ESRD Prospective Payment System (PPS) Project

Analysis, Methods Assessment, and Special Studies for the Development of a Fully Bundled Prospective Payment System for Outpatient End Stage Renal Disease Facilities

Under contract to the Centers for Medicare and Medicaid Services (CMS), the Prospective Payment Project supports research concerning current and proposed payment systems for routine dialysis services currently paid by Medicare. Changes in Medicare payment have been ongoing since the Medicare Modernization Act of 2003, which mandated that CMS study the possibility of expanding the scope of prospective renal care payments to include many or all of the dialysis related services now billed on a fee for service basis. Current work builds on the team’s prior research on case-mix adjustment for composite rate services. This team’s basic case-mix adjustment was implemented by CMS in 2005 for ESRD patients. The project is led by principal investigator Richard Hirth.