BioCentury
ARTICLE | Politics & Policy

GAO: ESRD bundling rate should reflect use

December 12, 2012 2:54 AM UTC

The U.S. Government Accountability Office said Congress should consider requiring HHS to adjust the bundled payment rate for end-stage renal disease (ESRD) patients to reflect the use of bundled dialysis items and services. Under the 2008 Medicare Improvements for Patients and Providers Act (MIPPA), CMS is required to annually increase the bundled payment rate to account for changes in prices but not the use of bundled items and services; the current rate is based on use in 2007. According to a GAO report, Medicare expenditures on dialysis care would have been $650-$880 million lower in 2011 if the bundled payment rate had been adjusted to reflect the 2011 use of ESRD drugs, which was about 23% lower than in 2007. GAO, which said the difference is largely due to the reduced use of erythropoiesis-stimulating agents (ESAs), said ESRD drug use is expected to decline further. ...