Have you observed a change in dialysis patient care since the debut of bundling?

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On January 1, 2011, Medicare's prospective payment system for dialysis services (“bundling”) debuted. Dialysis centers now are paid a flat global fee for all the care provided to a patient.

Recent studies suggest that after the introduction of bundled payments, use of erythropoiesis-stimulating agents (ESAs) has decreased (although ESA labeling changes also are cited as a possible cause of decreased ESA use) and use of intravenous iron has increased.

Renal & Urology News would like to know what nephrologists' experience has been since the debut of bundling, so please answer the following poll question.

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