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Supreme Court Erases Kidney Patients’ Insurance Protections

2024-03-29T01:10:07+00:00June 22nd, 2022|Categories: Article, Dialysis Funding, Medicare Advantage, Private Insurance Coverage, Protect Patient Care|

A U.S. Supreme Court ruling has nullified the law that protects dialysis patients from discrimination by insurers, threatening the system of financing kidney care that has stood for 40 years. The Court ruled that employer health plans may limit dialysis benefits. For four decades, employers understood the law as prohibiting limitations that only applied to dialysis. Some health benefit consultants encouraged a few small employers to disregard the law by paying no more than Medicare rates for dialysis. DaVita sued them, and one of the cases was appealed to the Supreme Court. The decision means that employers and insurers can [...]

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What Patients Should Know About Value-Based Care

2024-03-29T01:10:08+00:00May 23rd, 2022|Categories: Article, Care Coordination, Improve Access to Care, Increase Quality of Care, Medicare Advantage|

DPC is a strong advocate of Value-Based Care. Value-Based Care means that your primary providers accept a single payment or budgeted amount to cover all your medical needs. For instance, if you are in a program like Comprehensive Kidney Care Contracting (or CKCC, formerly known as the ESCO program) your dialysis provider and nephrologist take responsibility for all your care—not just kidney care but other conditions, such as diabetes, and other sites of care, such as hospitals. There are currently three types of value-based care programs that kidney patients may be in: Comprehensive Kidney Care Contracting (CKCC) – you are [...]

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DPC’s Letter to Dr. Meena Seshamani, Deputy Administrator and Director for CMS

2024-03-29T01:10:09+00:00March 7th, 2022|Categories: Comment Letter, Increase Quality of Care, Policy Issues, Protect Patient Care|

March 7, 2022 Dr. Meena Seshamani Centers for Medicare & Medicaid Services 7500 Security Boulevard Baltimore, MD  21244 Re:      Dialysis Workforce Issues Dear Dr. Seshamani: We are writing to express our concerns about shortages of labor and supplies that are causing disruptions in dialysis treatments. We urge CMS and its sister operating divisions in HHS to develop plans for health care workforce generally and dialysis workforce in particular; and to make whatever adjustments are necessary to Medicare payment policy necessary to assure patients’ access to care. To the best of our recollection, the U.S. is experiencing a tight labor market [...]

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DPC Urges Medicare Officials to Take Action on Dialysis Workforce Shortages

2024-03-29T01:10:09+00:00March 7th, 2022|Categories: Article, Comment Letter, Improve Access to Care, Increase Quality of Care, Medicare Advantage|

DPC has written to top Medicare officials asking that they develop policy options to address the current labor shortage. The letter notes that the lengthy rulemaking process used to update payments to healthcare providers is ill-suited to react to urgent changes in the labor market. Fourteen years ago, the prestigious Institute of Medicine warned that as Americans aged, there would be fewer workers to take care of more elderly and disabled individuals. DPC’s letter urges officials to take another look at the report, which recommended “wage pass through” components of provider payments to address rising wages and delegating more responsibilities to [...]

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Final ESCO Evaluation Documents Care Coordination Success Story

2024-03-29T01:10:09+00:00March 2nd, 2022|Categories: Article, Increase Quality of Care, Medicare Advantage, Protect Patient Care|

Medicare’s Comprehensive ESRD Care Model was designed to identify, test, and evaluate new ways to improve care for End-Stage Renal Disease (ESRD) patients. It established ESRD Seamless Care Organizations (ESCOs) that brought dialysis clinics and nephrologists together to coordinate patients’ kidney- and non-kidney care. This demonstration project ended last year and was replaced by a similar one this year. The Medicare Innovation Center has released the final evaluation report for the ESCOs. Overall, the ESCOs showed modest but statistically significant results over the five performance years, reducing Medicare expenditures. The number of hospitalizations decreased 3% and the percent of beneficiaries with [...]

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Don’t Forget to Apply for DPC’s 2022 Advocacy Day!

