FOCUS ON FINANCE: New Conditions for Coverage vs. Your Bottom Line

The Patients’ Right To Know, Choose

The patient rights CfCs stress not only include quality care and respect for the patient, but also the right to be adequately informed about his/her condition, patient care plan and treatment options.

Specifically to be “informed about all treatment modalities and settings, including but not limited to transplantation, home dialysis modalities (home hemodialysis, intermittent peritoneal dialysis, continuous ambulatory peritoneal dialysis, continuous cycling peritoneal dialysis), and in-facility hemodialysis.”

Moreover, “The patient has the right to receive resource information for dialysis modalities not offered by the facility, including information about alternative scheduling options for working patients.”

Patient Satisfaction—Protected and Promoted

In our previous articles, we discussed the cost vs. benefit of patient satisfaction enhancers. The new CfCs “stress patient satisfaction and ongoing patient involvement in the development of the care plan and treatment.” Specifically, the patient assessment condition requires “evaluation of the patient’s abilities, interests, preferences and goals, including the desired level of participation in the dialysis care process, the preferred modality (hemodialysis or peritoneal dialysis), and setting, (for example, home dialysis), and the patient’s expectations for care outcomes.”

So, What Will This All Cost?

CMS claims that overall, the new CfCs will enhance the provider’s bottom line. Various calculations are presented to prove this thesis. In the following parts of this miniseries, I will address CMS’s calculations, pointing out what has been assumed and what has been left out. In the meantime, I welcome your comments and insights.

Let the Renal Community Know What You Think!

Feel free to email your comments and opinions to me at jahern@ahernconsulting.com and check out next month’s issue of the Renal Business Today, Focus on Finance column, to see what your colleagues have to say. Please note, when you write, let me know whether or not you would like your name published with your remark.