Prospective Payment System
Phosphate binder rule is disease-specific discrimination
In April, CMS issued guidance for the inclusion of oral-only drugs in the end-stage renal disease bundled payment. The directive included Xphozah as a renal dialysis service.
Bundled payment system has hindered innovation in kidney care
In the movie Steel Magnolias, actor Julia Roberts plays Shelby, a young patient with diabetic kidney disease torn between her desire to be a mother and the reality of pregnancy pushing her into a life on dialysis.
Patients drawn to Medicare Advantage benefits, but higher costs, data issues remain
Sources of Healio | Nephrology News & Issues have made it clear that the explosive growth in the number of patients with end-stage kidney disease that join Medicare Advantage plans has overwhelmed everyone — payers and providers alike.
Independent dialysis providers face challenges with patient care under Medicare Advantage
Passage of the 21st Century Cures Act in 2021 allowed Medicare beneficiaries with end-stage kidney disease to enroll in Medicare Advantage plans regardless of their previous coverage or when they were diagnosed.
CMS proposes payment rate updates for hospital outpatient, ASC services
In its Calendar Year 2024 Hospital Outpatient Prospective Payment System and ASC Payment System Proposed Rule, CMS proposed updating payment rates for hospitals that meet applicable quality reporting requirements.
More than 10 years later, it is time to rethink the ESRD payment bundle
“You can’t connect the dots looking forward; you can only connect them looking backwards.” – Apple founder Steve Jobs
'Something needs to change': ACP plans to streamline specialty referrals
The ACP has proposed a new process to streamline specialty referrals — a step that experts have called critical to fixing a massive issue in health care — but questions remain about the plan’s feasibility.
Underlying issue of primary care in US is ‘overwhelmingly investment’
WASHINGTON — Primary care is severely underinvested in the United States, especially when compared with some other high-income countries, according to a speaker at the Primary Care Collaborative annual conference.
CMS proposed rule halts elimination of inpatient only list
AAOS responds to CMS-proposed Medicare payment policy changes for 2021
The American Association of Orthopaedic Surgeons issued two formal letters to CMS regarding the proposed Medicare outpatient prospective payment system, ASC payment system and physician fee schedule for 2021, according to a press release.