The Centers for Medicare & Medicaid Services has proposed a modest payment bump to hospital dialysis centers for calendar year 2015.
CMS would increase overall dialysis payments by 0.3 percent in 2015, although hospitals would receive a more generous increase of 0.5 percent. Rural facilities would see payments cut by 0.5 percent, according to the proposed rule.
Altogether, payments would increase by $30 million for dialysis services in 2013, with an additional $10 million coming from patients in the form of increased copayments. CMS also suggests a modest increase in the extra payments for outlier payments.
The Kidney Care Council, the primary lobby for dialysis centers, voiced concerns about the proposed changes to payments in the coming year.
"Any reduction in Medicare reimbursement will have a dramatic and negative impact on our already fragile payment system. Cuts of the size proposed by CMS put access to care for the most vulnerable patients in urban and rural areas at risk," said Kidney Care Council Executive Director Cherilyn Cepriano in a statement. About 85 percent of the nation's patients with end-stage renal disease receive coverage for their care through the Medicare program, according to the statement.
CMS transitioned dialysis care from fee-for-service to a bundled prospective payment system starting in 2010. The payments for a single dialysis session have increased from $229.63 to a proposed $239.33 in the current proposed rule. The rate is currently at $239.02.
Payment squeezes to the program in recent years have prompted some controversial cost-cutting initiatives by providers. In New York City, the New York Health and Hospitals Corp. turned over the operations of its dialysis centers to a private, for-profit operator, despite evidence indicating that dialysis patients tend to have higher mortality rates when for-profit providers manage their care.
CMS also proposed changes to its quality incentive program, including a readmission measure that would go into effect in calendar year 2017 and moving the patient survey measure to a pay-for-performance basis by 2018.
CMS will accept comments on the proposed rule until Sept. 2, and it will issue a final rule late in 2014.