10/2/2009 - The Proposed Rule for Reimbursing Dialysis Care: Learn, Share Knowledge, and Comment

Glendale, CA (October 1st, 2009) – The Renal Support Network (RSN) has created an online forum called KidneyPublicPolicy101.com to help people with chronic kidney disease (CKD), family members, and healthcare professionals learn about pending reimbursement changes for patients on dialysis. The new payment system takes effect in 2011, and will reimburse all dialysis-related drugs and services in one bundled payment (that is, medications administered during dialysis and laboratory tests will no longer be billed separately). The dialysis providers will be given a standardized bundled payment for each patient’s dialysis session. This payment rate may be increased based on factors such as:



• The patient’s case-mix (acknowledging some of the increased costs of providing care for a limited number of comorbidities and individual patient characteristics),

• Time on dialysis (providing a slight increase in reimbursement for new patients),



• The size of the dialysis facility (giving low volume dialysis centers additional reimbursement), and



• Outlier payments (providing a limited means to for dialysis facilities to recoup financial losses incurred for patients who require more resources than the norm).



The Centers for Medicaid & Medicare Services (CMS) has also proposed quality measures to protect patient quality of care. The initial three quality indicators include the percent of patients with hemoglobin less than 10 g/dL or above 12 g/dL, and the percent with a URR ≥ 65%. Additional quality indicators would be added in the future.



“The new payment system may change management and treatment parameters in dialysis and could negatively impact access to care and quality of life. It will also lead to an increase in co-pays for many patients,” stated Lori Hartwell, founder and president of RSN.



RSN’s new online forum is dedicated to the Proposed Rule for reimbursing dialysis. RSN encourages all patients (and their significant others) who depend on this system to survive to go to www.kidneypublicpolicy101.com and participate in the forum. The comments of healthcare professionals who treat those of us who live with CKD, public policy professionals, and others interested in the quality of life of patients with CKD are also welcome.



The forum is organized by topic such as: laboratory testing, medications, share of costs, home dialysis, quality of care incentives, and access to care. Users can click on these links for information on how each topic will be affected by the proposed bundled reimbursement program. A toll free number dedicate to the Proposed Rule has been created for patients to ask questions or leave comments and can be reached at 877-Kidney-Rule (543-6353).



RSN will be developing a position paper on the Proposed Rule to CMS, and will use the comments posted on the online forum as a vital information source. The deadline for comments to CMS on the Proposed Rule is November 16, 2009, so it is crucial that comments be received as soon as possible. We encourage all who are interested to join the discussion and let your voice be heard!



To help spread the word, RSN has created a one-page flyer to help get the word out. To download the KPP101 Flyer, visit http://www.rsnhope.info/1weKAN/PublicPolicy101FlyerFinal.pdf.

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