CMS Proposes Changes to ESRD Quality Incentive Program

12 July 2011  No Comments

Renal Business Today recently posted this news update about QIP. Read below for the complete article.

CMS Proposes Changes to ESRD Quality Incentive Program

WASHINGTON—On July 1, The Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that would make changes to dialysis payments, modify the hemoglobin ranges in the ESRD quality incentive program, as well as add new measures to the QIP program.

Click HERE to read the proposal.

The proposals, if finalized, would be effective for dialysis treatments furnished on or after Jan. 1, 2012; and the proposed new requirements for the ESRD QIP would affect the payment year (PY) 2013 and PY 2014 program years.

CMS is projecting that payment rates for dialysis treatments will increase by 1.8 percent, representing a projected inflation (or ESRD market basket) increase of 3.0 percent, less a projected productivity adjustment of 1.2 percent as required by statute. CMS estimates that federal payments to ESRD facilities in 2012 will total $8.3 billion.

“CMS continues to closely monitor implementation of the new prospective payment system. The proposals in this rule would ensure that Medicare beneficiaries with ESRD continue to have strong access to dialysis care,” said Jonathan Blum, Deputy Administrator and Director of the Center for Medicare.

CMS is also proposing to changes to the QIP, under which payments to individual facilities are reduced by up to 2 percent if they do not achieve a high enough total performance score based on their performance with respect to measures that assess the quality of dialysis care. The initial ESRD QIP will affect payments in PY 2012 based on performance standards CMS established with respect to two anemia management measures and one measure of dialysis adequacy.

The proposed rule proposes to change the performance measures for PY 2013 by retiring the hemoglobin level less than 10g/dL measure from the measure set, and equally weighting the two remaining measures (hemoglobin levels greater than 12g/dL and hemodialysis adequacy, as measured by Urea Reduction Ratio (URR) levels of at least 65).

“Clinicians should use the lowest dose of ESA sufficient to reduce the need for red blood cell transfusions,” said Patrick Conway, MD, MSc, CMS Chief Medical Officer and Director of the agency’s Office of Clinical Standards & Quality. “Retiring this measure means that providers and patients will have greater incentive to work together to tailor their anemia management strategies to the unique balance of risks and benefits that anemia treatment presents for each person, resulting in better outcomes for patients.”

The U.S. Food and Drug Administration (FDA) recently changed the ESA label for patients on dialysis. The label now advises physicians to initiate ESA therapy when the hemoglobin level is less than 10 g/dL and guides physicians to reduce or interrupt the dose when the hemoglobin approaches or exceeds 11 g/dL.

“We agree that the proposal to remove the quality measure for the ESRD program focused on keeping hemoglobin above 10 in all ESRD dialysis patients is consistent with the new ESA label approved by FDA on June 24, 2011,” said Ann T. Farrell, MD, acting director of the Division of Hematology Products in the FDA’s Center for Drug Evaluation and Research. “The recommendations in the previous drug labeling to achieve and maintain hemoglobin levels between 10 and 12 g/dL are no longer appropriate and have been removed from the drug labeling.”

CMS said it is investigating how it can use a number of policy levers to address incentives for treating anemia in dialysis patients. In the meantime, CMS also plans to actively monitor patients’ clinical outcomes to ensure that the retirement of this measure does not harm patients.

“CMS continues to believe that anemia management is vitally important for all patients on dialysis,” said Conway. “However, at this time, the medical evidence fails to demonstrate an exact minimum hemoglobin level at which all patients need treatment. Therefore, the anemia management and therapy should be determined by the patient’s physician in light of the patient’s individual needs.”

