Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2003 Summer;24(4):77-88.

Is case-mix adjustment necessary for an expanded dialysis bundle?

Richard A Hirth  1 , Robert A Wolfe, John R Wheeler, Erik C Roys, Philip J Tedeschi, Alyssa S Pozniak, Glenn T Wright
Affiliations

Is case-mix adjustment necessary for an expanded dialysis bundle?

Richard A Hirth et al. Health Care Financ Rev. 2003 Summer.

Abstract

Congress has required CMS to expand the Medicare outpatient prospective payment system (PPS) for dialysis services to include as many drugs and diagnostic procedures provided to end stage renal disease (ESRD) patients as possible. One important implementation question is whether dialysis facility case mix should be reflected in payment. We use fiscal year (FY) 2000 cost report and patient billing and clinical data to determine the relationship between costs and case mix, as represented by several patient demographic, diagnostic, and clinical characteristics. Results indicate considerable variability in costs and case mix across facilities and a significant and substantial relationship between case mix and facility cost, suggesting case mix payment adjustment may be important.

PubMed Disclaimer

References

    1. Ashby VB, Wolfe RA, Loos ME, Port FK. The Effect of Comorbidities on Facility Standardized Mortality Ratios. Journal of the American Society of Nephrology. 1998;9:197a.
    1. Dor A, Held P, Pauly M. The Medicare Cost of Renal Dialysis: Evidence from a Statistical Cost Function. Medical Care. 1992 Oct;30(10):879–891. - PubMed
    1. Federal Register. 1999 Jul 30;64(No. 146):41690–41696. - PubMed
    1. Forum of ESRD Networks Clearinghouse Office. Summary Report of the End Stage Renal Disease (ESRD) Network's Annual Reports, 2000. Internet address: http://cms.hhs.gov/esrd/2c.pdf.
    1. Hirth R, Held P, Orzol S, Dor A. Changing Treatment Patterns, Practice Patterns, Case-Mix, Medicare Payment Policy and Dialysis Facility Costs. Health Services Research. 1999 Feb;33(6):1567–1592. - PMC - PubMed

Publication types

LinkOut - more resources