Representatives Jim McDermott and Tom Marino, Co-Chairs of the Congressional Kidney Caucus, authored a letter to Secretary of the U.S. Department of Health and Human Services, Kathleen Sebelius, asking that Medicare review the payment amount for home hemodialysis (HHD) training. The letter was signed by a bipartisan group of 35 other Members of Congress.
The Co-Chairs expressed concern that Medicare's payments for HHD training are too low, thus discouraging the use of a treatment method that creates substantial benefits to certain dialysis patients and their families. Observational studies show better wellness and survival outcomes for those who dialyze at home, and there's reason to believe HHD can reduce the costs of care. "Home dialyzers often have the freedom to continue working a steady job," states the letter, "creating economic and other benefits to both patient and family."
The Fiscal Year 2013 payment amount barely covers the cost of one hour of a nurse's time, and training sessions usually require at least four hours to complete. Proper preparation can require as many as 25 training sessions, so outpatient dialysis centers often offer these services at a loss. Updating the training payments may encourage dialysis centers to offer more robust home-dialysis training programs.
"Increasing payments now will help remove one of the barriers that tacitly discourage dialysis patients from dialyzing at home," said McDermott, "it's common sense."
The letter follows the launch of the Congressional Kidney Caucus in the 113th Congress, which is dedicated to educating Members of Congress and the public about kidney disease, and the federal government's singular role in providing access to life-sustaining treatment for Americans with end-stage renal disease.
Full letter available in PDF below: