2006 proposed fee schedule - American Society of Clinical Oncology

to update the labor portion of the ESRD composite rate to
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which the wage index is applied. The basis for our proposed
revisions to the current ESRD composite rate wage index to
reflect these changes is set forth in the following
sections.
a. Current Urban and Rural Locales Based on MSAs
We currently adjust the labor-related share of the
composite payment rates to account for differences in area
wage levels using a wage index which is a blend of two wage
index values, one based on hospital wage data from FY 1982,
and the other developed from 1980 hospital data from the
BLS. The hospital and BLS proportions of the blended wage
index are 40 percent and 60 percent, respectively. The
hospital and BLS wage index values used to compute the
blended wage index were published in the Federal Register on
August 15, 1986 (51 FR 29412).
The use of a blended wage index results from our effort
to transition ESRD facilities from composite payment rates
using a wage index based on BLS data, to one developed from
hospital wage and employment data obtained from Medicare
cost reports (“the hospital wage index”). A major
limitation of the BLS wage index was its inability to
distinguish area differences in the use of part-time
hospital workers. In order to mitigate the impact of
changes in facility payment rates as a result of our