The Dialysis Patient Access to Integrated-care, Empowerment, Nephrologists, and Treatment Services (PATIENTS) Demonstration Act, would deliver high-quality, integrated care to patients receiving dialysis for the last stage of kidney failure called end-stage renal disease (ESRD). The bi-partisan proposal would establish an integrated care program where interdisciplinary teams, led by a nephrologist, provide holistic management for all of the patient’s healthcare needs.
What is value based and integrated care?
Value based care is an evolved model of healthcare growing in popularity because it rewards providers for the quality of care rather than the quantity of services delivered. It is often used interchangeably with the terms integrated care or care coordination. Value based care emphasizes patient outcomes by encouraging efficiency and effectiveness and is a replacement for traditional fee-for-service models that focus simply on volume. This new effort has the triple goal of improving care for patients, reducing total costs and improving the way we manage large populations with certain diseases.
The Centers for Medicare & Medicaid Services (CMS) has tested value based programs for ESRD. These programs have shown promising results toward improving care while reducing cost to the government. By incenting providers to work more cooperatively and holistically, patients will stay healthier and have fewer hospitalizations.
How would the Dialysis PATIENTS Demonstration Act work?
The program would utilize the dialysis facility as a central command point for patients to access coordinated healthcare services. This practical approach to care delivery would significantly improve health outcomes and increase quality of life for ESRD patients while reducing costs to the system through reduced hospitalizations and readmissions.
The Dialysis PATIENTS Demonstration Act will help drive better outcomes by improving support for transportation issues, nutrition, vision and dental care and comorbidities, such as cardiovascular disease, diabetes and hypertension. Through a team approach that focuses on the whole patient, we will make a positive impact on this complex patient population with ESRD.
Why would anyone oppose this idea?
While participation would be voluntary for both patients and providers, there are some industry stakeholders who are invested in the old fee-for-service status quo and are working to stop or delay passage of the act. We must look to new innovations that improve healthcare and lower costs.
In certain value based programs, we have already demonstrated a reduction in hospitalizations of 30 percent, lowering the total cost of care for this patient population. We should now expand this proven, new model of care embraced by most in the healthcare industry. That’s why we are excited to see bi-partisan support in Congress for the Dialysis PATIENTS Demonstration Act.