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The New ESRD Bundled Payment System: How Does It Affect Me

. Driving Factors for Revision of Medicare Reimbursement for ESRD. Randomized controlled trials failed to show improved outcomes when ESAs dosed to higher hemoglogin/hematocrit levels in patients with kidney diseaseCHOIR and CREATE in non-dialysis CKD patientsNormal Hematocrit Study in hemodialysi

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The New ESRD Bundled Payment System: How Does It Affect Me

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    1. The New ESRD Bundled Payment System: How Does It Affect Me? Jay Wish, MD Medical Director, Dialysis Program University Hospitals Case Medical Center Cleveland, Ohio

    2. Driving Factors for Revision of Medicare Reimbursement for ESRD Randomized controlled trials failed to show improved outcomes when ESAs dosed to higher hemoglogin/hematocrit levels in patients with kidney disease CHOIR and CREATE in non-dialysis CKD patients Normal Hematocrit Study in hemodialysis patients Costs of ESAs in ESRD patients escalating to >$2 billion/year High percentage of dialysis patients (50% in 2006) with hemoglobin >12 g/dL (upper limit per KDOQI guidelines) Previous payment policies did not provide financial incentive to constrain ESA use

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