WASHINGTON—A yearlong analysis of a new payment system for outpatient maintenance dialysis from the Centers of Medicare & Medicaid Services (CMS) showed changes in use patterns for certain services and procedures but no real changes in beneficiary health status in 2011.
In January 2011, the CMS implemented the end-stage renal disease (ESRD) prospective payment system and since then has used real-time claims analysis to monitor groups of Medicare beneficiaries that could be affected by the new payment method.
Analysts examined information about morbidity and mortality, anemia management, bone and mineral metabolism, access infection and fluid management before and after implementation of the new system.
According to analysis of bone and mineral metabolism—associated problems include fractures, kidney stones and peptic ulcers—there was no increase in adverse health conditions related to bone and mineral management since the ESRD prospective payment system was implemented.
“Historically, the incidence rate of fractures hovered at 2.0% and remained at this level during 2011,” the summary noted. “The percent of ESRD beneficiaries with kidney stones increased by approximately 0.1 percentage point from 2008-2011. However, this trend predated the ESRD PPS.”