPM) created to identify current trends and emerging shifts in clinical care as the new Prospective Payment System (PPS) for renal dialysis services takes effect. |
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CMS Eliminates Transition Adjuster for Dialysis Services
WASHINGTON, April 1, 2011 /PRNewswire-USNewswire/ -- Kidney Care Partners, a broad-based coalition of patient advocates, dialysis professionals, care providers and manufacturers, commends the Centers for Medicare and Medicaid Services (CMS) for eliminating the so-called "transition adjustment" imposed on dialysis facilities as part of the new Medicare end-stage renal disease (ESRD) prospective payment system (PPS). |
Kidney Care Partners Supports Accountable Care Organizations for Kidney Patients
WASHINGTON, March 31, 2011 /PRNewswire-USNewswire/ -- Kidney Care Partners, a broad-based coalition of patient advocates, dialysis professionals, care providers and manufacturers, applauded efforts today by the Centers for Medicare and Medicaid Services (CMS) to develop accountable care organizations (ACOs). Kidney Care Partners also urged CMS to extend the promise of ACOs to the end-stage renal disease population by incentivizing and enhancing care coordination, thereby improving patient outcomes and reducing the overall cost of care. |
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Bundling payments for a complete organ system service is a new concept, recently enacted by the US Congress for end stage renal care dialysis services.
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1. What are the main findings of the study?
The actual increment in Medicare reimbursement for the first 120 days of treatment is 11.7%. We applied the resultant 1.117 CMA to the first 120 days of treatment in the 5.6% of incident patients (estimated in the NPRM). Adding the 2% total payment reduction mandated by MIPPA, but not taking into account other case mix adjusters, a 5% reduction in base payment per treatment is necessary to make the incident patient adjuster 'budget neutral'. (continued)
Plus: Author Inteview:
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Course: Renal Week 2010: Abstract Sessions
Session: Free Communication: New Therapeutic Targets to Fight Anemia in Dialysis
Date: Friday, November 19, 2010
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Am J Kidney Dis. 2010 Sep 29.
Roach JL, Turenne MN, Hirth RA, Wheeler JR, Sleeman KS, Messana JM.
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Medicare - CMS held an open forum on 9/27/2010 to elaborate on the new dialysis bundling payment regulations, set to go into effect on January 1 2011.
The slides from that presentation are available here: Download CMS Slide Presentation
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July 26 2010: New Bundling Regulations Released by Centers for Medicare and Medicaid:
Oral Medications NOT included in Bundled hemodialysis payment which maintaing more independence for patients regarding their oral medications and less resource demands and liability for providers of hemodialysis services.
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