Northwest Kidney Centers believes the proposed Dialysis PATIENTS Demonstration Act (H.R. 4143 / S. 2065) will create barriers for patient care. This piece of legislation is fundamentally flawed for several reasons, most importantly its impact on patients.
Join Northwest Kidney Centers and others (see Letters of Opposition at right) in opposing this legislation. Click here to voice your opposition to this bill.
Here’s why we oppose this bill:
- We believe in choice, and this bill limits patient choice. Medicare ESRD patients will be enrolled involuntarily for insurance in this capitation demonstration project. To leave, they must opt out within 75 days or be locked in for one year.During the stressful time when they are coping with a new ESRD diagnosis, patients should not be given another complex decision involving opting out of a new kind of insurance. In the existing system, people with kidney failure have Medicare insurance (primary coverage for 75 percent of our patients), and they select a dialysis clinic due to geography, their doctor’s preference or available space. In the proposed system under the PATIENTS act, failing to opt out may force them into an HMO run by a big dialysis company, which will direct all care within its own contracted network of hospitals and doctors. We believe kidney disease patients, like all other patients, should be able to elect coverage that best meets their needs.
- The bill will cause further consolidation in an industry where already just two for-profit corporations provide dialysis care to over 70 percent of patients nationwide.To participate in this demonstration, a dialysis provider must bear the insurance risk for each person enrolled—an average of $80,000+ per year for a dialysis patient’s services from hospital, doctor, nursing home and dialysis clinic. Many small and mid-sized dialysis organizations will not be able to become an insurance entity or partner with one. So, over time, the bill could eliminate the role of regional, independent, nonprofit, community-based dialysis providers—members of the industry most likely to provide innovative, patient-centered, high quality care.
- The demonstration doesn’t allow providers to care for kidney patients through their entire journey, as it doesn’t cover hospice, palliative care or transplantation care.
Letters of Opposition
- American Society of Transplant Surgeons, American Society of Transplantation, Association of Organ Procurement Organizations, and American Association of Kidney Patients letter of opposition to the House
- Nonprofit Kidney Care Alliance letter of opposition to the House
- American Society of Nephrologists and American Association of Kidney Patients letter of opposition to the House
- Northwest Kidney Centers letter of opposition to the Senate
- Northwest Kidney Centers letter of opposition to the House