New prospective payment system contributes to improved patient choice, quality of care and costs

AcademyHealth today awarded its Health Services Research (HSR) Impact Award to work that contributed to the development of a prospective payment system that contributed to improved patient choice and quality of care, and reduced costs in the treatment of End Stage Renal Disease (ESRD).

This year's HSR Impact Award was presented to research conducted by Dr. Richard Hirth and colleagues that provided Congress and the Centers for Medicare and Medicaid Services with the evidence needed to develop a more efficient bundled prospective payment system for ESRD.

For more than 40 years, Medicare has been a near single-payer for ESRD patients. For many, dialysis is the primary, life-saving treatment, yet these patients experience both high mortality rates (up to 20 percent in the first year of dialysis) and very high costs. In fact, ESRD patients represent about 1 percent of Medicare population but account for more than 6 percent of Medicare spending. For these reasons, understanding and addressing the incentives built into the Medicare payment system could significantly impact both the cost and quality of care received by this highly vulnerable population.

The new system saves taxpayers money by creating incentives to reduce inappropriately high doses of medications and the use of higher cost medications when lower cost options exist. Early evidence indicates the new system is also preserving, and in some case enhancing, patient access to care.

"The HSR Impact Award is presented annually to health services research studies that make a clear impact on health policy and practice," said AcademyHealth President and CEO Lisa Simpson. "In this case, Dr. Hirth and his colleagues provided the evidence policymakers needed to make decisions that made care for critically ill patients more efficient. In doing so, the work exemplifies the important contributions health services research makes to health and health care."