Medicare issues bundle payment rules for dialysis

Beginning in January, the Centers for Medicare and Medicaid Services will pay a set fee for dialysis treatments. This bundled payment will cover both the dialysis service, in which wastes are removed from the body, and the drugs and laboratory tests that accompany it.

The new bundled payment is expected to sharply reduce the use of anemia drugs, including Epogen, which is currently a profit-making drug in many dialysis centers. Critics of the bundle worry that there will be an incentive to under use the drug, which could subject some dialysis patients to anemia and fatigue. CMS officials hope that the inclusion of quality measurement will protect against under use of the drug.

(Sources: The Advisory Board Daily Briefing,, July 28, 2010; The New York Times,, July 26, 2010)