Dialysis Technician Practice Exam

How are dialysis clinics reimbursed by Medicare?

1. Fee-for-Service

2. Composite Rate

3. Global Budget

4. Capitation

The correct answer is: Composite Rate

Medicare reimbursement for dialysis clinics primarily operates under the Composite Rate system. This method involves a bundled payment that covers a specified range of dialysis services and associated healthcare needs. The Composite Rate is designed to simplify the reimbursement process for facilities by providing a regular, predictable payment structure that accounts for the various costs incurred in providing dialysis treatment. This approach incentivizes efficiency and cost-effectiveness within dialysis clinics. Under the Composite Rate, facilities are compensated for the treatment of patients with end-stage renal disease (ESRD) through a fixed rate per treatment, regardless of individual variances in patient care. This means that dialysis centers generally receive a set amount that aims to cover the cost of the dialysis session, including equipment, nursing care, and other standard services. The other reimbursement options listed, such as Fee-for-Service, Global Budget, and Capitation, do not apply to the Medicare dialysis payment model. Fee-for-Service reimburses providers for each individual service rendered, while Global Budget would allocate a total budget to an institution, and Capitation involves paying a fixed amount per patient over a certain timeframe. None align with the targeted approach of the Composite Rate as it relates to the unique needs of dialysis services.