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Paying for Frequent Dialysis.

Adam S Wilk1, Richard A Hirth2, Joseph M Messana3

  • 1Department of Health Policy and Management, Rollins School of Public Health, Emory University, Atlanta, GA.

American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation
|March 30, 2019
PubMed
Summary
This summary is machine-generated.

New Medicare payment rules may limit frequent hemodialysis, a treatment option for kidney disease patients. This analysis examines the current system and suggests payment modifications to support broader access to frequent dialysis.

Keywords:
Hemodialysis (HD)MedicareMedicare Administrative Contractors (MAC)United Statescost of caredialysis modality selectionend-stage renal disease (ESRD)home dialysishome hemodialysis (HHD)payment modelspolicyreimbursement rates

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Area of Science:

  • Nephrology
  • Health Policy
  • Health Economics

Background:

  • Medicare's current payment system primarily supports thrice-weekly in-center hemodialysis.
  • Proposed payment rules may restrict coverage for hemodialysis treatments exceeding three sessions per week.
  • Stakeholders express concerns that these rules could hinder the adoption of frequent hemodialysis.

Purpose of the Study:

  • To analyze Medicare's payment system in relation to frequent dialysis modalities.
  • To assess the accommodation of peritoneal dialysis and frequent hemodialysis within the existing framework.
  • To propose modifications to the Medicare payment system to better support frequent dialysis.

Main Methods:

  • Review of Medicare's in-center hemodialysis payment structure.
  • Assessment of the current payment system's compatibility with higher-frequency dialysis.
  • Analysis of evidence on the effectiveness and utilization of frequent dialysis versus standard thrice-weekly hemodialysis.

Main Results:

  • The current Medicare payment system is largely centered around traditional thrice-weekly hemodialysis.
  • The proposed payment rules could create barriers for patients and providers seeking to utilize frequent hemodialysis.
  • Evidence suggests potential benefits of frequent dialysis modalities compared to standard treatment.

Conclusions:

  • The existing Medicare payment system needs adaptation to adequately support frequent dialysis.
  • Policy modifications are necessary to encourage the use of effective, higher-frequency dialysis treatments.
  • Ensuring appropriate reimbursement is crucial for patient access to optimal dialysis care.