For the PY 2014 payment determination, CMS is proposing to retain the anemia management measure (hemoglobin level greater than 12g/dL) and to adopt seven new measures that expand the breadth of dialysis services CMS would measure to determine whether patients with ESRD are receiving “high-quality care.” Specifically, CMS is proposing to adopt the following eight measures for PY 2014:

* Dialysis adequacy, as measured through the Kt/V method, which is widely recognized as a more accurate measure of whether dialysis cleanses blood effectively
* Anemia management, as measured by the rate of patients with a hemoglobin level greater than 12 grams per deciliter;
* Percent of patients receiving treatment through an arteriovenous fistula – a type of vascular access used to connect patients’ bloodstreams to dialysis equipment for cleansing;
* Rates of infection of the vascular access sites;
* Ratios of hospitalization rates among dialysis clinic patients;
* Whether the facility reports certain dialysis-related infections to the Centers for Disease Control & Prevention;
* Whether the facility administers a patient experience of care survey; and
* Whether the facility monitors phosphorus and calcium levels on a monthly basis.

The proposed rule also includes two proposals for scoring a facility’s performance under the ESRD QIP—one proposal relates to the two-measure framework proposed for PY 2013, and a second proposal outlines how CMS would score facilities under the eight-measure program proposed for PY 2014. The proposed PY 2013 scoring methodology would more closely align the ESRD QIP with the scoring methodology adopted for the Medicare Hospital Inpatient Value-Based Purchasing Program, make it easier to adopt new measures, and reward facilities not only for delivering high-quality care, but also for improving the standard of care they deliver over time.

Both the ESRD PPS and the QIP were mandated by the Medicare Improvements for Patients and Providers Act of 2008. The previous system consisted of a basic case-mix adjusted composite rate payment for a defined set of services, including certain laboratory tests, drugs and other supplies, while separate payments were made for any items or services furnished as part of the dialysis treatment but for which no payment was made under the composite rate.

CMS will accept comments on the proposed rule until Aug. 30, 2011, and will respond to them in a final rule to be issued by Nov. 1, 2011.

http://www.renalbusiness.com/news/2011/07/cms-proposes-changes-to-esrd-quality-incentive-program.aspx

At-Home Blood Pressure Monitoring

30 June 2011  No Comments

HealthDay News recently posted this article concerning blood pressure monitoring at home. Read below for the complete article.

At-Home Blood Pressure Monitoring More Telling Than Doctor’s Office Readings

June 27, 2011

MONDAY, June 27 (HealthDay News) — Blood pressure readings logged over a 24-hour period on a portable home monitoring device appear more effective than blood pressure readings taken in a doctor’s office for predicting whether patients with chronic kidney disease will experience kidney failure or death.
Click here to find out more!

That’s the finding of an Italian study that included 436 chronic kidney disease patients who were not on dialysis.

In the study, each patient’s blood pressure was measured multiple times while at a clinic over the course of two days. They were also given an ambulatory blood pressure monitor that took readings every 15 minutes during the day and every half hour at night over a 24-hour period.

At-home blood pressure monitors are believed to help overcome what’s known as “white coat hypertension,” in which a patient’s blood pressure spikes because of stress and anxiety when visiting a physician’s office. According to background information in the article, chronic kidney disease patients are especially vulnerable to this.

Prior research has also suggested that nighttime blood pressure readings may be a better measure of a patient’s actual blood pressure status because readings are taken when the patient is at rest and free of the physical and emotional stresses of everyday life that can have an impact on readings.

During an average follow-up of 4.2 years, 86 patients developed kidney failure and 69 died. There were also 63 non-fatal cardiovascular events and 52 deaths caused by cardiovascular problems.

Patients with the highest risk of kidney or cardiovascular problems were those whose daytime systolic (top number) blood pressure was 135 mm Hg or higher; those with high diastolic (bottom number) readings; those with nighttime systolic readings of 124 mm Hg or higher; and those with nighttime diastolic readings of 70 mm Hg or higher. All these readings were provided by the ambulatory device.

“In contrast, office [blood pressure] measurements … did not predict cardiovascular or renal events,” the researchers wrote.

The study appears in the June issue of the journal Archives of Internal Medicine.

More information

The American Academy of Family Physicians has more about chronic kidney disease.

Copyright © 2011 HealthDay. All rights reserved.

Study: More Frequent Dialysis Leads to Better Functioning Blood Vessels

23 June 2011  No Comments

“Study: More Frequent Dialysis Leads to Better Functioning Blood Vessels.” Interesting study featured in Nephrology News and Issues!

Researchers at St. Michael’s Hospital have found that cells that help protect blood vessels work better in patients who undergo dialysis at home during the night than those who undergo standard daytime dialysis in a hospital. This is important for patients with kidney failure, which causes damage to the endothelial cells that line blood vessels and help control the flow of blood.

Nephrologist Darren Yuen, MD, studied the function of cells called early-outgrowth endothelial progenitor-like cells (EPLCs). These cells, found in bone marrow and in the blood, can protect damaged endothelial cells and promote the growth of new ones, leading to healthier blood vessels. The results of his research appear in the June issue of the Clinical Journal of the American Society of Nephrology.

In his study, done in collaboration with the University Health Network, Yuen injected EPLCs from people receiving hospital dialysis into rats with blood vessel damage. He found no added improvements in blood vessel growth or blood circulation. But when he injected EPLCs from patients undergoing nighttime dialysis at home, the results were almost as good as if the cells had come from healthy people.

Since home dialysis lasts for six to eight hours a night, five to six times a week, the toxins and other waste products that build up in kidney failure are more effectively removed, Yuen said. The greater removal of these toxins may be responsible for the better function of EPLCs from patients on home dialysis, he said.

Renal Business Today Features “A Patient View of the ESRD Bundle”

16 June 2011  No Comments

A Patient View of the ESRD Bundle
By Eric J. Edwards

Billed as one of the biggest changes to dialysis in decades, the Centers for Medicare & Medicaid Services’ (CMS) new bundled payment structure for dialysis services, also referred to as “the bundle”, was designed to streamline the way dialysis facilities and services are reimbursed. This new payment structure, which allows the cost associated with dialysis treatment, labs, medicines, and supplies to be included in a bundled payment, became effective January 1, 2011. As is often the case with change, there is much anxiety and anticipation as dialysis facilities, suppliers, laboratories, pharmaceutical companies and, most importantly, the patients brace themselves for the impact the bundle will have on their dialysis care.

The medical benefits provided to end-stage renal disease (ESRD) patients by CMS is, without question, greatly appreciated. There is no doubt that a large percentage of ESRD patients rely on this coverage to help them sustain their lives. Many of us would not be able to afford this life-saving kidney replacement therapy; it is our life support. Unfortunately, until there is a cure or more preventative measures begin to take effect, the number of people with ESRD will continue to rise, increasing the burden on CMS to cover dialysis patients’ treatment cost. Because of this, most dialysis patients do understand CMS’ need to reign in the cost associated with such treatments, but patients have also expressed concerns that the change to the payment system might be to their detriment.

While I cannot speak for all ESRD patients, I believe all of us welcome any changes that promote CMS’ continued coverage of dialysis services for ESRD patients for years to come or until they find a cure. However, if such changes will restrict access to care; affect facilities’ ability to hire, recruit, train, and retain highly skilled staff; or limit our choices in treatments and medicines that we feel work best for us and improve our quality of life, these effects would be a major concern for dialysis patients. Whether payment for dialysis services are delivered separately or bundled in a single payment is not high on the list of concerns for many patients. Dialysis patients’ top priority is to make sure that we can continue to receive quality care in order to have a higher quality of life.

For example, it is extremely important for ESRD patients to take the medications that work best for them. With the inclusion of certain medicines in the bundle, many patients are concerned about the availability of the medications that they have found to be most effective in treating their conditions. Many are asking how this new payment structure will affect access to those medicines that patients have come to rely on. Additionally, the new payment structure has the potential to reduce innovation in the drug market. How much of an incentive will drug makers have to create new and more effective medications to improve patients’ quality of life when providers have the incentive to prescribe cheaper medications to maximize their return from the bundle?

From my perspective, as an experienced dialysis patient (11 years on hemodialysis), a more effective way for CMS and dialysis facilities to lower cost while improving quality, is to make use of their most valuable resource, the patient. If patients are educated and well informed about their condition, they will make better and healthier choices, which will lead to improved outcomes. When patients are encouraged to be active participants in the management of their condition and included in decisions regarding their treatment, they are more likely to comply and adhere to their prescribed treatment plan. These, along with other preventative measures that slow the progression of chronic kidney disease (CKD) in patients in earlier stages, will not only lower cost and improve quality of care, but also decrease the prevalence of kidney disease and kidney failure and improve the mortality of ESRD patients.

While many organizations and individuals dedicated to improving the quality of care and quality of life for dialysis patients have done what they can to raise awareness and educate patients and their families about the new ESRD bundle payment system, unfortunately, there are still many people who are unaware of this change. Even more unfortunate, they are unaware of how this change could potentially impact their dialysis care.

In order to help dialysis patients better understand the new bundled payment for dialysis services under Medicare that began in January 2011 and how it may affect their care, Dialysis Patient Citizens (DPC) has introduced a new Dialysis Patients’ Guide to the Medicare End Stage Renal Disease (ESRD) Bundle, available for free download via its website, www.dialysispatients.org. The resource provides easy-to-understand, readily available information to answer the questions patients may have about this new payment structure.

Edwards is a member of the Dialysis Patient Citizens Board of Directors.

The American Kidney Fund (AKF) Announces Multi-City Walkathon Events

7 June 2011  No Comments

The American Kidney Fund (AKF) has announced walkathon events for Kidney Action Day. Renal Business Today recently posted the walkathon dates and locations. Read below for additional details.

AKF Announces Multi-City Walkathon Events

ROCKVILLE, Md.—The American Kidney Fund (AKF) has announced its multi-city schedule for Kidney Action Day, which includes the Steps that Count fundraising walkathon.

The organization will kick off the event, which features free kidney health screenings and family-friendly activities, at Nationals Park in Washington, DC, on Saturday, June 11, followed by events in San Antonio, Houston and Atlanta later in the year.

Kidney Action Day brings together thousands of health advocates, patients and members of the community each year to raise funds for the American Kidney Fund’s programs and services that help kidney patients and those who are at risk of developing chronic kidney disease (CKD). The event is also designed to educate those who are at risk about the simple actions that can help to prevent CKD.

“Understanding your risk is a critical first step in the fight against kidney disease. Kidney Action Day helps raise awareness,” said LaVarne A. Burton, President and CEO of the American Kidney Fund. “It also raises critical funds needed to help in the fight against kidney disease. Perhaps most importantly, the event can help empower people to take charge of their health and prevent kidney disease.”

CKD is the nation’s ninth leading cause of death, and it is estimated that as many as 31 million people in the United States are living with the disease. Diabetes and high blood pressure are the leading causes of CKD.

“CKD is known as a silent killer because it typically has no visible symptoms until it is far advanced,” explained Burton. “It is often preventable, and that is the key—even simple lifestyle changes can help. And if a person is found through testing to have early CKD, its progression can often be stopped or slowed.” Left undiagnosed and untreated, CKD can lead to heart attacks, stroke, kidney failure and death.

As part of the event, free health screenings—open to both Steps That Count walk participants and members of the public –ill be offered. The screenings will check for indicators of kidney and heart health, diabetes, and other important health measures. Kidney Action Day will also feature healthy food samples, cooking and fitness demonstrations, among other activities aimed at increasing awareness of kidney disease.

The schedule for this year’s Kidney Action Day tour includes:

* June 11, Washington, DC, at Nationals Park;
* October 1, San Antonio, at the AT&T Center;
* October 16, Houston, at Discovery Green; and
* November 12, Atlanta, at Turner Field.

For more information on Kidney Action Day and the Steps that Count walk, visit www.stepsthatcount.org.

