Author Topic: CMS cuts dialysis funding (actually a good thing)  (Read 10168 times)

cschwab

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CMS cuts dialysis funding (actually a good thing)
« on: December 07, 2013, 09:45:53 AM »
As expected, and in response to a congressional directive from the American Taxpayer Relief Act, Centers for Medicare & Medicaid Services Department of Health & Human Services (CMS) made a 3.3% cut in payments for dialysis facilities for 2014 to account for reduced drug utilization.  Rather than implementing the full 12% reduction as proposed by the agency this summer, CMS instead chose to phase in the cuts over time.  The 2014 reduction is 27% of the total amount to be cut over the next 3-4 years.

According to federal law, dialysis facilities are entitled to inflationary updates and other fee increases each year to account for, among other items, the increases in the costs for operating a facility and providing the services.  For 2014, CMS calculated this to be 2.8%  When combined with other existing components of the payment formula, the net result is a slight decrease in payments to facilities.  CMS also noted in the rule that it expected the 2015 cut to the drug component would be largely offset by these adjustments  again, resulting in another flat payment.  CMS intends to complete the full 12% cut by 2016 or 2017.

Therefore, the impact of the CMS rule is that rather than getting payment increases each year, dialysis centers will receive flat funding at least for the next two years; this is a reduction in Medicare spending.  Da Vita has already publicly expressed its concerns with the CMS rule and has pledged to fight these reductions in Congress and with the agency in the weeks and months ahead. Also, by increasing payments for home dialysis training, CMS likely provided longer term incentives to shift care to the home and away from these dialysis centers.

http://dialysisadvocates.com/news/

Download the entire Patient Rights Watch Ruling.

http://dialysisadvocates.com/wp-content/uploads/2013/12/CMS-ESRD-2014-Payment-Final-Rule.pdf
Proud member of DialysisEthics since 2000

DE responsible for:

*2000 US Senate hearings

*Verified statistics on "Dialysis Facility Compare"

*Doctors have to review charts before they can be reimbursed

*2000 and 2003 Office of Inspector General (OIG) reports on the conditions in dialysis

*2007 - Members of DialysisEthics worked for certification of hemodialysis
technicians in Colorado - bill passed

*1999 to present - nonviolent dismissed patients returned to their
clinics or placed in other clinics or hospitals over the years

cschwab

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Re: CMS cuts dialysis funding (actually a good thing)
« Reply #1 on: December 07, 2013, 09:46:50 AM »
I've heard these for-profits have been crying about who will do dialysis if they don't.  Let's see, how about: hospitals, nonprofits, and I would love to see these medical co-ops I've been reading about!  Or maybe the Italians:

"Italy has one of the lowest mortality rates for dialysis care -- about one in nine patients dies each year, compared with one in five here. Yet Italy spends about one-third less than we do per patient."
http://www.propublica.org/article/in-dialysis-life-saving-care-at-great-risk-and-cost 
Proud member of DialysisEthics since 2000

DE responsible for:

*2000 US Senate hearings

*Verified statistics on "Dialysis Facility Compare"

*Doctors have to review charts before they can be reimbursed

*2000 and 2003 Office of Inspector General (OIG) reports on the conditions in dialysis

*2007 - Members of DialysisEthics worked for certification of hemodialysis
technicians in Colorado - bill passed

*1999 to present - nonviolent dismissed patients returned to their
clinics or placed in other clinics or hospitals over the years

cschwab

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Re: CMS cuts dialysis funding (actually a good thing)
« Reply #2 on: December 07, 2013, 09:47:42 AM »
Medicare payment cuts is a victory for Dialysis Patients

Wednesday, December 4, 2013 | By Scott | No Comments

This is a victory for dialysis patients. Medicare pays for healthcare and it appears to be squeezing the buffalo off the nickel. If Davita holds true to their statement of pulling away from the inner cities and rural areas. That should be a blessing, the patients will go back to their individual Nephrologist, where big non-profit companies donít want to buy them, and dialysis patient healthcare can only improve.  Nephrologists will be accountable for the patient care and keep factual statistics, a Nephrologist will remain the doctor, not become a sales agent. Patients will not be without dialysis, Nephrologist cannot dump or blacklist his patients legally. Plus these Nephrologist will be accountable for their units, and not have big non-profits protecting them.
Arlene Mullin-Tinker
Dialysis Advocates LLC
 

View letters sent to the Centers for Medicare & Medicaid Services/Department of Health & Human Services, House Ways & Means Committee, and the Senate Finance Committee.  Dialysis Advocates and other patient rights organization were a big part of influencing the ruling.

http://dialysisadvocates.com/news/
Proud member of DialysisEthics since 2000

DE responsible for:

*2000 US Senate hearings

*Verified statistics on "Dialysis Facility Compare"

*Doctors have to review charts before they can be reimbursed

*2000 and 2003 Office of Inspector General (OIG) reports on the conditions in dialysis

*2007 - Members of DialysisEthics worked for certification of hemodialysis
technicians in Colorado - bill passed

*1999 to present - nonviolent dismissed patients returned to their
clinics or placed in other clinics or hospitals over the years

cschwab

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Re: CMS cuts dialysis funding (actually a good thing)
« Reply #3 on: December 07, 2013, 09:48:44 AM »
I mentioned the Italians above.  If somebody out there is curious about dialysis in another country, I suggest visiting Australian nephrologist Dr. John Agar at Home Dialysis Central.  He referred to U.S. dialysis as "bazooka" style dialysis.  Gosh, darn if I don't know what he means: http://forums.homedialysis.org/index.php
Proud member of DialysisEthics since 2000

DE responsible for:

*2000 US Senate hearings

*Verified statistics on "Dialysis Facility Compare"

*Doctors have to review charts before they can be reimbursed

*2000 and 2003 Office of Inspector General (OIG) reports on the conditions in dialysis

*2007 - Members of DialysisEthics worked for certification of hemodialysis
technicians in Colorado - bill passed

*1999 to present - nonviolent dismissed patients returned to their
clinics or placed in other clinics or hospitals over the years