The year 2008 saw some of the biggest rule changes dialysis has seen in decades. A bundled payment system was signed into law, and the new Conditions for Coverage were released, just to name a few. The shockwaves from 2008 were still being felt in 2009, and will likely continue into next year as the renal community continues to learn how to run clinics under a continually changing system. To recap the year, RBT has compiled a list of the top stories from 2009.
1. Bundling Report Hits the Streets
Bundling was big news in 2008, bigger news in 2009, and will likely continue its reign in 2010. It’s a giant change in how dialysis is paid, and it affects everyone involved in the renal community—from clinic owners to patients. Although the bundle, which is rolling separately billable drugs and labs into the existing composite rate, was formally passed in July 2008, the renal community didn’t get its first look at the details until September this year.
Medicare initially set a comment deadline for Nov. 16, which left many scrambling to figure out what it all meant. Renal meetings, such as the NRAA and ASN shows were dominated by the bundle’s affect. After receiving more than 300 comments by the end of October, Medicare extended the comment deadline to Dec. 16 with the final rule expected to be released early next year. It’s an easy prediction that 2010 will be a busy time for dialysis clinics trying to adapt to this brave new world.
2. CROWNWeb Delays Full Implementation
Dialysis has always been a place for healthcare ideas to be tested in the United States, whether it is a new idea for a service or how to pay for them. It also serves as a fertile proving ground for data collection, as all patient information has the potential to be captured and analyzed. CROWNWeb was introduced in last year’s Conditions for Coverage to help facilitate this. But to many people, CROWNWeb became a four-letter word, especially among small dialysis providers.
The biggest point of contention centered on batch submission. Simply put, large dialysis organizations would be allowed to submit all of their data to CMS at once, whereas smaller clinics would have to enter the data on a patient-by-patient basis. This, many smaller providers argued, placed undue financial and time burdens on their clinics. Something they couldn’t afford.
However, these clinics fought back, and their concerns were heard in Washington. Instead of forcing every U.S. clinic to comply by Feb. 1, the rollout was broken up in phases, with the national rollout delayed to possibly March 2010.