Study Identifies New Diabetic Kidney Disease Treatment

2 June 2011  No Comments

Renal Business Today recently posted a new study that identifies a new diabetic kidney disease treatment. You can read the complete article posted below.

Study Identifies New Diabetic Kidney Disease Treatment
SACRAMENTO, Calif.— UC Davis investigators have shown that blocking a specific receptor pathway could slow or even prevent diabetic nephropathy an often fatal complication of diabetes for which there are few good treatment options, according to a study published online May 26 in Arteriosclerosis, Thrombosis and Vascular Biology.

The study is the first to clarify the role of the receptor ( toll-like receptor 2, or TLR2) in diabetes-associated kidney disease, according to the researchers.

“Diabetic nephropathy is one of the most serious outcomes of diabetes and the most common cause of renal failure,” said Ishwarlal Jialal, UC Davis professor of endocrinology, diabetes and metabolism and senior author of the study. “It is progressive and eventually requires chronic dialysis or transplant. But now we have a precise molecular target for treating this difficult disease.”

Nephropathy, which affects about 30 percent of diabetics, becomes apparent between five and 25 years following a diabetes diagnosis. It occurs when high glucose—often with hypertension—overworks the kidneys’ intricate blood filtration system, eventually causing that system to break down. It is typically diagnosed midway through the disease process, when the kidneys enlarge and protein appears in urine.

“We currently cannot fully predict why some people with diabetes, even some with well-controlled diabetes, get nephropathy while others do not,” said Jialal, whose lab specializes in studying the role of inflammation in heart disease and diabetic complications. “Our goal is to find a way to identify and stop it in its tracks at the earliest possible stages, well before dialysis is required.”

TLRs are receptors of the innate immune system that provide protection from microbes and other pathogens. Previous research by Jialal and his team showed that diabetics have increased TLR activity and inflammatory markers in their immune systems, which was worse in patients with microvascular complications, especially nephropathy. Research by other teams showed that one receptor in particular — TLR2 — is expressed in higher amounts in kidney biopsies of patients with diabetic nephropathy.

“We wanted to find out if this receptor could have a causal link to nephropathy,” said Sridevi Devaraj, UC Davis professor of pathology and lead author of the study. “We also wanted to take that work to the next step and see if we could identify a unique biomarker that could be used for early identification of the disease.”

The team used mice lacking the gene for TLR2 to see if it had an effect on the development of nephropathy. They divided 80 mice into two groups: 40 were genetically deficient in TLR2 and 40 were wildtype mice with no genetic modifications. Type 1 diabetes was induced in both groups, and then all were tested for features of diabetic nephropathy, including inflammation markers, significantly elevated kidney weight and at least a tenfold increase albumin — a blood protein — in urine.

At 14 weeks, the wildtype mice progressed to nephropathy, while the TLR2-deficient mice did not. In addition, kidney tissue biopsies of the wildtype mice showed an abundance of TLR2 and an influx of pro-inflammatory macrophages that produced increasing amounts of critical biomediators such as interleukin-6 (IL-6) and monocyte chemotactic protein-1 (MCP-1). This outcome was not seen in the genetically deficient mice.

“Finding concentrations of TLR2 and inflammation in the kidney tissues shows that TLR2 truly could be linked with the disease process in nephropathy,” said Jialal. “And showing that an absence of TLR2 protected kidneys from nephropathy strongly indicates that medications blocking TLR2 expression show great promise for preventing the disease.”

Additional tests showed that cells known as podocytes and a protein known as podocin — both of which help maintain the filtration barrier in kidneys and prevent albumin loss — were deficient in diabetic mice. Because tissue biopsies to determine podocyte changes are not easily obtained, Jialal is conducting research to find out if a blood biomarker for podocin or other indicators of podocyte function is possible.

“If confirmed, this biomarker could serve as a novel indicator of the onset of nephropathy, giving physicians the chance to intervene before much permanent kidney damage occurs,” said Jialal.

