How bundling affects dialysis patients
Bundling is Medicare's new payment system for dialysis and related services. Bundling goes into effect in January 2011. Here's how we expect it to affect Northwest Kidney Centers dialysis patients:
More information:
Dialysis Patients’ Guide
to the Medicare ESRD Bundle
Read highlights of the
final rule
Full text of the rule in the
Federal Register (900 pages)
Previous coverage of
the bundling issue
Treatment practices may change as we seek to improve quality while keeping costs under control. These changes affect all patients, not just those with Medicare coverage. For example, we may change medications that treat bone conditions related to kidney failure.
Coinsurance for patients with Medicare as primary payer will vary due to bundling's new calculation system. Medicare will pay more when a patient is new to dialysis (for the first four months). They will also pay more for certain medical conditions (GI bleeding, pericarditis, bacterial pneumonia and long-term blood disorders).
Also, the Medicare payment is slightly larger because common lab tests are now included instead of being billed by the lab. Thus the 20 percent co-insurance which is usually paid by the secondary insurance (Medicare supplement plan) may vary from today’s levels. It may go either up or down, and may vary by month.
Medicare will require some patients to get certain drugs they take by mouth from their dialysis provider. Our pharmacy will provide Vitamin D pills to patients on peritoneal dialysis who do not get this drug through an IV. In 2014, all patients with Medicare coverage will obtain some specific oral drugs from Northwest Kidney Centers.