Education program, bundled payments to improve care for kidney patients

[okarol]

INSIDE HEALTH CARE
Education program, bundled payments to improve care for kidney patients

By Bruce Japsen
Tribune reporter
chicagotribune.com

November 19, 2009

For the first time, a program to educate the public about treatment options for dialysis patients will be paid for by the federal Medicare health insurance program for the elderly and disabled come Jan. 1.

The news could be good for Americans with kidney disease as well as Deerfield-based medical products giant Baxter International Inc., which has a growing business of drugs and medical products used to treat patients with kidney disease with in-home dialysis.

"These education sessions will provide patients with chronic kidney disease information they need to understand their treatment options and participate in better management of their own care," Dr. James Sloand, senior medical director of Baxter's North American renal business, said of the six educational sessions Medicare will cover. "This program empowers individuals to take measures to slow the progression of their kidney failure."

Baxter's kidney disease-related business has been growing outside the U.S. as some countries seek to move away from center-based treatment in favor of a home-based option, which is less expensive and usually more convenient for patients.

In Mexico, for example, nearly 90 percent of dialysis patients receive home treatment, according to industry reports. Less than 10 percent of U.S. patients get home treatment.

In the U.S., reimbursement for dialysis is complicated by the fact that fees are paid separately for drugs and doctors office visits, and that leads to more fragmented and less effective service, Medicare officials said. By receiving bundled payments, Medicare officials hope centers and medical care providers will arrange their services in a way that they can operate more efficiently and improve the quality and cost-effectiveness of care.

Paying for education is the first step before Medicare in January 2011 begins to bundle payments to dialysis providers that would cover outpatient services.

In September, the Centers for Medicare and Medicaid Services proposed providing a single bundled payment to dialysis facilities that would cover services used in outpatient care, including dialysis treatment, prescription drugs and clinical laboratory tests.

"Combining a fully bundled prospective payment system with required performance standards would encourage facilities to operate more efficiently and ensure that beneficiaries receive high quality care, while saving dollars for both beneficiaries and the Medicare program," said Jonathan Blum, director of the agency's Center for Medicare Management.

Hear Bruce Japsen on WGN-AM 720 at 12:49 p.m. and 11:15 p.m. Mondays and 7:35 a.m. Sundays. See previous health care notebooks at chicagotribune.com/healthcare.

bjapsen@tribune.com
www.chicagotribune.com/business/chi-thu-notebook-baxter-dialysisnov19,0,2956510.story