Dialysis is one of the major treatments which is given to patients with kidneys that are not able to function properly. Whenever the kidney’s filter glomerular filtration rate is lesser than 15mL/min and there is one or more of the following such as symptoms or signs of uremia, inability to control hydration status or blood pressure, or progressive deterioration in the nutritional status.
Imposing Penalties On Low-Quality Dialysis Programs Are Not Working
To treat this mess, there is a treatment called Dialysis, which is the process of removing the excess water, solutes, and toxins from the blood in people whose kidneys can no longer perform these functions on their own. This also referred to as renal replacement therapy and the first successful case on which which this was performed was in 1943.
It is also observed that dialysis should be performed when there is a sudden rapid loss of kidney function, known as acute kidney injury or when the kidney gradually declines in its functions and chronic kidney disease reaches stage 5. Stage 5 renal failure is reached when the glomerular filtration rate is 10 to 15% of normal, creatinine clearance is less than 10 mL per minute, and uremia is present. Dialysis is majorly a temporary event for those who are waiting to get a kidney transplant. It is only permanent only when there is no chance for replacement.
As per the recent reports, there is some poor performance in the Dialysis center, and it not able to perform well and benefit its patients. So the federal government has imposed penalties on poor-quality medicare centers with the hope of improvement. But as per the new reports, the penalties imposed on this medicare center by theUnited States federal programs are not helping. As per the reports, the Dialysis centers face up to a 2% of reduction in their annual Medicare reimbursements if they get a low score on a set of quality measures as designed by the United States Center for Medicare and Medicaid Services.
The researchers also mentioned that these measures are not bureaucratic box-checking but if the kidney patients are treated with low-scoring programs. Then there is a high chance that they might die in the first year of their dialysis. As per the statements of the fellow researcher with the Center for Healthcare Outcomes and Policy at the University of Michigan, about one in five United States dialysis centers faced such penalties in 2017 based on the performance of the past two years. However, these dialysis centers did not improve their performance consistently in either 2017 or 2018 as per the reports of the fellow researcher.
She also mentioned that getting penalized by these medicare centers has not improved the quality of the dialysis programs that they are providing. The primary leverage that the program has over centers to improve the quality of the treatments did not work. As per the Affordable Care Act’s focus on improving the United States health care, there is a recent development they are tying Medicare reimbursements as per the new act.
As per the statements of Dr. Paul Palevsky, president of the National Kidney Foundation, the first End-stage Renal Disease Incentive Program was launched in 2012 was the first pay-for-performance program that the CMS has implemented where the payment for dialysis was pegged to performance in specific quality measures. Subsequent value-based programs track hospitals and penalize them for practicing poor quality treatments, too many readmissions, or a surge in infections and illnesses acquired by patients during the hospitalization. Other programs affect the pay of doctors, nursing, facilities, and home health care providers.
It is also observed that about half a million people are on dialysis in the United States of America, and CMS spends about $100,000 per person every year for kidney patients on dialysis, which is more the 6% of the total Medicare budget.