Recently two of the biggest champions for kidney patients in Congress, Reps. Bobby Rush (D-IL) and Jason Smith (R-MO), introduced the Improving Access to Home Dialysis Act (H.R. 5426). This bill is the result of months of discussion amongst the kidney community on the best ways to improve patient access and success on home dialysis.
We’ve heard from many patients throughout the COVID-19 pandemic who were dialyzing in a facility but wanted to transition to home dialysis. They were concerned about learning how to properly dialyze themselves and get the support they needed to succeed. As a result, this bill focuses heavily on improving patient training and education on home dialysis, and on providing in-home support from healthcare professionals to assist new home dialyzers with getting comfortable dialyzing at home.
- Provides for reimbursement through Medicare for in-home assistance by staff of the dialysis facility to patients on home hemodialysis and peritoneal dialysis for the first 90 days of their regimen;
- Provides for in-home respite staff assistance under certain circumstances outside the initial 90 days;
- Provides for the possibility of continuous staff assistance without a time limit for patients with certain disabilities;
- Expands the types of healthcare professionals who can provide home dialysis training;
- Provides for additional educational opportunities for patients to learn about the entirety of their dialysis options, including opportunities that can be provided in group settings or via telehealth;
- Provides for training on home dialysis to occur, when possible, in the location the patient intends to use to dialyze;
The bill would also provide for a government study to examine the racial disparities in the utilization of home dialysis and make recommendations on how to improve access to home dialysis for patients from communities of color. It also directs the Department of Health and Human Services (HHS) to create a patient-centered decision tool for dialysis patients to evaluate their lifestyle and goals and be assisted in choosing the dialysis modality that best suits them. It also directs the Center for Medicare and Medicaid Innovation (CMMI) to create a patient quality of life metric for all dialysis patients.
Home Dialysis Benefits Many Patients
Studies indicate that home dialysis, including peritoneal dialysis and home hemodialysis, can improve patient quality of life and flexibility in customizing care options. Home dialysis also eliminates the need for access to reliable transportation, which is often cited as a major barrier to accessing dialysis treatments. Unfortunately, not all patients are afforded the opportunity to utilize this care model and some face socioeconomic barriers to success
We are hopeful that this bill will begin to address these issues, help more patients make informed choices about their dialysis options, and feel confident and supported if they choose to dialyze at home. We thank Congressmen Rush and Smith for their leadership in introducing this bill, as well as the fourteen supporting organizations that recently signed our letter of support.
We will update our kidney community as we move forward with Senate introduction and ask all advocates to urge their House lawmaker to support HR 5426 on behalf of the kidney patients that they represent.