TO: THE RENAL COMMUNITY - URGENT ! HOME DIALYSIS IS ENDANGERED
FROM: Chris Blagg, MD, and Robert Lockridge Jr., MD
PROBLEM:
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 treatment.
WHY IS THIS A PROBLEM?
Inadequate payment 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 other activities.
- 4. TELL them that interest in home hemodialysis has been growing in recent years and that new programs are starting up.
- 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 blaggc@hotmail.com or Dr. Robert S Lockridge at rlockridge@lynchburgnephrology.com.
Chris Blagg, M.D.
Robert S. Lockridge, Jr., M.D.
Contact info for Dr. Lockridge:
email:rlockridge@lynchburgnephrology.com
Phone:434-947-3954 Ext 111
Fax:434-947-5944
103 Clifton Street
Lynchburg, Virginia 24501
http://www.lynchburgnephrology.com