Journal of the American Society of Nephrology
2007 JASN IMPACT FACTOR 7.111 HOME   AUTHOR INFO   EDITORIAL BOARD   SUBSCRIBE   FEEDBACK   ALERTS   HELP 
    advanced
CURRENT ISSUE ARCHIVES JASN Express ONLINE SUBMISSION


Published ahead of print on March 30, 2005
J Am Soc Nephrol 16: 1172-1176, 2005
© 2005 American Society of Nephrology
doi: 10.1681/ASN.2004110950
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow All Versions of this Article:
ASN.2004110950v1
16/5/1172    most recent
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Hirth, R. A.
Right arrow Articles by Wolfe, R. A.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Hirth, R. A.
Right arrow Articles by Wolfe, R. A.

Fast Track

Economic Impact of Case-Mix Adjusting the Dialysis Composite Rate

Richard A. Hirth, Erik C. Roys, John R.C. Wheeler, Joseph M. Messana, Marc N. Turenne, Rajiv Saran, Alyssa S. Pozniak and Robert A. Wolfe

Kidney Epidemiology and Cost Center, Department of Biostatistics, The University of Michigan, Ann Arbor, Michigan

Address correspondence to: Dr. Richard Hirth, Kidney Epidemiology and Cost Center, The University of Michigan School of Public Health, 315 West Huron, Suite 240, Ann Arbor, MI 48109-4262. Phone: 734-936-1306 or 734-998-6611; Fax: 734-998-6620; E-mail: rhirth{at}umich.edu

The Medicare program reimburses dialysis providers a flat rate for a bundle of services that comprise the basic dialysis treatment. This payment system is being modified to incorporate case-mix adjustment for age and body size, which have been shown to influence dialysis costs. This study simulated the economic impact of the recently issued Medicare rule on case-mix adjustment by estimating the variation in payments across patients, facilities, and broad classes of facilities. Case-mix adjustment results in considerable patient-level variation in payments ($12.99 SD in case-mix adjusted payments). The variation across dialysis facilities is smaller but still economically significant ($3.77 SD). However, there was little evidence that particular classes of facilities (e.g., ownership, chain membership, size) will be substantially advantaged or disadvantaged by case-mix adjustment. There do seem to be modest changes in the regional distribution of payments.




This article has been cited by other articles:


Home page
 CJASNHome page
A. A. Desai, A. M. Garber, and G. M. Chertow
Rise of Pay for Performance: Implications for Care of People with Chronic Kidney Disease
Clin. J. Am. Soc. Nephrol., September 1, 2007; 2(5): 1087 - 1095.
[Abstract] [Full Text] [PDF]

Home page
 J. Am. Soc. Nephrol.Home page
R. A. Hirth, M. N. Turenne, J. R.C. Wheeler, A. S. Pozniak, P. Tedeschi, C.-C. Chuang, Q. Pan, K. Slish, and J. M. Messana
Case-Mix Adjustment for an Expanded Renal Prospective Payment System
J. Am. Soc. Nephrol., September 1, 2007; 18(9): 2565 - 2574.
[Abstract] [Full Text] [PDF]

Home page
 J. Am. Soc. Nephrol.Home page
J. Himmelfarb and G. M. Chertow
Medicare ESRD Prospective Payment System: Weighing the Evidence
J. Am. Soc. Nephrol., May 1, 2005; 16(5): 1164 - 1165.
[Full Text] [PDF]


HOME CURRENT ISSUE ARCHIVES JASN Express ONLINE SUBMISSION AUTHOR INFO
EDITORIAL BOARD SUBSCRIBE FEEDBACK ALERTS HELP

Copyright © 2008 by the American Society of Nephrology. Online ISSN: 1533-3450 Print ISSN: 1046-6673