Increasing Efficiency & Reforming Payments to Improve Care
The average Medicare margins for dialysis facilities remains extremely low, even negative, despite the successful rollout of the ESRD Prospective Payment System (PPS) in 2011. In the current payment environment, payment rates are not aligned with the cost of providing care, thereby disincentivizing the provision of high-quality treatments to kidney failure patients. Our legislative agenda includes a series of technical fixes that would adjust the reimbursement landscape to coordinate payment for services with the actual cost of providing care.
We support policies that consolidate and modernize quality programs that are currently plagued by a great number of redundancies and inconsistencies. These inefficiencies have contributed to higher costs of care without providing additional benefits for patients. The proliferation of individual measures rather than identifying a comprehensive solution complicates efforts to reform the payment environment and causes the most important aspects of dialysis care to be lost in the confusion.
In order to reform reimbursement for kidney care providers, we also support changes that ensure the HHS Secretary focuses on reforms that are evidence-based and endorsed by the National Quality Forum. Concentrating on legitimate, statistically-supported treatments and therapies will lower costs by eliminating ineffective treatments that needlessly raise costs. By focusing only on effective treatments, kidney care providers will be able to optimize their practices to these treatment solutions instead of providing care that is ineffective and, therefore, that incurs unnecessary costs.
Furthermore, we support policies that incentivize the provision of high-quality care by rewarding service providers and renal dialysis facilities that exceed performance standards with bonus payments funded by penalties assessed under the Quality Improvement Program. High-quality care providers should be rewarded and providing financial motivation to that end will only lead to higher-quality care across the board.
