Kidney Disease Education Part of 2010 CMS Proposals

WASHINGTON—Stage 4 chronic kidney disease patients will have access to six, one-hour Medicare-reimbursed pre-dialysis education sessions next year, according to the Centers for Medicare & Medicaid Services’ Physician Fee Schedule Changes for 2010.

“Individuals could benefit from education interventions due to the large amount of medical information that could affect patient outcomes including the increasing emphasis on self-care and patients’ desire for informed, autonomous decision-making,” CMS wrote in the proposed rule. “There is evidence that many pre-dialysis patient lack knowledge about their condition and may develop a sense of despair regarding their condition.”

Starting Jan. 1, 2010, the education services would be provided to stage 4 chronic kidney disease patients. In the proposal, CMS defined stage 4 as a GFR between 15-29 mL/min/1.73m². “Because there are currently no agreed upon accepted clinical guidelines that describe the stage IV patients who would eventually require dialysis or a kidney transplant, we are proposing to cover all stage IV patients,” CMS wrote.

CMS wrote that pre-dialysis education can help patients better understand chronic kidney disease, their treatment options, and may also help delay the need for dialysis. “Education interventions should be patient-centered, encourage collaboration, offer support to the patient, and be delivered consistently,” CMS wrote.

Kidney disease education was mandated by the Medicare Improvements for Patients and Providers Act, which passed last year. In order to develop the proposed rule, CMS held two meetings with the renal community, and also consulted medical evidence, literature and available CKD patient education programs.

Based on feedback from these meetings, CMS proposed that face-to-face meetings should be the way the kidney disease education is delivered to the patient. However, patients can also use group education if it is a better way for them to learn.