WASHINGTON—Survey data from the Kidney Care Council (KCC) revealed that 98 percent of kidney care providers have opted into the new dialysis “bundled” payment system.
The study by The Moran Company found that of the 4,449 facilities that participated, 98 percent are opting to be paid fully under the new payment system in 2011. Based on this information, and assuming the CMS behavioral methodology for those facilities that did not participate, Moran projects that 90.4 percent of all facilities will select to be paid fully under the new PPS in 2011.
On Nov. 2, Fresenius Medical Care, which operates 1,839 dialysis clinics, announced that it had fully opted into the bundle.
"The number of facilities participating in the new PPS payment system is significant and we encourage Congress and the Centers for Medicare & Medicaid Services to correct the transition adjuster as soon as possible," said KCC Chairman Christopher Ford. "A seamless transition to the new reimbursement system will ensure that patients have continued access to high quality care, and we encourage government officials to use their authority to revise the transition adjuster effective January 1, 2011."
Congress established the "transition adjuster" to ensure budget neutrality in the new End-Stage Renal Disease (ESRD) bundled payment system, which is a single bundled case-mix adjusted payment to dialysis facilities for renal dialysis services, such as dialysis treatments and supplies, certain ESRD-related drugs, and ESRD-related clinical laboratory tests.
The final payment rate includes a 1 percent reduction to account for outlier payments, a 2 percent reduction to achieve budget neutrality and the 3.1 percent transition adjustment, or cut in reimbursement, for the first year of phase-in.
To calculate the transition adjuster, which is a 3.1 percent reimbursement rate reduction, CMS estimated that 43 percent of facilities would opt out of the transition period and choose to be paid under the new payment system by the Nov. 1 deadline.
Using this 90.4 percent figure, The Moran Company estimated that in order to maintain budget neutrality, the transition adjuster should be approximately 0.39 percent rather than the proposed 3.1 percent.
"If the transition adjuster is not revised," Ford said, "funding for dialysis care will be cut by approximately $250 million, threatening patients' access to quality care."
The KCC is a nonprofit national healthcare association composed of leading kidney dialysis provider companies who care for a majority of ESRD patients nationwide.
"We appreciate CMS staff's dedication, time and efforts in developing and implementing the new bundled payment system, and we look forward to ensuring a seamless transition to this new system by encouraging Congress and CMS to correct the adjuster immediately using the most up-to-date information," Ford added.
