- Access to healthcare is critical to detecting and managing chronic kidney disease (CKD) earlier. Earlier detection and management of CKD can often delay or prevent progression of kidney disease and the need for dialysis treatment, improve outcomes for patients and lower healthcare expenditures. NKF urges Congress to enact policies that maintain or increase the number of insured patients, which will enable earlier detection of CKD.
- People with end stage renal disease (ESRD) require either a transplant or dialysis to survive. Dialysis treatment becomes a lifelong physical, emotional and financial commitment. As such, insurers should be prohibited from rejecting third party premium assistance payments provided by charitable organizations on behalf of ESRD patients and limiting coverage to people with ESRD who choose not to enroll in Medicare.
- Most patients receive dialysis in outpatient clinics three times per week; four hours per treatment. Provider networks that significantly limit options for where patients are allowed to receive dialysis can result in patients traveling greater distances to receive care. These limited options place a significant hardship on an extremely fragile patient population; network adequacy standards should take their fragility into consideration.
- Over 200,000 ESRD patients have received a life-saving kidney transplant and must take immunosuppressive drugs for the life of the transplant.
- The insurance practice of placing immunosuppressive medications, including generics, on high cost sharing tiers requiring coinsurance amounts of greater than 20% and up to 50%, while also excluding generic immunosuppressive medications from fixed copayment amounts, severely jeopardizes the long-term success of the transplant.
- Cutting back on, or skipping doses of, immunosuppressive medications can be detrimental to the transplant and the patient.
- Each year Medicare spends $87,000 per dialysis patient; opposed to $32,500 for a transplant patient. Transplantation is far more cost effective than a lifetime of dialysis.
- In addition, as a member of the National Health Council (NHC), NKF supports its domains and values for health care reform as these are essential to ensuring that people with chronic conditions are able to obtain and afford insurance.
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 the NKF visit www.kidney.org.