In future research, Jialal will examine if genetic deficiency of another important receptor known as TLR4 may also prevent the progression of diabetic nephropathy. He also hopes to procure inhibitors of both TLR2 and TLR4 to test in animal models and, if safe, in people with diabetes.

“Now that we have identified the absence of TLR2 as pivotal in preventing diabetic nephropathy along with a potential indicator of the onset of nephropathy, we are excited to further define the clinical potential of our work for humans,” said Jialal.

The research was funded by the Juvenile Diabetes Research Foundation and the National Institutes of Health. Additional investigators were Rajendra Ramsamooj and Alaa Afify of UC Davis, Peter Tobias of The Scripps Research Institute, and Balakuntalam Kasinath of University of Texas Health Science Center.

RenaLab To Participate in RPA’s Advanced Practitioner Conference

25 May 2011  No Comments

RenaLab will head to Indianapolis, Indiana July 13-15 to participate in The Renal Physicians Association’s Advanced (RPA) Practitioner Conference. RPA’s Advanced Practitioner Conference is designed for physician assistants, nurse practitioners, registered nurses and other healthcare providers working in nephrology practices.

At RenaLab, we have always been committed to providing the highest level of support for the physician assistants and nurse care providers working in our field. We know that they work diligently to care and comfort their patients daily. We are very excited to attend the show to recognize them and to answer any questions they may have about CKD/ESRD blood testing. For more information about RPA’s Advanced Practitioner Conference, be sure to visit www.renalmd.org. We look forward to seeing you in July!

Take a Tour of Our Lab

31 January 2011  No Comments

Don’t have time to visit our staff in Jackson? Take a tour of our lab by taking a look at our new video, featuring the great work by our lab services team. View our video on http://www.renalab.com

How Will the Bundle Change Lab Service?

17 January 2011  No Comments

RenaLab CEO Mike Burney and other industry leaders were recently featured in the January issue of Renal Business Today.

The “bundle” may have a goofy name, but this new system cannot be ignored. Starting in January 2011, the bundle will transform the way everything is being paid for in dialysis, including laboratory services. In what ways will the delivery of labs change and what strategies should clinics and lab companies implement to deal with the new payment paradigm? Three industry experts offer advice to Renal Business Today readers on this topic.

According to Mike Burney, CEO of RenaLab, lab operators will need to help their centers minimize lab costs as well as give them all information needed to fully take care of the patient, all within bundle guidelines. Communication is necessary. “This has enabled us to partner with our clients to understand and prepare for the challenges and opportunities that we see ahead with the new bundling environment,” Burney said.

Quality of lab delivery will not be compromised, Burney predicts. “The quality delivery of lab results will continue and will not be affected by the bundling system,” he said. “The only change that we have seen has been a positive one, in that it has enabled us the ability to interact with our centers more during this transition. This is the biggest change that our industry has seen in 30 years, and we are all approaching it and preparing together.”

Paul Beyer, CEO of Satellite Laboratory Services, LLC, said he does not expect any changes at Satellite regarding delivery of timely, quality lab results. “Our clients depend on us to help them run efficiently, and their quality patient care depends upon our reliability as a laboratory,” Beyer said. “Our turnaround time for most tests is 24 hours, and our clients map workflow around this. Planning for patients and having results back so that their own workflow is not impeded is critical for the efficiency of our clients’ operations.”

Efficiency in every aspect of the laboratory and dialysis clinic business will be more critical post bundle than ever before. “Statistics show that the number of people in the United States on dialysis is approximately 400,000, and increasing every year. This translates to increased patient loads,” Beyer said. “The cost pressures of bundling makes running an efficient dialysis clinic more important. Our efficiency directly relates to the efficiency of our clients.”

The bundle isn’t exactly a ball of fun, especially since dialysis patients using Medicare can expect to see a 1.2 percent increase in their co-insurance payments largely due to the inclusion of laboratory tests into the new end-stage renal disease payment bundle, according to an analysis by the Centers for Medicare & Medicaid Services.

