End-Stage Renal Diease
Introduction
In the United States, hypertension and diabetes coexist and the prevalence of these diseases continue to rise daily. In conjunction with the aging population, these are the most common causes of kidney disease. Patients with end stage renal disease will require either transplantation or dialysis. With the rising cost of health care, peritoneal dialysis has been identified as being potentially more cost effective than in-center hemodialysis, but it is not the treatment of choice by most doctors for their patients. Treatment of end stage renal disease is challenged by cost, quality and access to health.
Major reimbursement mechanisms End stage renal disease causes a significant burden on the health care system and it consumes 6% of Medicare’s budget (Sullivan, 2009). In July 1973, the federal government extended Medicare benefits to patients suffering with chronic renal failure, and the End Stage Renal Disease (ESRD) Program was established (2009). Even with initiation of the program, cost still rose and higher mortality rates were seen. In 2011, the federal government made another change in reimbursement allowing payments to be bundled into one single payment, under the new End stage renal disease reimbursement system, Prospective Payment System. This change is expected create high quality environment by controlling cost due to additional drugs.
Economics of providing ESRD treatment
Anticipated shifts of economic responsibility, combined with increasing numbers of patients, have forced organizations to examine potential cost saving measures. The United States has the highest incidence rates of end stage renal disease and highest annual expenditure per patient (Knauf & Peter, 2009). The majority of dialysis that is performed in the United States is conducted under the high fixed-cost outpatient dialysis units (Sullivan, 2009). Fresenius Medical Care and DaVita control 82.1% of the market and the rest by smaller companies. Larger
In the United States, hypertension and diabetes coexist and the prevalence of these diseases continue to rise daily. In conjunction with the aging population, these are the most common causes of kidney disease. Patients with end stage renal disease will require either transplantation or dialysis. With the rising cost of health care, peritoneal dialysis has been identified as being potentially more cost effective than in-center hemodialysis, but it is not the treatment of choice by most doctors for their patients. Treatment of end stage renal disease is challenged by cost, quality and access to health.
Major reimbursement mechanisms End stage renal disease causes a significant burden on the health care system and it consumes 6% of Medicare’s budget (Sullivan, 2009). In July 1973, the federal government extended Medicare benefits to patients suffering with chronic renal failure, and the End Stage Renal Disease (ESRD) Program was established (2009). Even with initiation of the program, cost still rose and higher mortality rates were seen. In 2011, the federal government made another change in reimbursement allowing payments to be bundled into one single payment, under the new End stage renal disease reimbursement system, Prospective Payment System. This change is expected create high quality environment by controlling cost due to additional drugs.
Economics of providing ESRD treatment
Anticipated shifts of economic responsibility, combined with increasing numbers of patients, have forced organizations to examine potential cost saving measures. The United States has the highest incidence rates of end stage renal disease and highest annual expenditure per patient (Knauf & Peter, 2009). The majority of dialysis that is performed in the United States is conducted under the high fixed-cost outpatient dialysis units (Sullivan, 2009). Fresenius Medical Care and DaVita control 82.1% of the market and the rest by smaller companies. Larger
References: Knauf, F. & Aronson, P.S. (2009). ESRD as a window into America’s Cost Crisis in Health Care. Journal of the American Society of Nephrology. 20, 2093-2097 Sullivan, J. (2011, April 27). Bundling and its potential impact on dialysis service providers. Retrieved from http://www.nephrologynews.com/articles/bundling-and-its-potential-impact-on-dialysis-service-providers Sullivan, J. D. (2010). End Stage Renal Disease economics and the balance of treatment modalities. Journal of Service Science & Management, 3(1), 45–50.