ESRD Restriction Lifts
For the first time, the new 2022 MA contract year will provide the possibility of end-stage renal disease (ESRD) to enroll in a plan. Why now? Although the goal is to increase the membership in every MA organization, ESRD is a very expensive condition to manage.
The average beneficiary with ESRD cost $67,116 in 2016, in comparison with the $10,182 per beneficiary without the condition. There are other reports that showed how costs for members with ESRD exceeded MA benchmarks in nearly 46% of metropolitan areas. MA organizations need to ensure going into their contract bidding process for 2022 that they have accurate and timely data available.