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
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Now that the Senate Finance Committee has introduced its draft health care reform bill, we have a better idea of the status of many of the issues DPC has been championing throughout the year:
