Monitoring the Quality of Dialysis Care
Another major concern of the GAO in 2011 was the impact of financial incentives on quality of care.
The GAO “noted that bundled payment systems may give providers an incentive to under serve the most costly beneficiaries to avoid financial losses” and that “beneficiaries on dialysis are particularly vulnerable to any disruptions in care because of their need for life-sustaining dialysis.” The GAO therefore “recommended that CMS monitor access to and quality of dialysis care to identify any adverse effects of this payment system change on beneficiaries.
Having reviewed a draft of the GAO report, CMS was able to comment that CMS “was confident that the additional amount to be included in the ESRD prospective payment system to account for oral-only ESRD drugs would be adequate to account for the average patient’s oral drug needs.”
With regards to the GAO recommendation that CMS ensure the availability of data for monitoring the treatment of mineral and bone disorder, “CMS noted that it plans to include measures related to mineral and bone disorder in the ESRD Quality Incentive Program (QIP).”
Back to the Future
Looking back to the GAO’s 2011 concerns about the future or ESRD payment hopefully will stimulate productive and constructive discussion about where to focus our energy both as renal providers and as citizens with our limited, but very real ability to influence the actions of our government.
As always, I invite your comments at Jahern@ahernconsulting.com and let me know what you think!
With offices located in Chicago and in Washington, DC, Jack Ahern provides cutting edge financial and management consulting-services to the health care community. He has an MBA from the University of Chicago, and undergraduate degrees in both chemistry and engineering from Dalhousie Univeristy. He can be reached at (312) 997-2177.