I Hate Dialysis Message Board
Dialysis Discussion => Dialysis: News Articles => Topic started by: okarol on December 14, 2007, 11:45:40 AM
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Medicare Changes for Kidney Patients Could be Ahead
By Article Writers Inc.
The Association of Minority Nephrologists and the National Minority Quality Forum have released a report detailing changes that are currently under consideration from the current U.S. Congress. Lawmakers are discussing altering the current way that Medicare pays for patient care under the End Stage Renal Disease (ESRD) program.
Under the status quo program Medicare pays 80 percent of medical costs for an estimated 485,000 ESRD patients. The total payout from Medicare for dialysis, transplants, patient care on both an inpatient and outpatient basis for the ESRD patients is estimated to be around $20 billion. Presently, Medicare reimburses dialysis units at a 'composite rate' that they government sets to cover cost of related supplies and equipment. These facilities then receive a separate payment from Medicare to cover the costs of injectable drugs and diagnostic tests.
Congress is considering action to have these two payments grouped together in a new government specified 'bundled rate' for ESRD program participants. The current congress is not the first to consider such a program, starting in the 1990's previous legislatures had researched this cost saving option. However, the research showed that bundling the costs had the possibility of keeping beneficiaries from getting needed medical therapies.
Nevertheless, in 2003 the current congress, moved cautiously forward with a plan entitled the Medicare Prescription Drug, Improvement, and Modernization Act of 2003. This act required that they Centers for Medicare and Medicaid Services (CMS) complete a demonstration on the bundling issue by the year 2006. The CMS has not yet completed this assignment, which is why the current 2007 congress is moving forward, impatient on waiting for the demonstration to be completed. The proposed bundling changes to the ESRD program have already received approval from the House and have been forwarded on to the Senate for debate.
The proposed legislation has the Association of Minority Nephrologists and the National Minority Quality Forum concerned about the implications it may have on patient care for end stage renal disease patients. Citing worries that dialysis clinics in rural and inner-city areas alike may suffer financially and not be able to provide treatment in the patients in these areas, many of which are minorities. The two organizations recognize that there is a need to decrease the costs of the ESRD program but neither believes that the cost bundling option is the right one. They advocate to use funding and resources to develop new and more cost effective treatments, as well as new means of prevention from end stage renal disease.
They urge Congress to not pass the proposed ESRD program changes before the demonstration is completed and a better understanding of the implications that these changes could cause to patient care are clearly defined.
http://prnewswire.com/cgi-bin/stories.pl?ACCT=104&STORY=/www/story/12-10-2007/0004720205&EDATE =
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