GOVERNMENTRenal disease management demo launchedMedicare is using a flat-fee approach to rein in spiraling dialysis costs.By Markian Hawryluk, amednews staff. June 23, 2003. Washington -- In an effort to control the rampant growth of dialysis care expenditures, Medicare officials announced a demonstration project that would pay dialysis centers a lump sum rather than a payment for each procedure. But physician groups have expressed concern about the eroding role of doctors in managing these patients' care. The four-year demonstration project announced early this month by the Centers for Medicare & Medicaid Services seeks to change the incentives for dialysis treatment. Medicare currently pays a flat rate for the dialysis services, plus additional payments for any ancillary services a dialysis center may provide. "Right now the incentives for dialysis centers is to use as much as they possibly can," said CMS Administrator Tom Scully. "They lose money on their base Medicare rate, and they make all their money on ancillary services. So what we're trying to do is say we'll give you all the money in one bundle, and you try to use it more efficiently." The demonstration project is seeking bids for organizations to treat end-stage renal disease patients through two payment options. The first would pay a flat rate higher than the current rate for outpatient dialysis but would require organizations to cover all the costs of routine drugs and lab tests under that bundled payment. A second option would pay a capitated rate to health plans to provide all Medicare-covered services to enrolled patients, even care not related to dialysis. [...]Full text of American Medical News content is available to AMA members and paid subscribers.
Copyright 2003 American Medical Association. All rights reserved.
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