Health Care

CMS proposes add-on provider payment for at-home dialysis treatment

Dive Brief:

  • CMS is proposing to deploy an additional Medicare payment to providers for at-home dialysis treatment, particularly for new and innovative dialysis machines.
  • The agency said Monday the need for more at-home care has never been more urgent, especially for those with underlying health conditions like end-stage renal disease. In fact, CMS said the ESRD population has the highest rate of hospitalization due to COVID-19 among Medicare beneficiaries.
  • Currently, a substantial portion (85%) of fee-for-service Medicare members with ESRD go to an outpatient facility about three times a week, on average about 12 hours each week, to use a machine that filters the toxins from their blood.

Dive Insight:

The move builds on previous actions by President Donald Trump’s administration to shift how the U.S. pays for and treats patients with kidney disease.

Last year, the administration launched a three-pronged plan — an initiative dubbed Advancing American Kidney Health — to attempt to reduce the number of Americans with end-stage renal disease by upping preventative care, establishing incentives for at-home care and increasing organ transplants.

CMS also launched a handful of new payment models, most of them voluntary, to achieve these goals.

A large chunk of the U.S. has some form of chronic kidney disease, and for many of those patients have multiple underlying chronic conditions, complicating their health status. About 15% of adults in the U.S., or 37 million people, have chronic kidney disease, according to estimates from the Centers for Disease Control and Prevention.

Next year, the Trump administration expects to spend $10.3 billion paying 7,400 treatment centers for dialysis treatment. CMS also is proposing to bump up the base payment rate by about $16 to nearly $256.

“In the midst of a deadly pandemic that poses a particular threat to those with serious underlying conditions, President Trump’s call for increased access to home dialysis has never been more urgent,” CMS Administrator Seema Verma said in a statement. “Unfortunately, government rules too often stand in the way. Today’s action represents a sorely needed course direction, making it easier for ESRD facilities to make new and innovative home dialysis machines available to patients who need them.”

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