2024-03-29T01:10:09+00:00February 22nd, 2022|Categories: Advance Patient Choice, Improve Access to Care, Increase Quality of Care, News, Promote Financial Security, Protect Patient Care, Take Action|

DPC is pleased to invite you to apply for our 2022 Advocacy Day. Please apply by February 25th. Each year, Dialysis Patient Citizens is excited to host a Congressional Advocacy Day for kidney patients and transplant recipients to meet with their federal legislators and talk about issues that affect their quality of care. Historically, our members have come to Washington, D.C., to meet with their Congressional Members in person. However, we are conducting a virtual "fly-in" in 2022 due to the ongoing Covid-19 pandemic in order to ensure the safety of our participants. We will be hosting our Congressional Advocacy Day [...]

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Medicare Kicks Off New Kidney Care Demonstration Project

2024-03-29T01:10:10+00:00February 1st, 2022|Categories: Access to Transplant, Article, Increase Quality of Care, Medicare Advantage, News, Promote Financial Security, Treatment Options|

The Center for Medicare and Medicaid Innovation has announced 85 sites for its Kidney Care Choices (KCC) Demonstration Project, which started January 1, 2022. The program, initially announced by President Donald Trump in July 2019, is intended to “help health care providers reduce the cost and improve the quality of care for patients with late-stage chronic kidney disease and ESRD… and to delay the need for dialysis and encourage kidney transplantation.” KCC consists of two separate programs. In Kidney Care First (KCF), participating nephrology practices receive payments on a per-patient basis for managing the care of patients with late-stage chronic kidney [...]

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DPC Files Amicus Brief in Supreme Court Case

2024-03-29T01:10:10+00:00January 27th, 2022|Categories: Article, Dialysis Funding, Legal Defense, Medicare Advantage, Private Insurance Coverage, Protect Patient Care|

DPC filed a “friend of the court” brief in the U.S. Supreme Court case of Marietta Memorial Hospital v. DaVita. The case involves a dialysis patient whose employer-sponsored health insurance plan tied reimbursements for dialysis to Medicare prices. The Sixth Circuit Court of Appeals held that this constituted illegal discrimination. The employer appealed the decision, which is now scheduled for oral arguments before the U.S. Supreme Court on March 1. DPC’s brief argues that such discrimination circumvents dialysis patients’ right to keep their employer coverage for up to 30 months before Medicare becomes their private insurance. DPC emphasized the three [...]

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2021 Annual Survey Last Call!

2024-03-29T01:10:13+00:00August 26th, 2021|Categories: 5-Star Ratings, Access to Transplant, Article, Care Coordination, Charitable Premium Assistance, Dental Coverage, Dialysis Funding, Immunosuppressive Drug Coverage, Innovation, Medicaid, Medicare Advantage, Medigap Coverage, Patient's Voice, Protect Patient Care, Quality Incentive Program, Take Action, Transplant Donor Protection, Transportation Services, Treatment Options|Tags: |

24 hours remain to complete our survey. Make sure to complete your survey for a chance at one of 10 remaining $100 gift certificates. Our 2021 Annual Membership Survey is live, and it will remain open until Friday, August 27. Your feedback helps to shape our public policy agenda and patient education priorities for the next year. This year we ask that both patients and caregivers take our survey. Rest assured your responses will remain completely anonymous. We only share the overall survey results with state and federal level policy makers, so they will better understand your needs, experiences, and [...]

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DPC Urges Medicare to Add Resources for Health Equity

2024-03-29T01:10:13+00:00August 19th, 2021|Categories: Comment Letter, Improve Access to Care, Medicare Advantage, Quality Incentive Program|

DPC has filed its letter commenting on this year’s Medicare ESRD Proposed Rule, which governs payments to dialysis facilities. The Centers for Medicare & Medicaid Services (CMS) heralded this year’s payment rules as undertaking new initiatives to reduce health disparities. DPC’s letter critiques these initiatives as insufficient and endorses alternative approaches. CMS is proposing to collect new data on racial disparities, and to stratify quality measures so that facilities serving disadvantaged patients no longer receive QIP payment reductions simply because patients are poor. DPC endorses these moves, but points to recent calls by experts to address disparities by supplementing payments to [...]

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