DOES THE PROPOSED CUTS FROM CMS TO DIALYSIS IN PATIENT CENTERS AFFECT HOME HEMO AND PERITONEAL PATIENTS? As many of you know, I have been advocating against the proposed cuts to Medicare payments to dialysis centers and in turn the affect this has in all in center patients, including both Medicare patients as well as private insurance patients. Obviously a reduction in payments to centers could result in a cutting of services, a layoff of valuable dialysis employees like techs, nurses and social workers, the possible closing of centers, and the shuffling and relocation of dialysis patients to different centers. There has also been expressed that dialysis on demand may be in jeopardy as a possible return to dialysis by committee selection. Most of my in center dialysis friends have gotten the message and are taking steps to make their objections known. Where some resistance in the dialysis community remains is with people that take dialysis at home, either home hemo or peritoneal dialysis. The general remark that is made is that since the cuts do not affect home dialysis patients, this is not our fight. I wrote the Dialysis Patient Citizens asking if these cuts affect home dialysis patients and here is the response I received: “STATEMENT FROM THE ALLIANCE FOR HOME DIALYSIS: December 3, 2012 Dear Member of Congress: As you consider solutions to address the economic challenges facing the country, the Alliance for Home Dialysis urges you to protect Medicare beneficiaries’ access to home dialysis by refraining from making any additional payment reductions to the Medicare End Stage Renal Disease (ESRD) Prospective Payment for dialysis. The Alliance for Home Dialysis is a coalition of kidney dialysis stakeholders, representing patients, clinicians, providers and industry, that have come together to promote activities and policies that will facilitate treatment choice in dialysis care while addressing systematic barriers that limit access for patients and their families to the many benefits of home dialysis. Congress has long recognized the importance of ensuring beneficiaries have access to a choice of modalities, which include peritoneal dialysis (PD) and home hemodialysis (HHD), because they offer some patients significant quality of life advantages, including clinically meaningful improvements in physical and mental health. The Alliance is concerned that reductions to the ESRD Prospective Payment System (PPS) could jeopardize Medicare beneficiaries’ access to home dialysis. (Emphasis added). The implementation of the new ESRD bundled payment—the first value-based purchasing program under Medicare—has been successful in making progress towards one of its stated goals i.e., to “encourage patient access to home dialysis” 1 and to “make home dialysis economically feasible and available to the ESRD patient population.” 2 Today, only about 10% of U.S. dialysis patients receive treatment at home. Yet, the most recent annual survey of the ten largest providers found that between 2010-2012 home patients represented about 20% of the growth in ESRD patients. This is significant given that in years prior there had been little growth in home dialysis. We are concerned that payment reductions risk reversing the progress that has been made toward increasing access to home dialysis, as facilities may not be able to invest in the development and ongoing management of home dialysis programs . Dialysis facilities were already subject to a two percent payment reduction under the new bundled payment and are facing a two percent cut through sequestration next year. Because nearly 80% of dialysis patients are Medicare beneficiaries, facilities do not have the same ability to spread costs to other payers as broadly as other Medicare providers. Most importantly, the ESRD PPS system is still in its infancy, with full implementation not taking effect until 2014. More experience with the system is necessary to understand the full impact of the program before any fundamental changes are made. (Emphasis added). 1 75 Fed. Reg. 49,030, 49,058 (Aug. 12, 2010). 2 Id . at 49,060. Congress should maintain its commitment to the approximately 400,000 Americans on kidney dialysis by preserving current payment rates and ensuring continued access to home dialysis. (Emphasis added). If you have any questions or need additional information, please contact Lindsay Punzenberger at [email protected] or 202-466-4721. For a list of organizations participating in the Alliance’s working groups, please visit our website at www.homedialysisalliance.org . Sincerely, Stephanie Silverman Director” In other word, the Home Dialysis Alliance fears these cuts like the proposed cuts by the CMS will have an effect on both their Medicare patients and programs for home dialysis, which are sponsored by dialysis centers like Fresenius and DaVita. As I am reading this response, if you, your loved one, friends or family are on home dialysis, these cuts affect you, too. Please sign and share this petition: https://www.change.org/petitions/center-for-medicaid-and-medicare-services-cms-withdraw-the-proposed-cuts-to-dialysis-centers-and-esrd-patients To write a short form letter, go here: http://www.capwiz.com/dpcitizens/issues/alert/?alertid=62734766&PROCESS=Take+Action To make a scripted call to your Congressperson/Senators, go here: http://www.capwiz.com/dpcitizens/callalert/index.tt?alertid=62762041 TAGS: home dialysis, Ning, Live Journal, Tumblr, Weebly, WordPress, Facebook, Kidney
