There’s been much discussion in the media and online over the course of the last few weeks about the potential cuts to dialysis and the motivations of those against these cuts. As the nation’s foremost advocate for kidney patients, NKF urges lawmakers and the public to focus on the impact these cuts would have on the health and lives of hundreds of thousands of patients. This is truly the only issue.
Cutting payment to a program that over 350,000 Medicare beneficiaries rely on will hurt vulnerable patients and families who are already coping with the challenges of living with a chronic illness. These cuts will likely result in unintended consequences that disrupt dialysis patient access to quality care—now and in the future.
Most dialysis profits do not come from treating Medicare patients, so it is not accurate to assume that these companies are making lots of money at taxpayers’ expense. On average, dialysis facilities make about a 3-4 percent profit for treating Medicare patients. If Medicare payment for dialysis is cut by 9.4%, it is highly likely that facilities operating at a significant loss will have to close, leaving patients to find new units that may be a distance from their homes. Many patients have no means of transportation and such a situation would cause great hardship.
These cuts will also strain a staffing situation that is already difficult. It may become necessary to freeze the hiring of staff in the units which would mean less face time for patients with the nurses, social workers, and dietitians that are so important to their health and well being. Additionally, dialysis units may be forced to eliminate any extra benefits that improve quality care, but are not reimbursable. One such service is patient education that goes beyond Medicare’s requirements. This education is hardly a luxury for people who need to understand complex information about various treatment options, diet requirements and medication regimens.
These proposed cuts will cause many facilities to lose money treating Medicare patients. Providers will look for ways to mitigate that loss and those decisions are likely to harm some patients’ access to quality care.
NKF does not want to see patient care put at risk and as a result, we are urging the Center for Medicare and Medicaid (CMS) to appropriately cover the costs of providing dialysis treatment to Medicare patients, which may require reworking the entire payment system instead of just cutting down on the drug portion.
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