Provider monitoring and pay-for-performance when multiple providers affect outcomes: An application to renal dialysis.

ABSTRACT:

Objective

To characterize the influence of dialysis facilities and nephrologists on resource use and patient outcomes in the dialysis population and to illustrate how such information can be used to inform payment system design.

Data sources

Medicare claims for all hemodialysis patients for whom Medicare was the primary payer in 2004, combined with the Medicare Enrollment Database and the CMS Medical Evidence Form (CMS Form 2728), which is completed at onset of renal replacement therapy.

Study design

Resource use (mainly drugs and laboratory tests) per dialysis session and two clinical outcomes (achieving targets for anemia management and dose of dialysis) were modeled at the patient level with random effects for nephrologist and dialysis facility, controlling for pat

SUBMITTER: Hirth RA 

PROVIDER: S-EPMC2754549 | biostudies-literature | 2009 Oct

REPOSITORIES: biostudies-literature