The end-stage renal disease (ESRD) Medicare reform measures recently passed by Congress represent the most significant ESRD reforms in decades.
These measures and how they will impact the practice of nephrology and patient care will be the topic of a session during the American Society of Nephrology (ASN) 41st Annual Meeting and Scientific Exposition in Philadelphia, Pennsylvania.
Working with Kidney Care Partners (KCP), ASN helped shape the recently passed Medicare Improvement for Patients and Providers Act of 2008 (HR 6331). Key ESRD reform provisions in HR 6331 include funding for Medicare Chronic Kidney Disease (CKD) education sessions and a yet-to-be-determined CKD demonstration project, an increase in the composite rate that provides economic relief for providers, a bundled payment system meant to improve efficiency and outcomes, development of quality measures, and a Government Accountability Office (GAO) report on bundling needed to validate the system before it is implemented on a system-wide basis.
The bill also keeps CKD education sessions under the purview of a physician (or physician extender) recognized by the Centers for Medicare & Medicaid Services (CMS), requires costs of dialysis services to be equal in both hospital-based settings and freestanding outpatient settings, and increases reimbursement to nephrologists who provide comprehensive CKD education on comorbidity management, complication prevention, and treatment options.