CMS asked for comments on the adequacy of home training payment in their most recent proposed rule, and the community responded – the first word that comes to mind is "wow!"
Several hundred people (dialyzors, care partners, healthcare professionals, renal organizations and Members of Congress) clearly and directly called CMS to action to fix the currently inadequate training payment for home hemodialysis (HHD). The personal stories of the impact of HHD and the role of the training nurse that were shared were amazing and motivating. We are proud and humbled to join forces with you to drive change forward!
It will take several days for Medicare to post all of the comments they have received, but the current payment inequity has been made well known - over 25% of comments mentioned this. I think this speaks volumes for the resilience and mission of our grass root advocacy efforts.
To help in their decision, CMS specifically asked for data showing the actual costs of home dialysis training. We responded with new analysis looking at CMS' own updated cost report data, showing that actual training costs are $250-260 per HHD training session, far in excess of the $33 that is currently paid. So it is no surprise, then, that most centers don't offer HHD, that so few patients know it is a real option for them, that the percentage of patients on HHD is so vastly different than what physicians and nurses say they would choose for themselves…the list goes on. I invite you to read our specific comments and our recent press release.
Come this fall, we'll look to Medicare to respond to this strong appeal and to do the right thing. Because of all of our efforts, policymakers are increasingly aware of the barriers, and with knowledge comes the ability to fix it! It is a disservice to patients to allow this situation to remain unresolved.
More later – let's keep up the efforts! Let's all take whatever chance we get to continue to tell our stories to Medicare and Members of Congress about the benefits of HHD and the need for change!