A quote from the poet Blake: "the road of excess leads to the palace of wisdom" to which I say in reading an article in Modern Healthcare, "if wishes were horses, beggars would ride". Here is an excerpt from the article:
"Dialysis and kidney-care providers are taking issue with a Government Accountability Office report released this month that found the government may be over-paying for end-stage renal disease treatment.
The report called on the CMS to re-examine the amount it's paying (PDF) for dialysis care, arguing that the agency bases its bundled payment rates on 5-year-old drug utilization trends that are no longer current.
It added that if the payments accurately reflected current prescribing trends for end-stage renal disease, Medicare would have saved at least $650 million in 2011, up to as much as $880 million—and that those savings are only forecasted to grow.
Robert Sepucha, senior vice president of government affairs at Fresenius, the country's largest dialysis provider, called the report “disappointing” for providing an “incomplete and ultimately inaccurate view of the bundle.”.....
Dr. Thomas Hostetter, chairman of the public policy board at the American Society of Nephrology, noted that he agreed with the “raw findings” of the report concerning decreased utilization. But, he noted, “I think the biggest concern is that this is such a widely fluctuating area right now.”
My take: it's pretty evident to anyone who knows about the current economics of dialysis that providers are laughing their way to the bank as they profit under the current bundle. Of course this reflects falling ESA utilization amid continuing confusion on how best to manage anemia in dialysis patients. Rather than fighting any reduction in the bundled payment, providers should embrace the financial benefits and plough this back into beefing up patient care. For example, most dialysis providers haven't increased the proportion of their budget allocated to nursing care. What about paying nurses more? Or improving the infrastructure of their dialysis facility (remember the Robin Fields Atlantic report God Help You. You're on Dialysis?) Or spending some money on increasing the proportion of uninsured patients that dialyze in their facilities? But as I said: if wishes were horses...
"Dialysis and kidney-care providers are taking issue with a Government Accountability Office report released this month that found the government may be over-paying for end-stage renal disease treatment.
The report called on the CMS to re-examine the amount it's paying (PDF) for dialysis care, arguing that the agency bases its bundled payment rates on 5-year-old drug utilization trends that are no longer current.
It added that if the payments accurately reflected current prescribing trends for end-stage renal disease, Medicare would have saved at least $650 million in 2011, up to as much as $880 million—and that those savings are only forecasted to grow.
Robert Sepucha, senior vice president of government affairs at Fresenius, the country's largest dialysis provider, called the report “disappointing” for providing an “incomplete and ultimately inaccurate view of the bundle.”.....
Dr. Thomas Hostetter, chairman of the public policy board at the American Society of Nephrology, noted that he agreed with the “raw findings” of the report concerning decreased utilization. But, he noted, “I think the biggest concern is that this is such a widely fluctuating area right now.”
My take: it's pretty evident to anyone who knows about the current economics of dialysis that providers are laughing their way to the bank as they profit under the current bundle. Of course this reflects falling ESA utilization amid continuing confusion on how best to manage anemia in dialysis patients. Rather than fighting any reduction in the bundled payment, providers should embrace the financial benefits and plough this back into beefing up patient care. For example, most dialysis providers haven't increased the proportion of their budget allocated to nursing care. What about paying nurses more? Or improving the infrastructure of their dialysis facility (remember the Robin Fields Atlantic report God Help You. You're on Dialysis?) Or spending some money on increasing the proportion of uninsured patients that dialyze in their facilities? But as I said: if wishes were horses...
