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November 26, 2013

Medicare will slowly phase in controversial dialysis cuts

Daily Briefing

CMS will phase in cuts to dialysis providers over three to four years, meaning overall payments for 2014 will remain the same, according to a final rule released Friday.

As part of the last-minute "fiscal cliff" deal, CMS proposed $4.9 billion in savings from recalculating bundled payments for dialysis providers. The proposal came in response to a Government Accountability Office report that found Medicare had overpaid for end-stage renal disease treatment by relying on outdated drug-use trends. Specifically, Medicare relied on 2007 treatment protocols for anti-anemia drugs to calculate payments, though their use has declined significantly in recent years due to safety concerns.

The agency recommended the 9.4% cut in July, but industry advocates said such a cut would force smaller operators out of business and decrease patient care in rural areas.

CMS proposes 9.4% cut for dialysis providers

Friday's final rule authorized a 50% increase to home dialysis training payment adjustments and also reduced Medicare payments by 1.05%, according to Reuters.

According to the Wall Street Journal, the base rate per payment in 2014 will remain relatively unchanged at $239.02, a 0.55% decrease from the 2013 base rate of $240.36. In 2015, the rate will remain the same as 2014.

In total, according to documents from CMS, the payment rate will decrease by about $29 over the next three to four years (Beasley/Burger, Reuters, 11/22; Kutscher, Modern Healthcare, 11/22 [subscription required]; Walker, Wall Street Journal, 11/22).

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