I just spent a long week in Washington DC talking about dialysis reimbursement (imagine the excitement). I think how the bundle is structured will have a great deal of impact on the provision of dialysis generally and on home hemodialysis particularly.
I’ve been blogging about this for a while so rather then cross posting a bunch of information here is the link
http://www.billpeckham.com/from_the_sharp_end_of_the/dialysis_esrd_payment_bundle/index.html
The biggest disappointment about this Congress (renal-ly, there are in fact much larger and more important disappointments) has been the lack of any legislation addressing home hemodialysis. If bundling were to pass it could damage this already barely viable modality choice.