In light of the USRDS’ announced concerns regarding thrice-weekly dialysis, this perpetuation cannot be in the best interest of public health. This year, with the 2.5 percent proposed increase to the bundled payment rate, there are literally hundreds of millions of dollars being added to the budget for treatment of end-stage renal disease (ESRD) patients. While this increase is good news for patients and the dialysis providers, clearly some of this could be appropriately targeted to address the known HHD payment barriers.
CMS must respond to the outcry for change that it will again receive during the public comments to this year’s rulemaking process.
It is “the intent of Congress that the maximum practicable number of patients who are medically, socially, and psychologically suitable candidates for home dialysis…should be so treated.”
HHD is a proven, clinically beneficial modality, essential to achieving this intent (as not all patients are PD candidates). It also fits squarely within CMS’s quest for patient-centered care, delivered efficiently.
By making the necessary changes, CMS has the opportunity to regain its leadership position with respect to the access to quality home care of dialysis patients.
Joseph E. Turk, Jr. is the president of NxStage’s North American operations. Before joining NxStage in 2000, he served as director of New Business Development at Boston Scientific. Prior to this, he was one of the leaders of McKinsey & Company’s Midwest Health Care and Biotechnology Practice, as a senior engagement manager in the firm’s Chicago office. Joe received his AB in economics from Wabash College and an MBA in marketing and finance from Northwestern University’s J.L. Kellogg School.
Linda Upchurch, MBA, MHA, is the director of Public Policy and Economic Outcomes at NxStage Medical Inc. She has worked in the nephrology and dialysis field for more than 20 years. Known for her consistent advocacy for nephrology issues on the Hill and with CMS, Linda is respected for her experience and understanding of the implications of public policy on nephrology and dialysis. In her current role, she is working to identify and affect policy and practice patterns to expand the utilization of home hemodialysis in the U.S.
