End-Stage Renal Disease: Reduction in Drug Utilization Suggests Bundled Payment Is Too High

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Correspondence issued by the Government Accountability Office with an abstract that begins "Utilization of ESRD drugs in 2011 was about 23 percent lower, on average, than it was in 2007, driven largely by a decline in the utilization of ESAs. As a result, Medicare may have paid more than necessary for dialysis care in 2011 because the bundled payment rate in that year was based on 2007 utilization levels. We estimated that Medicare expenditures on dialysis would have been about $650 million to $880 million lower in 2011 if the bundled payment rate were rebased to reflect the 2011 utilization ... continued below

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United States. Government Accountability Office. December 7, 2012.

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Correspondence issued by the Government Accountability Office with an abstract that begins "Utilization of ESRD drugs in 2011 was about 23 percent lower, on average, than it was in 2007, driven largely by a decline in the utilization of ESAs. As a result, Medicare may have paid more than necessary for dialysis care in 2011 because the bundled payment rate in that year was based on 2007 utilization levels. We estimated that Medicare expenditures on dialysis would have been about $650 million to $880 million lower in 2011 if the bundled payment rate were rebased to reflect the 2011 utilization level of ESRD drugs. Furthermore, this estimate of potential savings could be larger in future years if the level of ESRD drug utilization at the end of 2011 declines further, as preliminary data suggest. Rebasing the bundled payment rate to account for changes in ESRD drug utilization could help ensure that Medicare pays appropriately for dialysis services and also yield savings to Medicare. However, CMS officials indicated that they did not have immediate plans to rebase the rate and that the statute does not provide CMS with explicit authority to do so. Therefore, Congress should consider requiring the Secretary of HHS to rebase the ESRD bundled payment rate as soon as possible and on a periodic basis thereafter, using the most current available data."

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Government Accountability Office Reports

The U.S. Government Accountability Office (GAO) is an independent, nonpartisan agency that works for the U.S. Congress investigating how the federal government spends taxpayers' money. Its goal is to increase accountability and improve the performance of the federal government. The Government Accountability Office Reports Collection consists of over 13,000 documents on a variety of topics ranging from fiscal issues to international affairs.

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  • December 7, 2012

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  • June 12, 2014, 7:50 p.m.

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United States. Government Accountability Office. End-Stage Renal Disease: Reduction in Drug Utilization Suggests Bundled Payment Is Too High, text, December 7, 2012; Washington D.C.. (digital.library.unt.edu/ark:/67531/metadc301541/: accessed October 16, 2018), University of North Texas Libraries, Digital Library, digital.library.unt.edu; crediting UNT Libraries Government Documents Department.