"Bundling" and the renal community in the US - page 2

In the renal community life has changed drastically since the 1st January 2011 a new and dreaded word became the norm, the word which strikes fear into the hearts of our community is "Bundling". ... Read More

  1. by   Chisca
    When the needs of the system take front seat over the needs of the patient we have arrived at a hellish situation. Non compliance in dialysis patients is evident because being a renal patient places so much demands on your life and you are monitored so closely. If the financial health of the system is to be the highest priority then what is to stop medicare from denying treatment for diabetics whose HgbA1C is high? Denying treatment for cardiac patients whose cholesterol is too high? At this point we still allow patients the freedom to decide what they want even if it is not in their best interests. Unless they are dialysis patients.
  2. by   Marisette
    I have questions about the justification of bundling simply because I don't understand who is determining
    what the quality outcomes should be and how they come to the conclusion that these numbers are benefiting
    patients. Should a patient on dialysis with metastic cancer who does not want to dialize 4-5 hrs still be obligated
    to complete the hours dialized so the dialysis company can be reimbursed? Who sets the anemia management goal, the medication providers or the md based on the needs of the patient? Is it fair that the dialysis company not get reimbursed if a patient gets a HGB level less than 0.1 below or above the CMS goal? Do dialysis patients obtain a good adequacy or kt/v everyday or just on the day tested so that the company can get the CMS number and reimbursement. We just test and test until patients meet the goal for reimbursement. Is this good for the patient, the dialysis company or goverment regulators. I don't believe it's about the patient. It's business and reimbursement that impacts care delivered to patients.
  3. by   madwife2002
    Marisette you have raised some very valid and relevent points, the answer is simple!
    Only the nurses and techs care-upper management dont care one bit it is all about the $'s
    It comes to something when you report a death, and somebody higher up says
    'I hope they didn't have a fistula'
    I am speechless!