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Advisory Board on the Demo. of Payment System for (ESRD) Services

Advisory Board on the Demonstration of a Bundled Case-Mix Adjusted Payment System for End Stage Renal Disease (ESRD) Services

The Advisory Board on the Demonstration of a Bundled Case-Mix Adjusted Payment System for End Stage Renal Disease (ESRD) Services, chartered on May 11, 2004, advises and makes recommendations to the Secretary of Health and Human Services and the Administrator of the Centers for Medicare and Medicaid Services (CMS) on the establishment and operation of a demonstration project to test the use of a fully case-mix adjusted payment system for ESRD services. Specifically, the ESRD Advisory Board will study and make recommendations on issues such as the following: drugs, biologicals, and clinical laboratory tests to be bundled into the demonstration payment rates; method and approach to be used for the patient characteristics to be included in the fully case-mix adjusted demonstration payment system; how payment for bundled services provided by non-demonstration providers should be handled for beneficiaries participating in the demonstration; the feasibility of providing financial incentives and penalties to plans operating under the demonstration that meet or fail to meet applicable quality standards; the specific quality standards to be utilized; the feasibility of using disease management techniques to improve quality and patient satisfaction and reduce costs of care for the beneficiaries participating in the demonstration; and selection criteria for demonstration organizations. Upon implementation of the demonstration, the ESRD Advisory Board will continue to advise the Secretary and the CMS Administrator on the operation of the demonstration. The Secretary appoints eleven members to serve for the duration of the ESRD Advisory Board. The MMA provides that the ESRD Advisory Board will terminate on December 31, 2008. Members include representatives of patient organizations; individuals with expertise in ESRD dialysis services, such as clinicians, economists, and researchers; the Medicare Payment Advisory Commission, established under section 1805 of the Social Security Act (42 USC 1395b-6); The National Institutes of Health; Network Organizations under section 1881(c) of the Social Security Act (42 USC 1395rr(c)); Medicare contractors to monitor quality of care; and representatives of providers of services and renal dialysis facilities furnishing ESRD services.

Federal Register Notices

The Federal Register Notices files are located in a zip file in the Downloads Area below.

  • CMS-5033-N5-Medicare Program; Meeting of the Advisory Board on the Demonstration of a Bundled Case-Mix Adjusted Payment System for End-Stage Renal Disease Services-July 14 Through July 15, 2005 Federal Register / Vol. 70, No. 121 / Friday, June 24, 2005 / Notices (PDF, 55 KB)
  • CMS-5033-N4-Medicare Program; Meeting of the Advisory Board on the Demonstration of a Bundled Case-Mix Adjusted Payment System for End-Stage Renal Disease Services-May 24, 2005 Federal Register / Vol. 70, No. 82 / Friday, April 29, 2005 / Notices
  • CMS-5033-N6-Medicare Program; Cancellation of the April 13, 2005 Advisory Board Meeting on the Demonstration of a Bundled Case-Mix Adjusted Payment System for End-Stage Renal Disease Services Federal Register / Vol 70, No. 69 / Tuesday, April 12, 2005 / Notices
  • CMS-5033-N3-Medicare Program; Meeting of the Advisory Board on the Demonstration of a Bundled Case-Mix Adjusted Payment System for End-Stage Renal Disease Services Federal Register / Vol. 70, No. 57 / Friday, March 25, 2005 / Notices
  • CMS-5033-N2-Medicare Program; Meeting of the Advisory Board on the Demonstration of a Bundled Case-Mix Adjusted Payment System for End-Stage Renal Disease Services Federal Register / Vol. 70, No. 18 / Friday, January 28, 2005 / Notices

Meetings Reports

The Meeting Reports, Agendas, and Transcript files are located in a zip file in the Downloads Area below.

February 16, 2005 Agenda

  • Meeting Materials-- Slides
  • Background Materials Handout
  • Minutes
  • Transcript

May 24, 2005 Agenda

  • Meeting Materials--CMS/Office of Research, Development & Information (ORDI) Preliminary Report on Alternative Bundles
  • Data Tables on Bundle Definitions
  • CMS/ORDI Paper on Framework for Bundling Options
  • CMS/ORDI Paper on Descriptive Statistics
  • University of Michigan Kidney Epidemiology and Cost Center (KECC) Presentation on Case Mix Adjustment
  • CMS/ORDI Paper on Framework for Discussion of Pay-for-Performance )
  • KECC Specification of Alternative Case Mix Models
  • Minutes
  • Transcript

July 15, 2005 Agenda

  • Discussion Document: Proposed Demonstration Design
  • Discussion Document: Patient Volume and Facility Risk
  • Discussion Document: Use of Dose-Response in Case Mix Models
  • Supplemental Data: Laboratory Tests
  • Supplemental Data: 'Other' Services (Bundle 1D)
  • Analytic Results: Alternative Case Mix Models Using Dose-Response
  • Analytic Results: Impact Analysis for Case Mix Model 9