I won't try to change any more minds, as it's obvious where you all (who have responded in this thread anyway) stand on this ... I would just ask for posterity's sake that you at least correct whatever information is false which I have presented.
I value the IHD community too much, so for the sake of civility:
My second post had a link to the AAMI site which explains more about the ESRD payments. I would suggest you go there first.
The way we do this, is by contacting our congressmen and women and letting them know how we as patients are affected, and that we expect them to do their job and support legislation like this that changes lives for the better.
This can be done here
It takes less than 2 minutes, and they will contact your representatives for you, letting them know your expectations on this issue.
Legislation may not be the answer. Besides, you didn't inform us of the full length and breadth of the so-called
Kidney Care Quality Improvement Act. It seems as if you just expect us to just take your word for it, and go to the DaVita site (which you failed to mention) and take less than two minutes to fill out the form letter. Once Congress gets a hold of revising the ESRD program, they may screw things up. And who, by the way, do you think might have helped write the legislation in the first place?
You may all be familiar with this topic - the Medicare compensation to dialysis providers (and how it hasn't been adjusted in something like 30 years).
The Medicare compensation to dialysis providers
has been adjusted over the years. Be careful of what you hear or read by the dialysis industry. There's a lot of false and incomplete information being propagated by various groups to patients.
Here's the information on the composite rate you weren't told:
The composite rate was
increased by 1.2 percent in 2000 and 2.4 percent in 2001. And ...
The Deficit Reduction Act of 2005
increased the composite rate by 1.6 percent in 2006. In addition, CMS set the add-on payment at 14.7 percent of the composite rate for both freestanding ($128) and hospital-based ($132) facilities in 2006. Meaning an
increase of more than
$18.80 per treatment on average was added to the composite rate this year.
Medicare's policies for paying for outpatient dialysis services changed in 2005Beginning in 2005, the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) and regulations that CMS issued to implement the new law substantially changed the outpatient dialysis payments system by:
... paying the acquisition cost for separately billable dialysis drugs,
... shifting some of the profits previously associated with payments for separately billable drugs through an add-on payment to the prospective payment rate (called the composite rate) for outpatient dialysis services,
... adjusting the composite rate for differences in case mix, and
... updating the wage index and the definitions used to define the labor market areas.
Report to the Congress: Medicare Payment Policy | March 2006, submitted by
MedPac:
We include the payments and costs for dialysis drugs because their use has increased significantly throughout the 1990s, and their effect on the financial performance of facilities is significant. Including these payments and costs gives a more accurate picture of the financial performance of dialysis providers and the adequacy of Medicare's payments for dialysis services.We believe that given the design of the payment system, the long-run profit margin will be 6 percent. The industry is transitioning to the new payment system in 2006, which might result in lower profits in the short term ... It is likely that the largest four dialysis chains, who furnish 60 percent of all dialysis treatments, will attain greater margins than non-chain facilities.The Congress should update the composite rate in calendar year 2007 by the projected rate of increase in the end-stage renal disease market basket index less half the Commission's expectation for productivity growth.Data from industry sources show that between 1999 and 2004, the publicly held chains' net revenues grew from 9 percent to 20 percent annually. Key operational ratios for the largest chains suggest average or above-average performance in 2004:
... Return on equity, a key measure of capital efficiency, ranged from 21 percent to 118 percent (pre-tax).
... Return on total capital, a measure of how effectively a company uses capital, ranged from 20 percent to 38 percent (pre-tax).
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