Cover: Patterns of Inpatient Physician Services for End Stage Renal Disease Beneficiaries

Patterns of Inpatient Physician Services for End Stage Renal Disease Beneficiaries

Published 1992

by Joel Kallich, John L. Adams, Adnan Rahman

Download

Download eBook for Free

FormatFile SizeNotes
PDF file 1.4 MB

Use Adobe Acrobat Reader version 10 or higher for the best experience.

Purchase

Purchase Print Copy

 Format Price
Add to Cart Paperback54 pages $9.00

On April 1, 1988, the Health Care Financing Administration (HCFA) directed all carriers to have a uniform policy and allow physicians the use of "dialysis procedure codes" for the supervision of inpatient dialysis services to End Stage Renal Disease (ESRD) beneficiaries. In the year following this change, inpatient dialysis services provided by physicians increased from 12.7 percent ($38.8 million) to over 16 percent ($62.8 million) of all allowed charges. Allowed charges for other inpatient medical care services also increased from $66.2 million to $77 million. Physicians who provide routine care for dialysis patients had a 24.7 percent increase in their total allowed charges for inpatient physician services. Our most conservative estimate of the effect of the policy change is that it increased charges by 4 percent, and other factors accounted for some of the remaining 20 percent. Although the services that the physician provides for a hospitalized patient are more intensive than monitoring outpatient dialysis, the large difference between reimbursement rates for inpatient hospital and outpatient physician services is a significant incentive to provide services in the hospital.

This report is part of the RAND monograph report series. The monograph/report was a product of RAND from 1993 to 2003. RAND monograph/reports presented major research findings that addressed the challenges facing the public and private sectors. They included executive summaries, technical documentation, and synthesis pieces.

This document and trademark(s) contained herein are protected by law. This representation of RAND intellectual property is provided for noncommercial use only. Unauthorized posting of this publication online is prohibited; linking directly to this product page is encouraged. Permission is required from RAND to reproduce, or reuse in another form, any of its research documents for commercial purposes. For information on reprint and reuse permissions, please visit www.rand.org/pubs/permissions.

RAND is a nonprofit institution that helps improve policy and decisionmaking through research and analysis. RAND's publications do not necessarily reflect the opinions of its research clients and sponsors.