February 22, 2008
WASHINGTON, Feb. 25 /PRNewswire-USNewswire/ -- In response to the Centers for Medicare and Medicaid Services (CMS) payment bundling report released earlier this week, Kidney Care Partners (KCP) -- an alliance of patient advocates, dialysis professionals, care providers and manufacturers working together to improve quality of care for individuals with kidney disease and kidney failure -- applauds CMS for issuing its long-awaited report which recognizes the importance of much needed reform surrounding the End Stage Renal Disease (ESRD) program for the hundreds of thousands of Americans suffering from kidney failure.
Specifically, KCP noted the report's emphasis on the under-funding of the composite payment rate - the prospective payment system used to reimburse for dialysis services, some medicines, lab tests and other services - which cites the average cost of treatment was $162.00 versus a reimbursement amount of $143.20. The dialysis community is the only provider group within Medicare without an automatic annual update to account for inflationary changes. These automatic adjustments account for routine increases in costs of care and services associated with dialysis. The non-partisan Medicare Payment Advisory Commission (MedPAC) recommended a 1.2 percent update to the composite rate last year, and a 1 percent update this year. Neither update has been passed by Congress to date.
KCP - which includes the nation's leading doctor, patient, nurse, provider, manufacturer and research groups - has been working collaboratively on a set of community consensus principles for payment reform that would ensure an effective bundle by maintaining the integrity of the ESRD benefit. KCP urges policymakers to work closely with the kidney community to ensure that a new system encourages sustainable quality improvements and protects access to quality dialysis care. While we believe the CMS report requires further analysis, we feel strongly that any changes to the payment methodology for dialysis services under the Medicare ESRD program do the following:
-- Ensure that patients continue to have access to safe and high quality care.
-- Include a continuous quality improvement initiative that rewards providers and physicians who attain certain quality benchmarks or demonstrate substantial improvements in quality over a period of time.
-- Include an annual inflationary adjustment that will account for increases in the cost of providing care to dialysis patients.
-- Encourage innovation in the treatments and services provided, including removing obstacles to providing clinically beneficial services, new technologies, pharmaceuticals, and products to patients that may be currently available and proven efficacious, but are not within the existing composite rate services.
-- Ensure that all dialysis modalities are appropriately and adequately funded.
-- Establish correct treatment goals to avoid the over-utilization or under-utilization of items or services.
-- Reflect the full cost of providing dialysis care and account for the cost of items or services not currently available and that are additive to the services covered by the composite rate.
-- Establish an ESRD Advisory Committee that will work with the Secretary of HHS to ensure the appropriate design and implementation, including issues such as cost report reform and periodic review of the payment system.
KCP recognizes that bundling of payment is inevitable to achieve comprehensive reform of Medicare's ESRD benefit, though stresses caution over the importance of being especially attentive to the details so that the benefit is not disrupted in any way.
We look forward to working closely with Congress and CMS to ensure that the necessary safeguards and structural program reforms are in place before bundling is implemented. Hundreds of thousands of Americans rely on this critical benefit for a second chance at life, and we in the kidney community who are on the front lines of patient care will do everything we can to protect the integrity of this benefit.
|SOURCE Kidney Care Partners|
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