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The organization and financing of kidney dialysis and transplant care in the United States of America

  • Richard A. HirthEmail author
Article

Abstract

In the United States, end-stage renal disease (ESRD) patients are primarily insured by the publicly funded Medicare program. Compared to other countries in the International Study of Health Care Organization and Financing (ISHCOF), the United States has the highest health care expenditures for the general population and among ESRD patients. However, because the Medicare program is more influential in the market for ESRD-related services than for other medical services, ESRD price controls have been relatively stringent. Nonetheless, ESRD costs have grown substantially through increases in prevalence and use of ancillary services. Treatment costs are also controlled by the relatively high rate of transplantation. Proposed reforms include bundling more services into a prospective payment system, developing case-mix adjustments, and financially rewarding providers for quality.

Keywords

End-stage renal disease Dialysis Health care financing Medical costs Reimbursement United States 

JEL Classification

I10 I11 I12 I18 

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Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  1. 1.Health Management and PolicyUniversity of Michigan School of Public HealthAnn ArborUSA

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