why pd

Reimbursement

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 Summary of Analysis 2014. Medicare Institutional Cost Reports submitted from over 4,750 chronic dialysis facilities.

Why pre-dialysis education benefit is good for your patients while it reimburses you for your time3,4

Legislation established a Medicare benefit for pre-dialysis education regarding modality choices.3

What does this mean?

  • Medicare reimburses face-to-face, pre–end-stage renal disease education sessions.3,4
  • Patients in Stage 4 of chronic kidney disease (CKD) also qualify.3

What type of information should be covered in the pre-dialysis education sessions?3

  • Treatment options, including in-center hemodialysis, peritoneal dialysis, home hemodialysis, and transplant
  • Comprehensive information regarding options for renal replacement therapy
  • Management of comorbidities

Learn how Baxter can help

Baxter has resources available to help you determine infrastructure and staffing models and to help train your staff on patient education techniques.

Click here for resources


References:

  1. Rivara MB, Mehrota R. The changing landscape of home dialysis in the United States. Curr Opin Nephrol Hypertens. 2014;23(6):586-591.
  2. Baxter Internal Data on File. (2018). The Moran Company Summary of Analysis 2014.
  3. Medicare.gov. Your medicare coverage. Kidney disease education. Available at: https://www.medicare.gov/coverage/kidney-disease-edu.html. Accessed on August 1, 2018.
  4. Shukla AM, Easom A, Singh M, et al. Effects of a comprehensive predialysis education program on the home dialysis therapies: a retrospective cohort study. Perit Dial Int. 2017;37(5):542-547.