TO: THE RENAL COMMUNITY - URGENT ! HOME DIALYSIS IS ENDANGERED
FROM: Chris Blagg, MD, and Robert Lockridge Jr., MD
As the House of Representatives in Washington, DC develops the new
Medicare Bill, the draft includes a
provision that increases payment for dialysis in a center BUT WOULD
PAY FOR THIS BY SIGNIFICANTLY REDUCING PAYMENT FOR
HOME DIALYSIS. This would be disastrous for both home hemodialysis and
peritoneal dialysis. The wording of this ESRD
provision is as follows: "Increased composite rate for facility-based
dialysis treatment funded out of the corresponding
reduction in composite rate for home-based dialysis treatment." The
results of this ESRD provision (based on 90% of
dialysis patients in US on in-center dialysis and 10% of dialysis
patients in US on peritoneal and home hemodialysis)
would be a 2.6% increase composite rate in the facility-based dialysis
treatment which would result in corresponding 20
to 25% reduction of the composite rate for home-based dialysis
WHY IS THIS A PROBLEM?
would harm patients on both home peritoneal dialysis (CAPD and CCPD)
and home hemodialysis, as it would be a major
financial disincentive for dialysis units to continue these programs
and an even greater barrier to the development of
new home dialysis programs.
WHAT YOU CAN DO TO HELP:
As soon as possible, because this bill will be marked up next week
(5-8-02), please call the
office of Congresswoman Nancy Johnson, Chair of the House Ways and
Means Subcommittee on Health at 202-225- 4476 and/or
fax her at 202-225-4488 and call the office of Congressman Michael
Bilirakis, Chair of the House Energy and Commerce
Committee Health Subcommittee at 202-225-5755 and/or fax him at
202-225-4085. Inform them that you are opposed to this
ESRD provision. Do not mail letters - they are slow in getting there
because of precautions with mail. Also, attached
are the names and addresses of the members of the Health Subcommittees
of the Ways and Means and the Energy and Commerce
Committees. They will be considering this legislation over the next
few weeks. If any of your state's Representatives
are listed (other than Washington State), you should contact them too.
House Ways and Means Health Subcommittee contact list
Energy and Commerce Health Subcommittee contact list
Use your own words to:
WHO ELSE IS CONCERNED:
- 1. ASK them to support REMOVAL of this provision as it will be
a disaster for home dialysis in this country.
- 2. INFORM them that data from the U.S. Renal Data System has shown that home hemodialysis provides the best survival
for patients as well as the best quality of life and opportunity for rehabilitation and return to work, school or other
activities of all dialysis treatments and maximizes patient independence and control over their own care.
- 3. POINT OUT that peritoneal dialysis (CAPD and CCPD) is also a home treatment, is the preferred treatment for more
than 10% of patients nationwide and particularly allows new patients to go home quickly and return to work, school or
- 4. TELL them that interest in home hemodialysis has been growing in recent years and that new programs are starting
- 5. TELL them that several manufacturers have developed patient-friendly equipment for home hemodialysis recently.
- 6. REMIND them that projections are that the number of dialysis patients in this country will double over the next
10 years, while the number of nephrologists will not increase and the nursing shortage will continue. The best solution
is for more patients to dialyze at home where they will also receive the most adequate dialysis!
- 7. MOST IMPORTANTLY, if this provision passes, this will limit patients' choice of treatment.
In addition to individual physicians, patients and dialysis programs, various organizations
including the American Association of Kidney Patients, the American Nephrology Nurses Association, the National Kidney
Foundation and the Renal Physicians are also concerned about this provision, as are several of the manufacturers of
dialysis equipment and others. PERSONALISE YOUR COMMENTS: If you are a patient who has been treated by home hemodialysis
or peritoneal dialysis, say how this has benefited you. If you are an in-center dialysis patient, comment on whether you
were given the opportunity to select home hemodialysis and CAPD or CCPD and point out that destroying these treatments
will eliminate patient choice. If you are a member of the renal community, comment from your experiences. If you have
questions please feel free to email Dr. Christopher R. Blagg at email@example.com or Dr. Robert S Lockridge at
Chris Blagg, M.D.
Robert S. Lockridge, Jr., M.D.
Contact info for Dr. Lockridge:
Phone:434-947-3954 Ext 111
103 Clifton Street
Lynchburg, Virginia 24501