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
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
“STATEMENT FROM THE ALLIANCE FOR HOME
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.
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
1 75 Fed. Reg. 49,030, 49,058 (Aug. 12, 2010). 2 Id . at 49,060.
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
If you have any questions or need additional information, please
contact Lindsay Punzenberger at email@example.com or
202-466-4721. For a list of
organizations participating in the Alliance’s working groups, please visit our
website at www.homedialysisalliance.org .
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:
To make a scripted call to your Congressperson/Senators, go
TAGS: home dialysis, Ning, Live Journal, Tumblr, Weebly, WordPress, Facebook, Kidney
Stories, Jim Myers, kidney, dialysis, blood, transfusion, donor, recipient,
seeking, awareness, National Kidney Foundation, Indiana University, sharing,
kidney disease, End Stage Renal Failure, polycystic kidney disease, chronic
kidney disease, kidney for, diabetic, save my life, living kidney donor, organ
donation, find a kidney for, NCS, share a spare, transplant list, fundraiser,
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
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.
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Live, Medicare, Myers, NCS, National, Ning, PKD, Renal, Stage, Stories, Tumblr,
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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
the following in your About Section
you are from (just City and State) people need to know this, the closer to you
the easier to donate
you started this page
them to push the Like Button, that way they get your
nature of your illness and reason for your kidney
other illnesses that complicate your issues
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
address, t/p# and email for your transplant
blood type (needs to match your donor)
personal reasons why this is important to you (family, school, freedom, your
children, want your life back)
else you want to include
you do that, every time you see a doctor or there is a change in your
circumstances, update your page.
Try to post something every
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.