Key facts about PD reimbursement
The Centers for Medicare & Medicaid Services (CMS) continues to offer incentives for home therapy1
- All dialysis modalities are reimbursed at the same prospective payment system (PPS) per-treatment payment rate, PD benefits under the bundle
- The three-month waiting period for Medicare coverage is waived if patients choose home therapy over HD
How PD provides financial benefit to the healthcare system2
| Average patient | Average ICHD patient | Average PD patient | Net change ICHD vs. PD patient |
|
|---|---|---|---|---|
| Number of reporting facilities | NA | 5,000 | 2,200 | NA |
| Average revenue per Medicare beneficiary year |
$41,000 | $41,000 | $42,000 | $1.000 |
| Average cost per Medicare beneficiary year |
$41,000 | $42,000 | $37,000 | ($5,000) |
| Average margin per Medicare beneficiary year |
$200 | ($800) | $5,700 | $6,500 |
| % margin per Medicare beneficiary year |
0.5% | (2.0%) | 13% | 15% |
Adapted from The Moran Company of Analysis 2014. Medicare Institutional Costs Reports submitted from over 4,750 chronic dialysis facilities.