Recombinant Erythropoietin and Medicare Payment-Reply
| Autor: | Jane E. Sisk, Frank D. Gianfrancesco, John M. Coster |
|---|---|
| Rok vydání: | 1991 |
| Předmět: |
medicine.medical_specialty
business.industry media_common.quotation_subject medicine.medical_treatment General Medicine Payment Medicare payment Financial incentives medicine Dosing Hematocrit levels Fixed interest rate loan Intensive care medicine Recombinant erythropoietin business health care economics and organizations Dialysis media_common |
| Zdroj: | JAMA: The Journal of the American Medical Association. 266:2706 |
| ISSN: | 0098-7484 |
| DOI: | 10.1001/jama.1991.03470190053027 |
| Popis: | In Reply. —We have read with interest Dr Eggers' comments on our article. The article commended rather than criticized the HCFA for its initial payment policy. We expressed concern not with the initial policy but with its monitoring and refinement over time. The HCFA should have anticipated that a fixed payment rate per treatment for a non-life-threatening condition would create strong financial incentives for low dosing. Dialysis facilities have historically been responsive to the financial incentives of Medicare's fixed rate per dialysis treatment, eg, by reusing dialyzers. 1 One would thus have expected that their dosages of recombinant erythropoietin would also reflect financial incentives, as they apparently did. We appreciate Eggers' clarification of the system that the HCFA established to monitor use. Contrary to the information that we received previously, the HCFA's central office obtains from its intermediaries monthly billings that include individual patient's dosage and hematocrit levels (P. Eggers |
| Databáze: | OpenAIRE |
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