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Details for End-Stage Renal Disease (ESRD) Disease Management Demonstration: Fresenius Medical Care North America (FMCNA) and Fresenius Medical Care Health Plan (FMCHP)
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| Title |
End-Stage Renal Disease (ESRD) Disease Management Demonstration: Fresenius Medical Care North America (FMCNA) and Fresenius Medical Care Health Plan (FMCHP) |
| Project Number |
95-W-00187/01 |
| Project Officr(s) |
Heather Grimsley |
| Start Date |
January 2006 |
| End Date |
December 2009 |
| Funding |
$0 |
| Award |
Waiver-Only Project |
| Principal Investigator(s) |
Not Applicable |
| Awardee Name |
Fresenius Medical Care North America (FMCNA) |
| Awardee Street |
920 Winter Street |
| Awardee City/State/Zip |
Waltham, MA 02451-1457 |
| Description |
The End-Stage Renal Disease (ESRD) Disease Management Demonstration will increase the opportunity for Medicare beneficiaries with ESRD to join integrated care management systems. Ordinarily, Medicare beneficiaries with ESRD are prohibited from enrolling in Medicare Advantage (MA) plans. This demonstration makes an exception to the rule, allowing MA organizations to partner with dialysis organizations to enroll beneficiaries with ESRD in specified service areas. The dialysis/MA organization must provide all Medicare covered benefits. Organizations serving ESRD patients will receive the same risk-adjusted ESRD capitation payments as the MA program overall " with separate rates for dialysis, transplant, and post-transplant modalities.
The actual payment amount, however, will be reduced by 5 percent, which will be available to the organizations depending on performance on quality measures. CMS has determined six dialysis-related indicators on which performance will be assessed. These indicators are adequacy of dialysis, anemia management, serum phosphorous, serum calcium, fistulas, and catheters. These indicators and standards were developed in consultation with participating organizations and with the CMS implementation contractor, Arbor Research Collaborative for Health.
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| Status |
The organization began enrolling patients January 1, 2006. The total enrollment in all FMCHP plans as of November 2007 is 693 beneficiaries.
In 2008, FMCHP plans are available to beneficiaries with ESRD in select counties in the following states: Alabama, California, Connecticut, Illinois, Massachusetts, Minnesota, New York, Pennsylvania, Rhode Island, Tennessee, and Texas. |
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Last Modified Date : 02/15/2008
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