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Can increasing home dialysis options lower costs and save lives?

Undergoing dialysis treatment to keep the body in balance after kidney failure can change a person’s life dramatically. Patients often visit a dialysis clinic three days a week and spend three to five hours on each treatment.

Now the federal government is working on a new approach for treating kidney disease that favors lower-cost, in-home care and transplants in lieu of expensive and time-consuming clinic visits.

Nearly 15 percent of Americans live with chronic kidney disease and an estimated 720,000 people have progressed to kidney failure. At the current rate, Reuters reports, this number will jump to 1.26 million by 2030. It is no wonder the U.S. government has spent a whopping $114 billion to treat chronic kidney disease and end-stage renal disease.

Current treatment models have been very profitable for some providers. DaVita Inc. and Fresenius Medical Care AG control about 70 percent of the U.S. market and have more than 5,000 dialysis clinics nationwide.

A new payment approach being developed by the U.S. Centers for Medicare & Medicaid Services (CMS)calls for more focus on early intervention to slow the progression of kidney failure, shortening the waiting list for kidney transplants, and encouraging patients to receive dialysis treatment at home and at night while they sleep.

Home dialysis options have been available and are paid by Medicare, but adoption has been slow because of the current system’s structure.

In fact, today “a lot of perverse incentives” prompt people to get treatment in an institutional setting rather than home, said CMS Administrator Seema Verma.

Home care would increase the frequency of patients undergoing dialysis by avoiding the so-called “killer gap,” which is the two-day wait between in-clinic dialysis treatment. The gap is blamed for increased hospitalizations that account for 40 percent of government spending on dialysis patients.

Do you have chronic kidney disease? How much time do you spend traveling to and from or at the dialysis clinic? Would home dialysis and telehealth innovations improve your quality of life? Share your voice with Voices for Affordable Health