AJMC in the Press, July 15, 2016

The new study in The American Journal of Managed Care, “Effects of Physician Payment Reform on Provision of Home Dialysis,” received extensive coverage this week. Researchers led by Kevin F. Erickson, MD, MS, examined patterns of care after a change in Medicare payment rules for home-based dialysis. The study found that patients in traditional Medicare were 1% less likely to have home-based dialysis after a change that increased payments for in-center dialysis for patients with end-stage renal disease. As Jacqueline Belliveau wrote in RevenueCycle Intelligence, financial incentives were a significant factor in deciding where patients would be treated. Making in-center dialysis more lucrative could work against patient quality of life, because some dialysis patients have mobility issues or problems finding transportation. Emily Rappleye, writing for Becker’s Hospital Review, noted that the patients most affected were those living near large dialysis facilities. She quoted the authors: “These findings highlight both an area of policy failure and the importance of considering unintended consequences of future efforts to reform physician payment.”