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This is my son Jim and I having dinner earlier this week. He lives in Phoenix now so I value the time I get to spend with him. As many of you know, I am a ESRD/PKD/dialysis patient that relies on dialysis to stay alive. Polycystic Kidney Disease is an hereditary disease. In my family, I have lost a cousin, an uncle, 2 aunts and my father to PKD. PKD is the most life threatening of all of the most common life threatening genetic diseases. 600,000 of us in America are effected. There are 12.5 million children and adults world-wide affected with cysts on their kidneys that inevitably lead to kidney failure. The number of people who have PKD is greater that the combined number of people with cystic fibrosis, muscular dystrophy, hemophilia, sickle cell anemia, Down's Syndrome and Huntington's Disease. It is twice as common as MS and 20 times more common than CF. When your kidneys fail because of PKD, you have 3 choices: dialysis, transplant or death. Transplants are hard to come by and take time. I am on 3 waiting lists and the shortest time I have been quoted is 3 years and the longest is 6+. Death is what I am trying to avoid. I want to see my son grow up, progress in his career, (he works for the AZ Diamond backs in their PR department) get married, have children. I'd like to meet my grandchildren. I have to take dialysis 3x/week 4 hours a shot. I have to do this just to live. Without dialysis, I could die in as short as 3-5 days; at the outside maybe a month or two. Recently, the Center for Medical Services that runs Medicare and Medicaid in response to the cuts passed during the Fiscal Cliff, proposed cuts to dialysis centers, their services and to Medicare patients who rely on dialysis just like me to live. A 2% cut was expected. A 9.4% cut was proposed, amounting to a $970 million dollar cut. The Dialysis Patient Citizens, The National Kidney Foundation and the PKD Foundation all strongly objected. These devastating cuts would have a drastic effect on the medical care we receive at dialysis centers. These effects could include a loss of access to quality care, lead to lowering of the standard of care provided, layoffs of vital dialysis personnel like techs and nurses, cause of closure and consolidation of dialysis centers, and worse yet the rejection of Medicare dialysis patients, who make up 82% of all dialysis patients. Imagine driving several hundred miles a week to obtain life saving dialysis because the center 5 minutes from your home closed. The CMS knows these cuts are radical and dangerous. They have given members of the public until August 30th to object. All of the organizations that I belong to are urging you to contact your Congresspersons and Senators to register your objections. If we don't object the CMS will assume we don't care or the cuts are not harmful and after January 1, 2014, they will be implemented. You can use this link to send a letter: http://tinyurl.com/qet4zj2 . You can use this link to make a phone call: http://tinyurl.com/n46cfrp. You can write a letter. You can sign a petition: https://www.change.org/petitions/center-for-medicaid-and-medicare-services-cms-withdraw-the-proposed-cuts-to-dialysis-centers-and-esrd-patients. I am personally meeting with my local reps of my pols on this issue in the next two weeks. I have written a letter to the editor to my local and most large national newspapers and TV stations. I'm hitting the bloggers next (Daily Kos, Salon, Politico). I do this for my clinic mates that come in and leave everyday by ambulance, have diabetes, have lost mental acuity, are amputees, walk with walkers and canes, and just are not able to fight back or truly understand what is occurring. I do this for my son, my father, and my unborn grandchildren. Please use the links, write a letter, make a call or sign the petition. My son and I would like to keep having dinner together. TAGS: CMS, DPC, End, Facebook, Failure, Foundation, Indiana, Jim, Journal, Kidney,
Live, Medicare, Myers, NCS, National, Ning, PKD, Renal, Stage, Stories, Tumblr, University, Weebly, WordPress, a, awareness, blood, centers, chronic, cuts, diabetic, dialysis, disease, donate, donation, donor, find, for, fundraiser, kidney, life, list, living, my, organ, polycystic, recipient, save, seeking, share, sharing, spare, transfusion, transplant Does High Creatinine Level Mean Kidney Failure As of February 18, 2013 at 2:48 PM, there are 117,131 HOW TO WRITE A GOOD KIDNEY STORY-SHORT VERSION 1. Put the following in your About Section 2. Name 3. Where you are from (just City and State) people need to know this, the closer to you the easier to donate 4. Why you started this page 5. Ask them to push the Like Button, that way they get your updates 6. The nature of your illness and reason for your kidney failure 7. Any other illnesses that complicate your issues 8. Are you on a transplant list, if so the name and city, state of the transplant center(s) some people are listed at more than 1 9. Name, address, t/p# and email for your transplant coordinator 10. Your blood type (needs to match your donor) 11. Your personal reasons why this is important to you (family, school, freedom, your children, want your life back) 12. Anything else you want to include 13. Once you do that, every time you see a doctor or there is a change in your circumstances, update your page. 14. Try to post something every day 15. If you need help let me know. Send me an email or text me online. I help you write it or if you give me the info, I can write it with your permission. Let me know what happens. If you don't have all of these things yet that is OK. Answer what you can and say for example that you are seeking a good transplant center in your area. Your nephrologist can point you in the right direction. Hope that helps. All my best, Jim from Kidney Stories. https://www.facebook.com/KidneyStories |
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