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 firstname.lastname@example.org 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
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