Medical Design and Outsourcing

  • Home
  • Medical Device Business
    • Mergers & Acquisitions
    • Financial
    • Regulatory
  • Applications
    • Cardiovascular
    • Devices
    • Imaging
    • Implantables
    • Medical Equipment
    • Orthopedic
    • Surgical
  • Technologies
    • Contract Manufacturing
    • Components
    • Electronics
    • Extrusions
    • Materials
    • Motion Control
    • Prototyping
    • Pumps
    • Tubing
  • Med Tech Resources
    • DeviceTalks Tuesdays
    • Digital Editions
    • eBooks
    • Manufacturer Search
    • Medical Device Handbook
    • MedTech 100 Index
    • Podcasts
    • Print Subscription
    • The Big 100
    • Webinars / Digital Events
    • Whitepapers
    • Video
  • 2022 Leadership in MedTech
    • 2022 Leadership Voting!
    • 2021 Winners
    • 2020 Winners
  • Women in Medtech

Physician payment reform has led to a decrease in home-based dialysis

July 11, 2016 By Rogene Evans

The Medicare program’s transition in 2004 to tiered fee-for-service physician reimbursement for dialysis care had the unintended consequence of reducing the use of home dialysis, according to a paper co-authored by a nonresident scholar at Rice University’s Baker Institute for Public Policy and colleagues from Stanford University and Baylor College of Medicine.

More than 100,000 people develop end-stage renal disease every year in the United States. Due to a shortage of kidneys available for transplantation, the vast majority receive dialysis, which can be provided through one of three methods. In-center hemodialysis is the most common and involves patients going to a dialysis facility three or four times per week to receive therapy; home-based dialysis therapies (which include peritoneal dialysis and home hemodialysis) are alternatives that offer more flexibility and lifestyle benefits for some patients.

The authors of “Effects of Physician Payment Reform on Provision of Home Dialysis” conducted analyses comparing patients with traditional Medicare coverage who were affected by the policy with others who have Medicare Advantage and were unaffected by the policy. The analyses consisted of a cohort study of patients starting dialysis in the U.S. in the three years before and the three years after payment reform. The study also examined whether the policy had a more pronounced influence on dialysis method assignment in areas most affected by the policy due to lower costs of traveling to dialysis facilities.

Patients with traditional Medicare coverage experienced a 0.7% reduction in the absolute probability of home dialysis use following payment reform compared with patients with Medicare Advantage. Patients living in areas with larger dialysis facilities (where payment reform made in-center hemodialysis comparatively more lucrative for physicians) experienced a 0.9% reduction in home dialysis use following payment reform compared with patients living in areas with smaller facilities (where payment reform made in-center hemodialysis comparatively less lucrative for physicians).

The paper was co-authored by Dr. Kevin Erickson, nonresident scholar in the Baker Institute’s Center for Health and Biosciences, assistant professor in the Section of Nephrology and an investigator at the Center for Innovations in Quality, Effectiveness and Safety at Baylor; Dr. Wolfgang Winkelmayer, the Gordon A. Cain Chair of Nephrology and professor of medicine at Baylor; Dr. Glenn Chertow, professor of medicine and chief of the Division of Nephrology at Stanford’s School of Medicine; and Dr. Jay Bhattacharya, professor of medicine at Stanford. It was published in the American Journal of Managed Care.

Due to concern that home dialysis is underused and that some patients with end-stage renal disease could benefit from increased autonomy and health-related quality of life if they received home dialysis, the House of Representatives Committee on Ways and Means’ Subcommittee on Health asked the U.S. Government Accountability Office to investigate key barriers to home dialysis use. The GAO’s October 2015 report highlighted the current physician payment policy’s incentives as a potential barrier to home dialysis use. However, the GAO investigation of this topic was limited to interviews with physicians and physician associations. The study co-authored by Erickson provides empirical evidence supporting the concern raised by the GAO.

Rice University’s Baker Institute
bakerinstitute.org

Related Articles Read More >

Johnson & Johnson Office of Digital Innovation Leader Peter Schulam
Imagining the future of cloud-connected medical devices with Johnson & Johnson leaders
Withings Body Scan
Withings plans launch for Body Scan smart scale platform
BinaxNow COVID-19 Ag Card
Time recognizes Abbott offerings among this year’s 100 best inventions
Koya Medical’s Dayspring device
Koya Medical reports positive early results in Dayspring lymphedema trial

DeviceTalks Weekly.

May 13, 2022
Our Pre-Post-DeviceTalks Boston episode, also MedtronicTalks replay with Gastro CMO Austin Chiang
See More >

MDO Digital Edition

Digital Edition

Subscribe to Medical Design & Outsourcing. Bookmark, share and interact with the leading medical design engineering magazine today.

MEDTECH 100 INDEX

Medtech 100 logo
Market Summary > Current Price
The MedTech 100 is a financial index calculated using the BIG100 companies covered in Medical Design and Outsourcing.
DeviceTalks

DeviceTalks is a conversation among medical technology leaders. It's events, podcasts, webinars and one-on-one exchanges of ideas & insights.

DeviceTalks

New MedTech Resource

Medical Tubing

Enewsletter Subscriptions

Enewsletter Subscriptions

MassDevice

Mass Device

The Medical Device Business Journal. MassDevice is the leading medical device news business journal telling the stories of the devices that save lives.

Visit Website
MDO ad
Medical Design and Outsourcing
  • MassDevice
  • DeviceTalks
  • MedTech 100 Index
  • Medical Tubing + Extrusion
  • Drug Delivery Business News
  • Drug Discovery & Development
  • Pharmaceutical Processing World
  • R&D World
  • About Us/Contact
  • Advertise With Us
  • Subscribe to Print Magazine
  • Subscribe to E-newsletter
  • Attend our Monthly Webinars
  • Listen to our Weekly Podcasts
  • Join our DeviceTalks Tuesdays Discussion

Copyright © 2022 WTWH Media, LLC. All Rights Reserved. Site Map | Privacy Policy | RSS

Search Medical Design & Outsourcing

  • Home
  • Medical Device Business
    • Mergers & Acquisitions
    • Financial
    • Regulatory
  • Applications
    • Cardiovascular
    • Devices
    • Imaging
    • Implantables
    • Medical Equipment
    • Orthopedic
    • Surgical
  • Technologies
    • Contract Manufacturing
    • Components
    • Electronics
    • Extrusions
    • Materials
    • Motion Control
    • Prototyping
    • Pumps
    • Tubing
  • Med Tech Resources
    • DeviceTalks Tuesdays
    • Digital Editions
    • eBooks
    • Manufacturer Search
    • Medical Device Handbook
    • MedTech 100 Index
    • Podcasts
    • Print Subscription
    • The Big 100
    • Webinars / Digital Events
    • Whitepapers
    • Video
  • 2022 Leadership in MedTech
    • 2022 Leadership Voting!
    • 2021 Winners
    • 2020 Winners
  • Women in Medtech