Congress Should Advance Integrated Care for Dialysis Patients

Hrant Jamgochian, Chief Executive Officer, Dialysis Patient Citizens
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As CEO of America’s largest patient-led kidney disease organization representing 30,000 dialysis patients and family members, I have the distinct honor to work with and represent some of the most dedicated individuals advocating to improve patient quality of life before Congress.  One of them is the President of our Board of Directors, Jack Reynolds, who has managed his health conditions himself while on dialysis for over 40 years. He takes extra care with his diet, his rest and never misses a dialysis treatment.

Like Jack, millions of Americans with a serious illness know how complicated our health care system can be to navigate.

There’s a simple fix to this pervasive problem: integrated care. This allows for the true “quarterbacking” of a patient’s care. Integrated care allows a patient’s doctors and other health care providers to share information with one another in real time—truly coordinating their care. It’s a straightforward concept with proven results. Research has shown that integrated care can help to improve the health of people with chronic conditions and lower their health care costs.

As you may guess, integrated care is especially important for people with kidney failure. These patients suffer from other chronic conditions, including diabetes, high blood pressure and cardiovascular disease. They see multiple health care professionals, and are often prescribed numerous medications.

With integrated care, patients undergo fewer duplicative and wasteful tests, and they receive holistic care that focuses on the whole patient, not just their disease. For a patient receiving dialysis three times per week for up to four hours per visit, these benefits are invaluable.

For dialysis patients, the benefits of integrated care have been demonstrated time and again. In Medicare Advantage ESRD Chronic Special Needs Plans (C-SNPs), dialysis patients have experienced 25% fewer hospital stays, 51% fewer readmissions, and 66% fewer catheters[1] than those patients in Medicare Fee for Service.

Unfortunately, most ESRD patients don’t have access to coordinated care as these programs only serve about 40,000 patients, less than 10% of ESRD patients today.  Just a few weeks ago, 8 dedicated bipartisan, bicameral leaders in Congress reintroduced a bill to remedy that.

The Dialysis Patient Access to Integrated-care, Empowerment, Nephrologists, Treatment, and Services (PATIENTS) Demonstration Act, otherwise known as the Dialysis PATIENTS Act, would create a demonstration project in Medicare to broaden access to integrated care. The Dialysis PATIENTS Act seeks to build on the successes of the CEC Model and C-SNPs, while expanding dialysis patients’ access to integrated care. 

On behalf of dialysis patients across the country, we’d like to thank Reps. Jason Smith (R-MO), Earl Blumenauer (D-OR), Cathy McMorris Rodgers (R-WA), and Tony Cardenas (D-CA) and the Committees on Ways and Means and Energy and Commerce for their tireless work on this landmark legislation. In addition, it was Sen. Todd Young (R-IN) who managed the bill through Ways and Means in the House last September – and we applaud him and his new partners Sens. Bill Nelson (D-FL), Dean Heller (R-NV) and Michael Bennet (D-CO). 

Lastly, we urge all in the Congress to co-sponsor this legislation and we ask leadership to quickly consider the bill for passage so thousands more ESRD patients can be empowered towards superior health outcomes and a better quality of life.


[1] Analysis of 2016 DaVita MA ESRD C-SNP results vs. 2017 USRDS (2015 results) and ESRD National Coordinating Center

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