MedPac

MedPAC Reports to Congress

The Medicare Payment Advisory Commission (MedPAC) has released a new report to Congress on new approaches in Medicare. The report looks at the Medicare Modernization Act's prescription drug and chronic care provisions. A case study of chronic kidney disease (CKD) and chronic care improvement programs (CCIP) is also included.

Conclusion from the case study: Renal patients experience substantial morbidity and mortality and are among the costliest populations for Medicare. Evidence from the literature suggests that earlier intervention and better management of patients with CKD may, in some cases, delay or prevent permanent kidney failure. In addition, MedPAC’s analysis of claims data suggests that earlier referral of CKD patients to a Nephrologist may reduce some of the morbidity associated with ESRD.

The CCIP will provide opportunities to promote earlier intervention and improve management of CKD. Patients with CKD will undoubtedly be among the program’s participants because of the high prevalence of diabetes and CHF in this population. In the initial phase of the CCIP, policymakers should consider including in the evaluation how well each contractor met the special needs of patients with CKD.

As more information becomes available, MedPAC may examine the potential of different approaches to coordinate the care for patients with CKD. Such an effort would include interviewing providers of programs focusing on improving the quality of CKD care and reviewing studies examining the effectiveness of different approaches. It is not yet clear that population-based disease management is the optimal approach because CKD is asymptomatic for many persons. Programs that coordinate the care of CKD patients may need laboratory data for targeting patients.

CMS has excluded patients with ESRD from participating in the CCIP, but not patients with other costly conditions, such as rheumatoid arthritis and multiple sclerosis. Care coordination programs as configured under the MMA might have provided opportunities to improve renal care. Although CMS will be initiating a disease management demonstration for ESRD patients in the near future, not all ESRD patients will be able to participate in this program.

-Case Study
-Presentation brief
-Public Meeting

For more information please contact:

Mark Emley
Transonic Systems Inc.
800-353-3569
Mark.Emley@transonic.com