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7-26-10 CMS Press Release
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First Pay for Performance
Implementation in the New
Era of Healthcare Reform
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Rewards Dialysis Clinics for
Moving Patients Off
Catheters to Permanent
Access and Lowering
Infections
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The new rule which CMS released
on 7-26-10, was implemented on
Jan. 1, 2011.
•
The ew ESRD payment system is a
single bundled case-mix adjusted
payment to dialysis facilities for
renal dialysis services such as
dialysis treatments and supplies,
certain ESRD-related drugs, and
ESRD-related clinical laboratory
tests. CMS currently uses a partial
bundle system,
which doesn’t
include “separately billable drugs”
•
The $229.63 payment rate includes
payment for the services in the
current composite rate,
as well as
most items and services that are
currently paid separately
.
The base
rate was derived from 2007 claims
data for both composite rate and
separately billable services and
updated to reflect projected 2011
prices.