Reforming the Medicare Payment System
KCP seeks to ensure that Medicare funding, which covers treatments for approximately 80 percent of individuals on dialysis, reflect the true cost of providing care. The economics of dialysis care are tenuous, especially given the increasingly tight margins and the overwhelming high proportion of patients who rely on Medicare for their treatments.
The Medicare payment system must support the cost of patient-centered care by ensuring proper payment to promote and expand patient access. In the short-term, this means working with the Centers for Medicare & Medicaid Services on ESRD Prospective Payment System (PPS) and ESRD Quality Improvement Program (QIP) adjustments and reforms that recognize the true cost of care.
However, PPS and QIP adjustments alone are not enough. The systemic barriers to accessing basic health care likely play a substantial role in these individuals developing kidney disease and progressing to kidney failure. Disproportionate challenges to access basic health care services have inequitably resulted in chronic diseases, such as diabetes, obesity, and heart disease, not being fully managed, which led to the development of kidney disease. KCP renews its commitment to work with CMS and other federal agencies to find ways to address these challenges prior to an individual’s kidney failing.
KCP Comment Letters & Resources:
- KCP Principles for Care Coordination (February 2021)
- Comments on the CY 2022 End-Stage Renal Disease (ESRD) Prospective Payment System (PPS) Proposed Rule (August 26, 2021)
- Comments on the CY 2021 End-Stage Renal Disease (ESRD) Prospective Payment System (PPS) Proposed Rule (September 3, 2020)
- CY 2020 End-Stage Renal Disease (ESRD) Prospective Payment System (PPS) Proposed Rule (September 11, 2019)
- Comments on the Quality Incentive Program (QIP) provisions of the CY 2020 End-Stage Renal Disease (ESRD) Prospective Payment System (PPS) and QIP proposed rule (August 30, 2019)
- ESRD PPS, Payment for Renal Dialysis Services Furnished to Individuals with Acute Kidney Injury, ESRD QIP, DMEPOS, CBP and Fee Schedule Amounts, and Technical Amendments to Correct Existing Regulations Related to the CBP for Certain DMEPOS (August 23, 2018)
- LCD Frequency of Hemodialysis (March 30, 2018)
- Advance Notice of Methodological Changes for CY 2019 for MA Call Letter & CMS-HCC (March 2,2018)