December 8, 2005 - The Centers for Medicare and Medicaid Services (CMS) announced that it has selected an additional organization, Evercare of Georgia, a United Healthcare product, to participate in a new demonstration that will increase the opportunity for Medicare beneficiaries with end stage renal disease (ESRD) to join managed care plans.

This demonstration has been designed to test the effectiveness of disease management models to increase quality of care for ESRD patients while ensuring that this care is provided more effectively and efficiently.

News release from CMS.

November 9, 2005 - Fresenius Medical Care AG announced that the Centers for Medicare and Medicaid Services (CMS) has awarded Fresenius Medical Care North America (FMCNA) and its wholly owned subsidiary Fresenius Medical Care Health Plan (FMCHP) a four year capitated End Stage Renal Disease (ESRD) demonstration program.

The capitated ESRD demonstration is designed to test the effectiveness of disease management models to increase quality of care for ESRD patients while ensuring that this care is provided more effectively and efficiently. Fresenius Medical Care Health Plan is contracting with Sterling Life Insurance Company in Philadelphia and Pittsburgh, Pennsylvania and Dallas, Houston and San Antonio, Texas and with American Progressive Life & Health Insurance Company of New York in Boston and Springfield, Massachusetts to offer Medicare Advantage Private Fee-for-Service plans. Press release from FMC web site.

November 1, 2005 - The Centers for Medicare and Medicaid Services (CMS) announced that it has selected two organizations to participate in a new demonstration that will increase the opportunity for Medicare beneficiaries with end stage renal disease (ESRD) to join managed care plans. News release from CMS.

In the first year of the demonstration, the Medicare Advantage plans will be offered in portions of California, Pennsylvania, Texas and Massachusetts. Beneficiaries can enroll in the new plans beginning Nov. 15, with coverage beginning Jan. 1. CMS will reserve 5% of the capitation payment rates for incentive payments related to quality improvement. The organizations will receive payment for improvement on past performance and performance above national averages for dialysis-related quality measures.

CMS has selected two dialysis providers to participate in Medicare Advantage managed care demonstrations that will test the effectiveness of disease management models to increase quality of care for Medicare beneficiaries with ESRD.

DaVita, a dialysis provider, is partnering with SCAN Health Plan to offer a Medicare Advantage Special Needs plan in parts of San Bernadino and Riverside counties in California.

Fresenius Medical Care North America, a dialysis provider, through it�s wholly owned subsidiary Fresenius Medical Care Health Plan is partnering with Sterling Life Insurance Company in Philadelphia and Pittsburgh, Pennsylvania and Dallas, Houston and San Antonio, Texas and partnering with American Progressive Life and Health Insurance Company in Boston and Springfield, Massachusetts to offer Medicare Advantage Private Fee-for-Service plans.

Further information on the ESRD Disease Management Demonstration is available at http://www.cms.hhs.gov/researchers/demos/esrd_demo.asp .

Article from The Press-Enterprise (Riverside, CA).

[Page reviewed on 12/21/05.]