In the wake of recent action by CMS to maintain Medicare Advantage funding, the time is ripe to follow up on a recommendation made by the Medicare Payment Advisory Commission 14 years ago: repeal the law prohibiting dialysis patients from enrolling in Medicare Advantage. The exclusion of end-stage renal disease (ESRD) patients from Part C deprives them of the opportunity to access two important benefits: care coordination by a single, accountable entity; and maximum out-of-pocket limitations. ESRD Patients Lack Access to Care Coordination, Resulting in Avoidable Complications As AHIP noted in a 2010 white paper, “health plans provide a life line” [...]

Medicare is changing how it pays for dialysis, and this is expected to impact your care. These changes started in 2011 and will continue through 2016. This is a guide to what you need to know and what you can do to help ensure you continue to receive quality dialysis care during this transition period. HOW WAS DIALYSIS PAID FOR TRADITIONALLY? Dialysis treatments, injectable medications received in the clinic, laboratory tests and other items used to treat end stage renal disease (ESRD, also known as kidney failure) are paid for by Medicare Part B for most patients. However, before January [...]