The Trump administration is working on a new payment approach for treating kidne...
- The Trump administration is working on a new payment approach for treating kidney disease that favors lower cost care at home and transplants, a change that would upend a dialysis industry that provides care in thousands of clinics nationwide.
“A lot of the way the program has been set up, it creates a lot of perverse incentives to actually keep people in an institutional setting,” said Verma, who first signaled in a speech this year that CMS wanted to curb costs and improve quality of life for kidney disease patients through a new payment structure.
The company is expanding in home dialysis with its $2 billion purchase of NxStage, a U.S. maker of home-use dialysis machines. Fresenius Medical Care said it plans to convert some dialysis clinics into “transitional care units” to train people for care at home. It aims to boost the percentage of its U.S. customers using home dialysis to more than 15 percent by 2022 from around 12 percent currently.
DaVita and Fresenius Medical Care offer two forms of home dialysis: hemodialysis, which requires a machine and special filter much like in clinics, and peritoneal dialysis, which utilizes the lining of the abdomen to filter waste from the blood. Medicare pays for home dialysis, but adoption has been slow. Only around 8 percent of end-stage renal disease patients were on home dialysis in 2016. The U.S. Department of Health and Human Services, which oversees CMS, is also seeking to increase the number of kidney transplants through proposals it hopes will expedite access to organs. More than 20,000 people received kidney transplants in the United States in 2018, a fraction of the more than 100,000 people on the waiting list.
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