July 12, 2018
Quotes for attribution to National Kidney Foundation
Yesterday evening the Centers for Medicare & Medicaid Services (CMS) issued the annual proposed rule governing Medicare payments to dialysis facilities and the quality measures for which the dialysis facilities are held accountable.
The National Kidney Foundation (NKF) is pleased that CMS has included key issues that we, and the patients we represent, have spoken out on for many years such as lack of innovation in therapies for dialysis patients, improving access to kidney transplants, and empowering patients to choose the type of kidney replacement therapy that best aligns with their individual goals, preferences and values.
CMS is proposing to pay separately for all new dialysis medications and biologics for a period of two years. The intent is to improve patient access to new therapies and improve innovation in treatments for patients on dialysis, however the National Kidney Foundation will be carefully reviewing this new proposed rule to ensure that it indeed will be good for dialysis patients.
CMS shares our concerns that dialysis patients must appropriately be educated about kidney transplantation, referred to the organ donation waitlist and tracked for waitlist status. CMS is searching for solutions to ensure that dialysis facilities are adequately helping patients receive this information and that patients are given a chance to receive a kidney transplant. Informing patients about their waitlist options and helping patients learn about living organ donation, which can greatly reduce their time waiting for a kidney transplant, are essential to improving the quality of life for dialysis patients. No patient should believe that they must face a lifetime of dialysis if they are eligible for a transplant. NKF will work closely with our patients, transplant professionals and dialysis care professionals to develop robust, feasible recommendations to CMS and we look forward to helping CMS on this issue.
Additionally, NKF is pleased that CMS is soliciting input on ways to correct the disparities that exist in patients receiving home dialysis. NKF will work closely with our patients and our professionals to develop patient-centered recommendations on how to ensure that all patients fully understand their dialysis options and are empowered to select the treatment that best aligns with their individual goals, preferences and values. Home dialysis is a viable option that must be made more widely available to end stage renal disease patients. It can greatly lesson the burden of dialysis, have clinical outcome benefits and provide better quality of life and increased independence for many patients.
Through the ESRD Quality Incentive Program (QIP) CMS is seeking to further promote patient access to transplantation by measuring the percent of dialysis patients on the waitlist starting in 2022. The QIP also will promote better care coordination and safety for dialysis patients with another new quality measure used to improve medication reconciliation by clinics. These important steps will help ensure that dialysis facilities have better information on the medications and the doses that dialysis patients are currently taking, and also ensure that dialysis facility staff work to update any changes in medications after patients return from a hospital stay.
National Kidney Foundation Home Dialysis Resources
Dialysis modality planning and decision-making is integral to the treatment process for many CKD patients, and home dialysis has the potential to address some of the quality of life issues experienced by dialysis patients. The barriers to accessing home dialysis, and remaining on it, are largely known: the time and costs of home dialysis training for the patient, family member, and caregiver; the lack of care partner support; lack of patient and clinician familiarity with the home dialysis prescription and follow-up care; and late diagnosis which requires a rapid start of hemodialysis in–center with a catheter. The KDOQI Home Dialysis Controversies Conference is a multi-year project for home dialysis which will foster collaboration among a multi-stakeholder group of patients, clinicians, care partners, researchers, health payers and healthcare industry representatives to facilitate the development of research designs to measure home dialysis quality and create interventions to overcome the barriers of maintaining dialysis treatment at home.
National Kidney Foundation Living Donation Resources
THE BIG ASK: THE BIG GIVE platform, which provides nationwide outreach, is designed to increase kidney transplantation through training and tools that help patients and families find a living donor. It includes direct patient and caregiver support through our toll-free help line 855-NKF-CARES, peer mentoring from a fellow kidney patient or a living donor, online communities, an advocacy campaign to remove barriers to donation, and a multi-media public awareness campaign. All of these resources are free and designed to teach kidney patients, or their advocates, how to make a “big ask” to their friends, loved ones, or community to consider making a “big give,” a life-saving living organ donation. For more information visit www.kidney.org/livingdonation.
Kidney Disease Facts
In the United States 30 million adults are estimated to have chronic kidney disease—and most aren’t aware of it. 1 in 3 American adults are at risk for chronic kidney disease. Risk factors for kidney disease include diabetes, high blood pressure, heart disease, obesity and family history. People of African American, Hispanic, Native American, Asian or Pacific Islander descent are at increased risk for developing the disease. African Americans are 3 times more likely than Whites, and Hispanics are nearly 1.5 times more likely than non-Hispanics to develop end stage renal disease (kidney failure).
The National Kidney Foundation (NKF) is the largest, most comprehensive and longstanding organization dedicated to the awareness, prevention and treatment of kidney disease. For more information about NKF visit www.kidney.org.