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Kidney Patients' Health Is Jeopardized by Proposed Medicare Changes
Date:12/10/2007

ull bundling, CMS has not yet completed this requirement. Impatient with CMS's inaction, the House recently voted for the implementation of bundling without a demonstration.

"Approximately half of all U.S. patients with end-stage renal disease are members of racial or ethnic minority groups," said Gary A. Puckrein, PhD, President and Chief Executive Officer of the National Minority Quality Forum. "We are extremely concerned that Congress would contemplate altering the payment system without studying the implications of bundling and without testing it as originally mandated under the Medicare Prescription Drug, Improvement, and Modernization Act of 2003."

The consensus report cautions that small, independent dialysis facilities in rural and inner-city areas may also be negatively impacted by bundling. "Because these facilities may not have the volume of patients to manage the risks of an untested bundled system, they may be forced to close, which would harm many patients, particularly among minority populations," said Dr. Puckrein.

The National Minority Quality Forum and the Association of Minority Nephrologists recognize that the costs of ESRD treatment must be contained, but they warn that the proposed bundled system is a short-term solution that would widen the gap between patients and the quality care that they need. "Resources and energy should be devoted to preventing end-stage renal disease and to finding more cost-efficient technologies and therapies to treat it," said Keith Norris, MD, President of the Association of Minority Nephrologists. "The government plays a crucial role in stimulating the market and has the ability to encourage innovation and investment to reduce the cost in the ESRD Program, rather than force an untested system without a full understanding of risks and benefits for patient care. These are the tools needed to break this cycle of chronic disease among minorities and in the U.S. population as a whole."

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SOURCE National Minority Quality Forum; Association of Minority
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