Impact of end-stage renal disease (ESRD) Medicare reform explained

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.

ASN President Peter S. Aronson, MD, of the Yale University School of Medicine in New Haven, CT, adds that "ASN played a significant role in ensuring that important ESRD provisions were included in the final version of the Medicare bill. Through congressional meetings, comment letters, and action alerts, ASN actively lobbied Congress on behalf of the renal community. This legislation is just one example of the many ways in which ASN members influence congressional action."

Jonathan Himmelfarb, MD, of the University of Washington in Seattle, WA, and Chair of the ASN Public Policy Board, will moderate this special session, entitled "HR 6331: Medicare Implications for Nephrology," that will take place during Renal Week on Friday, November 7, from 11:00 a.m.-Noon ET in Room 201 A of the Pennsylvania Convention Center in Philadelphia, PA.

"This session will provide a thorough examination of key provisions contained in this landmark legislation," says Paul C. Smedberg, Director of Policy and Public Affairs for ASN. "It is important for nephrologists to understand the impact this legislation will have on the practice of nephrology, ESRD patient care, and CKD education."

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