Give the Gift of Coordinated Care to Dialysis Patients

Allen R. Nissenson, MD, FACP, Chief Medical Officer, DaVita Kidney Care
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The holiday season is a time for reflection and a time for giving. We should reflect on the things we are thankful for, and on what we have done to improve the lives of those around us. We should push ourselves to give more to our families, our friends, and our communities.

As the Chief Medical Officer for DaVita Kidney Care, a leading provider of kidney care in the United States that serves nearly 200,000 patients with kidney failure, I am thankful for the opportunity to improve the lives of those living with End Stage Renal Disease. People with kidney disease are one of the most vulnerable populations in our country, and one of the populations most in need of a gift this holiday season.

That is why I am calling on Congress to pass the Dialysis PATIENTS Demonstration Act (H.R. 4143/S. 2065). The PATIENTS Act would allow dialysis providers, nephrologists, and other members of the kidney care community to better coordinate care for our kidney patients, the vast majority of whom are dependent on Medicare. Patients on dialysis face a dizzying array of medical complications, often dealing with other chronic illnesses like diabetes and hypertension, managing appointments with many different doctors, and taking roughly 18 pills per day. Worst of all, these patients spend an average of 11 days per year in the hospital. That is exactly why patients on dialysis need coordinated care, and therefore, need the PATIENTS Act.

We know that coordinated care works for dialysis patients because we have the results to prove it. In select counties across the country, dialysis patients participate in ESRD Chronic Condition Special Needs Plans, or C-SNPs. Dialysis patients enrolled in these programs have 25% fewer hospital stays, 51% fewer readmissions, and 66% fewer central venous catheters than dialysis patients in Medicare Fee-for-Service. This means that dialysis patients with coordinated care are spending less time in the hospital and more time at home. What better gift could we give to our patients?                

The PATIENTS Act is essential to giving this gift. Today, only a fraction of Medicare dialysis patients have access to coordinated care. The PATIENTS Act takes the most effective elements from today’s various coordinated care programs, and creates a demonstration program that could scale across the country. More patients will benefit when coordinated care is available to them.

As a physician, I’ve asked the same questions that any caring clinician would ask about this program: How would it affect my patients’ benefits? How would it affect my patients’ access to their current providers?  Fortunately, these answers are simple under the PATIENTS Act: patients receive extra support in addition to the benefits they have today, and can continue to see any Medicare provider. So here’s another question: Why not support a bill that preserves patient choice and provides additional benefits?  It is voluntary for the provider and it is voluntary for the patient.  Supporting the PATIENTS Act is an easy call.

If you’re interested in doing more to help those in your community this season, join me in calling for the passage of the PATIENTS Act. We know integrated care works for dialysis patients, and the PATIENTS Act would expand access to this great gift. I’ll end with a quote from someone who knows this best, one of our dialysis patients in Indiana named J. Pekrul:

“I am diabetic, have a defibrillator, low thyroid, high blood pressure, and high cholesterol. While today I am capable of coordinating all my medical care, manage my medications and still drive myself, I realize that the day may come when I will need help in all of these areas. I encourage you to pass the Dialysis PATIENTS Demonstration Act. It will be a tremendous help to people in kidney failure with multiple health problems.”



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