FME & DAV’s main objection has been removed CMS released a revised request for applications for CEC (http://goo.gl/HW5arJ), whereby dialysis care providers would provide care for patients outside the clinic. The previous request allowed CMS to claw back any cost savings that the care providers via a rebasing of the comparison base. The most recent proposal removes this provision which may make the proposal more attractive to dialysis care providers.
FME & DAV still treated differently, but not necessarily worse Large Dialysis Organisations (LDOs), i.e Fresenius Medical and DaVita, are exposed to more benefits, and risks, than Small Dialysis Organisations (SDOs). LDOs are expected to make 4% savings after 4 years before they can benefit from any upside, against some SDOs at 2%. However LDOs could take up to 75% of savings above this rate up to a maximum to 15% of total cost whilst SDOs split savings 50/50 up to a maximum of 5% of total cost. The detail of the model has not been released as yet but we see no provision that would allow SDOs to be treated like LDOs or vice versa if they so choose.
Is Fresenius Medical already getting ready? Fresenius Medical earlier this week announced an agreement with Joslin Diabetes Center to help care for diabetic patients before they have been diagnosed with kidney failure and so need dialysis (or kidney transplant). This is a clear commitment to the strategy announced at the recent Capital Markets Day to expand their care beyond dialysis even without CMS’s CEC plan. Fortune favours the prepared…
[+] source: UBS