Designing a Capitation Payment Plan for Medicare End Stage Renal Disease Services

by Donna O. Farley, Joel Kallich, Grace M. Carter, Thomas W. Lucas, Karen Spritzer


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This reports presents findings from a study of design options and payment methods for a capitation payment plan for the Medicare End Stage Renal Disease (ESRD) Program. The study contributes to payment policy development by evaluating capitation as an alternative payment method to control Medicare costs while maintaining access and quality of care for ESRD patients. A capitation payment method has been developed that combines monthly capitation payments for dialysis and functioning graft patients with one-time payments for kidney transplant and graft failure events.

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