An advocacy group that includes health plans, dialysis equipment companies and the National Kidney Foundation is urging the Centers for Medicare and Medicaid Services to relax rules regarding home dialysis. One of the proposals would allow manufacturers to train patients on how to dialyze in their homes.
In a position paper reported by Helio, Innovative Kidney Care said the severe nursing shortage is making it difficult for patients to move from facility-based dialysis to home dialysis. The U.S. Renal Data System estimated there has been a 5% to 7% deficit in registered nurse positions at outpatient dialysis facilities for nearly 20 years. In 2018, that amounted to approximately 1,750 opened positions.
“Allowing manufacturers to provide expertise to patients on their dialysis machine could help alleviate the nurse staffing shortage,” Tonya Saffer, vice president of government affairs for Outset Medical told Helio. “We can’t expect a home dialysis nurse to be an expert on every new dialysis machine.
The kidney care advocates are looking for rule changes in Condition of Coverage rules that dialysis providers must follow to receive Medicare reimbursement. Those rules have not been updated since 2008.
CMS is trying to move more dialysis into homes. Last year, it launched the End Stage Renal Disease Treatment Model, which requires 30% of treatment providers in all 50 states to encourage home dialysis or transplants. The program aims to reduce Medicare spending on chronic kidney disease by $23 million over five years.
Although home dialysis is more convenient for many patients with end-stage renal disease, the ESRD Treatment model has been plagued by challenges. Some patients don’t have access to broadband connectivity, allowing them to communicate with healthcare staff. Also, while Medicare and Medicaid cover the cost of home dialysis, they don’t cover the cost for a home health aide to assist patients, a requirement of some nephrology programs.
