The Government Accountability Office (GAO) has issued a report entitled "End-Stage Renal Disease: CMS Should Monitor Access to and Quality of Dialysis Care Promptly after Implementation of New Bundled Payment System." The report focuses on the new ESRD payment system that begins January 2011, under which CMS will make a single payment to pay for dialysis and related services. To help ensure that changes in Medicare payment methods for dialysis care do not adversely affect beneficiaries, the GAO recommends that CMS monitor access to and quality of dialysis care for groups of beneficiaries, particularly those with above-average costs of dialysis care, under the new payment system. Such monitoring should begin as soon as possible once the new bundled payment system is implemented and be used to inform potential refinements to the system. CMS agreed and noted that it is planning to actively monitor the effects of the new payment system on all ESRD beneficiaries, including those with above-average costs. CMS noted that it plans to have a comprehensive monitoring strategy in place when the system is implemented.