The Economics of End Stage Renal Disease: A Case Study

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The purpose of this paper is to discuss healthcare financing in America, as it relates to a case study about End Stage Renal Disease (ESRD). I will discuss the major reimbursement mechanisms for ESRD. Additionally, I will provide the organization’s point of view about the economics of providing ESRD treatment. I will share options and potential trade-offs related to cost of treatment, quality of treatment, and access to treatment. Finally, I will discuss the ethical implications of resulting treatment options based on cost evaluation.

Reimbursement Mechanisms

In 1972, Medicare coverage for beneficiaries and individual under 65 years of age was spurred on by economic and political forecasts. The support for ESRD reimbursement was due to the belief that the kidney transplant would become a routine practice and dialysis would become more obsolete (Munn-Short, 2008). Unfortunately the expectation was not met, as in 2006 there were over 65,000 beneficiaries on dialysis and waiting for a kidney transplant. In 2003 the Medicare Modernization Act mandated the first revision to the reimbursement system since 1972; coverage was restructured and cost measures were implemented. (Munn-Short, 2008). This was due to the belief that the current reimbursement system promoted insufficient use of resources and over use of medications which were billed separately. This required that services billed separately by physicians and laboratories are to be bundled for each dialysis session. Bundling of services includes all laboratory tests, supplies, injectable medications, and the shifting the responsibility of oral medications coverage (that used to be covered under the Medicare part D) to the dialysis facilities (Wish, 2009). In addition to stronger r...

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...lthcare service is monitored to ensure that the financial gains does not compromise the quality of care.

Works Cited

Brewer, C. S., & Rosenthal, T. C. (2008). The health-care' class='brand-secondary'>health care workforce. In A. R. Kovner, J. R. Knickman & S. M. Jonas (Eds.), Health care delivery in the united states (pp. 321-335). New York, NY: Springer Publishing Company.

Laureate Education, I. (Producer). (2010). Healthcare economics and financing [DVD]. In The nurse leader: New perspectives on the profession.

Munn-Short, N. (2008). Applied healthcare economics for the noneconomics major. In K. Sullivan (Ed.), Health policy and politics: A nurse's guide (pp. 231-243). Sudbury, MA: Jones and Bartlett Publishers, Inc.

Wish, D. (2009, December 1). Revisions in the end stage renal disease prospective payment system: Implications for nephrology nurses. Nephrology Nursing Journal, 36(6), 635-641.

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