The Government Accountability Office (GAO) has issued a report entitled “End-Stage Renal Disease: CMS Should Monitor Effect of Bundled Payment on Home Dialysis Utilization Rates.” According to the GAO, the Medicare bundled payment system for ESRD services, which must be implemented by January 1, 2011 under the Medicare Improvements for Patients and Providers Act, could end up encouraging or discouraging home dialysis depending on how the bundle is structured. The GAO recommend that CMS establish formal plans to monitor the impact of bundled payments on access to home dialysis services; CMS concurred.