In 2006, all major U.S. dialysis providers have been a formidable challenge. Having survived a period of intense consolidation and steadily declining operating margins, they were now struggling to understand what lay ahead. With more than 80% of their patients covered by Medicare End-Stage Renal Disease (ESRD) Program and Medicare barely covers to cover the costs, these providers increasingly rely on additional reimbursement for certain injectable drugs, as well as on the small … Read more »

In 2006, all major U.S. dialysis providers have been a formidable challenge. Having survived a period of intense consolidation and steadily declining operating margins, they were now struggling to understand what lay ahead. With more than 80% of their patients covered by Medicare End-Stage Renal Disease (ESRD) Program and Medicare barely covers to cover the costs, these providers increasingly rely on additional reimbursement for certain injectable drugs, and based on the small percentage of patients with private insurance , for financial viability. However, these two sources of profitability have been under pressure. Current demonstration projects by the Center for Medicare and Medicaid Services (CMS) opened the way for dramatic changes in the reimbursement landscape and private payers have been what they are and how much they pay for increasingly restrictive in terms. These actions by CMS and private payers were certainly far-reaching consequences for patients, providers and the ESRD program have as a whole. Imminent change and the uncertainty over party was creating significant challenges.
«Hide

from
Stefanos Zenios,
Elizabeth Rodriguez,
Melanie Wyld
Source: Stanford Graduate School of Business
27 pages.
Release date: 07 April 2004. Prod #: OIT51-PDF-ENG
Challenges in RCG HBR case solution

[related_post themes="flat"]