Take a look at the just-published review, "How to Overcome Barriers and Establish a Successful Home HD Program" in the Clinical Journal of the American Society of Nephrology. I believe this marks the start of a turning point in how the nephrology community thinks about its obligation to endorse home hemodialysis and increase access. The authors of this publication are respected worldwide thought leaders in the field of home dialysis, with particular expertise in today's most commonly prescribed home therapy - peritoneal dialysis. This journal is highly credible. The fact that this independent (and diverse) group calls for increased access to home hemodialysis is a strong endorsement of the therapy. NxStage applauds the authors for taking a stand on this important issue!
As the authors clearly state, there are significant benefits associated with home hemodialysis and there are also barriers to patient access to this therapy. It is very important that the authors specifically identified inadequate payment to providers for home hemodialysis training as a barrier. As you know, we believe this is a major stumbling block to patient access. We are working hard to change this. With today's low training reimbursement, many dialysis centers are reluctant to invest in the up-front training capacity so there is little motivation to provide access- let alone create patient awareness or change patient perceptions.
The wonderful news is that now others are joining our fight! As of last count, there were 49 comment letters that were submitted to CMS on the latest proposed rule. Of these, 23 of the submitting organizations explicitly mentioned the need to update home hemodialysis training payment either on their own or as part of consortiums they are part of. Clearly we commented; others that commented (either on their own or consortium signees) included DaVita, Fresenius, Baxter, the Renal Physicians Association, the American Society of Nephrology, the National Renal Administrators Association, key patient groups, and a number of other interested parties.
Given all of the supportive clinical data and now this clear strengthening of support in the dialysis community, we’re nearing a turning point AND CMS must do the right thing and fix the home hemodialysis training payment. Patients deserve this!