Kidney Care Partners said they are concerned that a combination of flat payments and increased regulatory pressures proposed by the Centers for Medicare & Medicaid Services may negatively impact stability and affect quality of care in Medicare's end-stage renal disease program. KCP is a coalition of kidney patient advocates, clinicians, care professionals, dialysis providers, researchers, and manufacturers.
CMS released a proposed rule July 2 that would increase payments to dialysis facilities by 0.3% to 0.5%, while rural facilities will receive a decrease of 0.5%. CMS projects that ESRD facilities in Puerto Rico and the Virgin Islands will receive a 3.6% decrease in estimated payments, based on the proposed rule.
"On initial review, KCP appreciates the agency's interpretation of the kidney provisions contained in the Protecting Access to Medicare Act of 2014 (PAMA) to stabilize rates through 2015, though we remain concerned that despite these actions, Medicare reimbursement for dialysis care is not keeping pace with the rising costs of delivering quality health care to individuals with kidney disease," said Dr. Edward R. Jones, Chair of KCP. "While the proposed rule implemented Congressional intent by modifying deep cuts planned for 2015, many dialysis facilities continue to face economic hardship."
In recent years, the Medicare ESRD benefit has not received an inflation adjustment from CMS, which when coupled with sequestration cuts and other reductions by CMS, has resulted in Medicare reimbursement that is below the cost of care for most patients, according to KCP. "Without adequate Medicare funding, providers and physicians are forced to make difficult choices regarding staffing, quality improvement interventions, and ultimately whether to keep a center's doors open to patients," KCP said in a statement.
"KCP supports efforts to ensure that payments reflect the actual cost of providing care so that our community can continue delivering high quality dialysis care and sustained quality improvements," said Jones. "We will continue our diligent work with the broader kidney care community to submit detailed comments to the proposed rule during the public comment period."
Jones said that KCP will devote significant time and attention to the portion of the proposed rule pertaining to quality. "The Quality Incentive Program has tremendous implications for care quality and economic stability. We look forward to working with CMS to ensure that the final rule contains policies that continue to elevate the quality of patient care," Jones said.