CMS Releases Proposed Payment System

On September 15, 2009 the Centers for Medicare and Medicaid Services (CMS) released their proposed bundled payment structure.  This is the new payment system, passed into law in July 2008, that said dialysis services and medications will be paid to dialysis providers in one lump payment often referred to as “the bundle”.  This new payment system will be phased in over 3 years beginning January 2011 and fully implemented by 2014.  DPC sent a letter to CMS prior to the proposed rule asking CMS to consider patients’ choice and flexibility in receiving their treatments. 

In the proposed rule two important recommendations DPC sent to CMS were accepted.  The new payment system will continue to pay providers for each dialysis treatment given (this is often referred to as the “per treatment model”) and it would also allow for patients to obtain more treatments per week with medical justification. These are both great wins for dialysis patients.  Initially CMS had considered paying providers for a set number of treatments weekly or monthly, which could have made dialyzing at another clinic while traveling difficult for patients. 

While there are many changes to the payment system that could be good for patients there are some areas where the impact to patient care will need to be closely monitored to ensure the new bundled payment does not pose harm to patients’ care and choice in treatment. Given that the new payment will result in dialysis providers making changes to how they provide care, the aspects of how patient care will be impacted will depend on how easy and affordable it will be for dialysis providers to offer the wide range of services and medications that patients have access to now.

> Read more about the proposed payment system

Patient Connection - Draft ESRD Bundle

As was discussed in the article above, “CMS Releases Proposed Payment System”, the draft ESRD Bundled Payment system could affect how your dialysis is provided. 

DPC wants to ensure that we answer our members’ questions concerning the “bundle.” If you have questions or concerns about the bundle, we want to hear them.  We’ll do our best to provide the answers in a timely manner.

> Submit your questions

Going Home for Dialysis: Capitol Hill Briefing

Most dialysis patients do not know all the treatment options available to them.   With access to additional education, patients who need dialysis and their nephrologists could better determine which modality is best for them.  That was the take away message from a joint Capitol Hill briefing, Going Home for Dialysis: Opportunities and Barriers in Home Dialysis Therapy, held by Dialysis Patient Citizens (DPC) and the National Kidney Foundation (NKF).

> Read more about the Capitol Hill Briefing

DPC Federal Advocacy Update

• Immunosuppressive Drug Coverage
• Medicare Secondary Payer (MSP)
• Medigap
• Accountable Care Organizations (ACO's)

> DPC federal advocacy issues in detail

You May Need Two Flu Shots This Year!

The influenza (flu) vaccine protects against the three main flu strains that research indicates will cause the most illness during the flu season. This year’s vaccine contains three new virus strains.  They are: A/Brisbane/59/2007 A/Brisbane/10/2007 B/Florida/4/2006 This year’s influenza vaccine can protect you from getting sick from these three viruses.  It can also make your illness milder if you get a related but different flu virus strain.      > What your kidney doctor wants you to know about this flu season