“The patient’s share of costs is likely to increase for most everybody because the 20 percent coinsurance for the bundle compared to the composite rate they pay now is going to be more because there are more services in the bundle,” said Tonya Saffer, deputy director, Dialysis Patient Citizens, in a September 2010 article for Renal Business Today. “For patients, who have a higher than average utilization of previously separately billable items like ESAs, CMS has theorized that there is a chance that overall their coinsurance or co-pays could be lower.”

Under the current system, Medicare beneficiaries on dialysis pay 20 percent of the dialysis base payment plus 20 percent of ESRD-related separately billable drugs, such as Epogen, the article stated. However, patients currently do not pay co-insurance on separately billable lab tests.

The new ESRD Prospective Payment System, which was released in July 2010, bundles separately billable drugs, labs and the existing payments for dialysis services into one payment per treatment. CMS will pay for 80 percent of each treatment and patients will be responsible for the remaining 20 percent. That’s the patient consequence. What about the clinics?

How Dialysis Providers Should Handle Labs

Bundling will require more work to track and bill labs, plain and simple. There will be more effort needed as any change brings added responsibility and the requirement to adapt, Burney said. “Dialysis providers will now have laboratory charges on their claims, and will now have some of the billing complexities that labs had in the past,” he said. “But no matter what, their patients will still get the same quality of care.”

Olivier Gindraux, CFO of Satellite Laboratory Services, LLC, theorizes that billing will be a major change for clients. “There will be more work for facilities to track, account for and bill for labs,” Gindraux said. “For instance, effective Jan. 1, 2011, tests must be designated by the physician as ESRD-related or not, and this designation determines billing and payment flow. There will be an admin burden that did not exist pre-bundling that directly affects how labs are submitted for payment for Medicare/Medicaid patients as a result. And importantly, clinics will now receive payment from CMS for Medicare/Medicaid patients, not the laboroatory, so the flow of payments will be something that is new for them. In this sense, it is not enough to just handle billing. Revenue management is also required.”

Satellite currently performs a significant number of tasks to facilitate billing, according to Gindraux. His team recognized the eventual potential administrative burden to clients and the need for revenue management, and has responded with three initiatives.

First, Satellite modified its billing software system to provide clients with information CMS requires in order to bill and substantiate to CMS and insurers. Second, the company established a Bundling Support Team to work directly with clients on billing and CMS-related questions. Lastly, to assist with revenue management, the team developed laboratory test cost, utilization and control tools called LabCheck Analytics and LabCheck Formulary. These tools are meant to serve as bundling calculators and remove worry from the new model. They allow clients to see their ordering patterns, assess them within the framework of the new bundled payment system, understand duplication and lock in test menus to control costs. Satellite reported “tremendous interest and uptake” in these resources.

Meet Our New National Director of Sales

25 August 2010  No Comments

Over the next couple of months, we want to introduce you to the faces and personnel behind our work at RenaLab. We know our field service representatives who you see in your facilities, and our customer service associates who you speak to on the phone, do extraordinary work.

Let us introduce you to our new National Director of Sales, Ken Lowry. In just a few short months, Ken has already strengthened our company with his leadership and approach to new business.

Ken joins our team with amazing work and education background as he holds two degrees, along with more than 28 years of experience in the dialysis industry. Ken’s wife is a professor at a state university. She teaches in the School of Education, working with future teachers who plan to work with students with learning disabilities.

Ken and his wife live in close proximity to both the RenaLab corporate office in Nashville and the RenaLab laboratory in Jackson, MS, giving him the ability to work out of both locations. He will also be traveling throughout the country working with dialysis clinics and physician’s offices for their dialysis lab needs.

In his own words:
“I joined RenaLab because of the people and the reputation of the company. The combination of the people and their experience, along with the company’s highest code of ethics and its desire to serve the clinic, is what makes this organization unique. Their reputation for quality of care, combined with their forward thinking makes the organization the best in the industry.”