The program: Medicare's end-stage renal disease program provides dialysis and kidney transplants to patients of all ages suffering from kidney failure. Kidney failure has numerous causes, but the most common are diabetes and high blood pressure.
Estimated cost (fiscal 1997): $8.4 billion
Share of Medicare expenditures: 3.9%
Beneficiaries (fiscal 1997): 243,000
Share of Medicare enrollees: 0.6%
Average annual growth in enrollment (1988 to 1993): 8.6%
The problem: Dialysis patients in the United States die at higher rates than in other parts of the world. Treatment procedures vary from facility to facility, while healthcare providers do not have many guides to best practices or what constitutes good performance.
The project: The National Kidney Foundation convened the Dialysis Outcomes Quality Initiative in March 1995 to develop practice guidelines and outcomes measures for dialysis. The final draft report on practice guidelines will be reviewed early this year by all providers in the dialysis community, with guidelines to be published in April. Outcomes measures may be ready for use by year-end.
Sources: House Ways and Means Committee, National Kidney Foundation