Sensing Savvy

Home hemodialysis has several benefits for patients. Despite this, the modality remains underused among patients receiving hemodialysis. Here’s a look at some of the latest stats on home hemodialysis.

Did you know Medicare reimbursement for dialysis treatments has increased?

This past November, the Centers for Medicare and Medicaid (CMS) released its final rule for dialysis clinics, and the new stipulations, including the composite rate increase, went into effect Jan. 1. As a dialysis clinic professional, you’ll be responsible for managing these changes and updates in the year ahead.

To help you navigate the CMS final payment rule for 2019, here’s a breakdown of the three most significant changes.

Women May Have Lower Risk for Chronic Kidney Disease Progression

A recent study has revealed women have a lower risk of chronic kidney disease (CKD) progression and death than men, but men have a higher likelihood of progression to end-stage renal disease (ESRD). Researchers noted that the prevalence of CKD is higher among women, while men have a 50 percent higher lifetime risk of developing ESRD. The findings suggest that, compared to men, women could have a slower decline in kidney function or they’re more likely to die before progressing to ESRD.

Source: Nephrology News & Issues

As a hemodialysis nurse, you have probably performed cannulation on hundreds of hemodialysis patients. But, did you know researchers have noted that the ideal person to do the procedure is the patient? That’s because the patient is always there for his or her hemodialysis session.

Despite the fact many patients may not have had any medical training, most can quickly achieve expert-level skill with self-cannulation, which not only makes the patient more active in his or her care and reduces the risk for complications, it also frees nursing staff up to do other pre-dialysis and dialysis tasks.

Multiple Comorbidities Increases Risk of Early Dialysis Initiation
Patients who have CKD along with other comorbidities face an increased risk of early dialysis initiation, researchers found. Smoking, older age and proteinuria significantly increased the risk for  two or more comorbidities. The most common comorbidities found in these patients are diabetes, hypertension and hyperlipidemia.

What’s your No. 1 goal for patient care? As a nephrologist or nephrology care professional, it’s likely keeping your patients alive. But, according to a recent study performed at the Icahn School of Medicine in Mount Sinai, NY, many patients have a different leading objective.

Life-threatening bleeds (LTB) from arteriovenous fistulas or grafts are significant bleeds which are not stopped by application of a normal amount of pressure as is commonly used to stop bleeding after dialysis needle removal. In many cases they occur spontaneously at home between dialysis sessions, away from the clinic or caregiving team. Although access-related LTBs are not common, they can result in the loss of the patient’s access and even be fatal.

As a healthcare professional, you know your treatment plans are only as powerful as your patients’ commitment. Your patients’ quality of life not only depends on your expertise but also on how well they implement their care plan after they leave your office. And when it comes to patients with end-stage renal disease (ESRD), non-adherence to dialysis and supporting factors such as diet and medication can lead to severe complications and an increased risk of mortality. Unfortunately, at least 50 % of hemodialysis patients are believed to be non-adherent, according to a study by the Department of Internal Medicine at Cairo University.

In February, the Bipartisan Budget Act of 2018 was signed into law, expanding Medicare reimbursement for a small list of telehealth services, including home dialysis for end-stage renal disease (ESRD), according to the Clinical Journal of American Society of Nephrology. 

DaVita’s Medical Group Division to Pay $270 Million Over Inflated Charges

The division, which is being sold to UnitedHealth Group, agreed to pay the sum to settle claims it provided inaccurate information on patients enrolled in Medicare Advantage plans, which led to overpayment from Medicare.

Source: Nephrology News & Issues