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Advancing American Kidney Health

Published: 07/11/2019

As you may have heard, President Trump signed an Executive Order yesterday to launch Advancing American Kidney Health, a bold new initiative to improve the lives of the 30+ million Americans suffering from kidney disease, expand options for patients, and reduce healthcare costs. The initiative provides specific solutions to deliver on three goals: fewer patients developing kidney failure, fewer patients receiving dialysis in dialysis centers, and more kidneys available for transplant.

The initiative also outlines three goals for improving kidney health: (1) reduce the number of Americans developing ESRD by 25% by 2030; (2) have 80% of new ESRD patients in 2025 either receiving dialysis at home or receiving a transplant; and (3) double the number of kidneys available for transplant by 2030. There are currently more than 700,000 Americans with ESRD and nearly 100,000 waiting for a kidney transplant.

Dialyze Direct applauds the administration’s long overdue recognition of the growing crisis in the dialysis industry and its bold initiative to overhaul the system which has been dominated by the same in-center thrice weekly dialysis treatment model for over 40 years. We had been faced with certain industry headwinds as we developed and rolled-out our innovative home dialysis care model and we now look forward to the tailwinds of this administration’s support for and emphasis on home dialysis as we continue with our expansion to bring this much-needed therapy to dialysis patients across the nation.

As directed by the Executive Order, the U.S. Department of Health and Human Services (HHS) announced yesterday that the Centers for Medicare & Medicaid Services (CMS), through its Center for Medicare and Medicaid Innovation (CMMI), released a proposed required payment model and four optional payment models to adjust payment incentives to encourage preventative kidney care, home dialysis, and kidney transplants.

Under the proposed required payment model, the End-Stage Renal Disease (ESRD) Treatment Choices (ETC) model, Medicare would expand coverage of care for kidney disease and offer financial incentives for the provision of dialysis services in the home, which, for the purposes of the rule, would also include nursing homes.

As proposed, the ETC payment model would include two adjustments to the current Medicare reimbursement model. The first would be an increase in the Medicare reimbursement rate for home dialysis and home dialysis-related services during the initial three years of the model. The second adjustment would apply to both home and in-center dialysis and related claims, and could be either positive or negative. These adjustments, which are based on a dialysis provider’s home dialysis rate and transplantrate performance, would be made to the adjusted Medicare reimbursement rate for dialysis treatments. The payment adjustments under the proposed ETC payment model would apply to applicable Medicare claims starting on January 1, 2020.

As the largest provider of on-site home hemodialysis in nursing homes in the U.S., Dialyze Direct is in a unique position to promote and advance home dialysis care in line with this bold new initiative and receive increased reimbursement rates for its home dialysis treatments under the proposed ETC payment model.

Dialyze Direct is excited to be a part of the administration’s push toward greater use of home dialysis as we have designed our unique care model to bring home dialysis therapy to the medically complex geriatric patient population for whom this treatment modality is most beneficial. Our initial focus has been treating geriatric dialysis patients in the challenging nursing home environment and we have successfully begun scaling our model, delivering home dialysis care to thousands of patients since we started. Our mission is to lead the way in providing unparalleled and cost-effective kidney care for geriatric patients – healing the system for all stakeholders and improving what matters most: quality of life, and the chance to enjoy it.