Financial implications of choice of dialysis type of the revised Medicare payment system: an economic analysis

American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation
John Hornberger, Richard A Hirth

Abstract

In 2011, the Medicare Improvements for Patients and Providers Act replaced the case-mix-adjusted composite payment system for Medicare outpatient dialysis facilities with a bundled end-stage renal disease prospective payment system (PPS). We assessed the economic implications for modality choice of the revised Medicare payment system. Microeconomic analyses. Patients eligible for dialysis in the United States. The perspective of this analysis is that of a financial administrator of a representative dialysis center in the United States. Data were obtained from the Medicare Payment Advisory Commission, the US Renal Data System, the DOPPS (Dialysis Outcomes and Practice Patterns Study) Practice Monitor, the US Bureau of Labor Statistics, and Medicare fee schedules. Recently implemented end-stage renal disease PPS versus the prior case-mix composite payment system. Medicare payment per month, center fixed and variable costs per month, net difference in revenue and variable costs (direct contribution), and net difference in revenue and total costs (operating margin). The direct contribution and operating margin for in-center hemodialysis and peritoneal dialysis are expected to be positive under the new bundled PPS. For Medicare fisc...Continue Reading

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Citations

Jan 17, 2014·BMC Nephrology·Richard J FluckRobert S Lockridge
Jun 12, 2013·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Philip Kam-tao Li, Kai Ming Chow
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