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首页> 外文期刊>The New England journal of medicine >Bundled payment for ESRD--including ESAs in Medicare's dialysis package.
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Bundled payment for ESRD--including ESAs in Medicare's dialysis package.

机译：ESRD的捆绑付款-包括Medicare透析包中的ESA。

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摘要

In response to a congressional mandate, Medicare has introduced a more constrained method of paying for services covered by its end-stage renal disease (ESRD) program - a method with benefits and risks for patients and providers alike. In the Medicare Improvements for Patients and Providers Act (MIPPA), Congress bundled into a package most of the services provided to dialysis recipients and directed Medicare's administrators to establish a fixed compensation amount for dialysis facilities. This system, which went into effect January 1, trims payments to ESRD facilities by 2% overall and reduces "incentives to overuse profitable, [previously] separately bill-able drugs," particularly erythro-poiesis-stimulating agents (ESAs), because studies showed that such overuse harms patients.
机译：为了响应国会的授权，Medicare推出了一种更为受限的付费方式，以支付其终末期肾脏疾病（ESRD）计划所涵盖的服务-这种方式对患者和医疗服务提供者都具有收益和风险。在《 Medicare改善患者和医疗提供者法案》（MIPPA）中，国会将向透析接受者提供的大多数服务捆绑在一起，并指示Medicare的管理人员为透析设施确定固定的赔偿金额。该系统于1月1日生效，将对ESRD设施的付款总体削减了2％，并减少了“过度使用可获利的，[以前]可单独计费的药物的激励措施”，特别是促红细胞生成刺激剂（ESA），因为研究表明过度使用会伤害患者。

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