When it comes to the financial impact of the proposed ESRD bundled payment system, all dialysis centers may not be created equal. A study presented at Renal Week 2009 suggested that dialysis units with certain characteristics and in some regions—including some of the most impoverished regions in the United States—could see disproportionate cuts in Medicare payments under the new system.
Under a bundled payment system, Medicare makes a single reimbursement for all the hospital and physician care for kidney disease, rather than separate payments for the facility and physicians.
“Based on facility-level analysis, it appears there may be unanticipated geographic variation in facility reimbursement payments,” according to lead author Sumit Mohan, MD, of Columbia University. The findings raise concerns that some dialysis centers—and the patients they serve—may be at risk under the Centers for Medicare & Medicaid Services’ (CMS) proposed Medicare bundle.