What's Happening?
The current Medicare payment system for dialysis care is outdated and underfunded, discouraging investment in innovative treatment options for patients with End-Stage Kidney Disease (ESKD). The bundled payment system, implemented in 2011, reimburses providers with a fixed fee for dialysis services and related medications, limiting access to new therapies. Despite efforts by the Centers for Medicare & Medicaid Services (CMS) to introduce policies like TDAPA and TPINIES to support new drugs and technologies, many innovations fail to reach patients due to inadequate reimbursement.
Why It's Important?
The lack of innovation in kidney care has significant implications for millions of Americans living with kidney disease. Outdated Medicare policies prevent patients from accessing advanced treatments, impacting their quality of life and health outcomes. Reforming the payment system to support innovation could lead to the development of new therapies, improving care for ESKD patients. The bipartisan Kidney Care Access Protection Act, introduced by Senators Marsha Blackburn and Cory Booker, aims to address these issues by creating a payment system that supports long-term adoption of new treatments.
What's Next?
Lawmakers are urged to advance the Kidney Care Access Protection Act to build a better Medicare payment system that ensures CKD and ESKD patients can benefit from medical innovation. The act would help create a payment system that supports the adoption of new treatments, potentially transforming kidney care and improving patient outcomes. If successful, this legislation could serve as a model for reforming payment systems in other medical specialties.
Beyond the Headlines
The need for Medicare payment reform highlights broader issues in healthcare policy, including the balance between cost control and innovation. Supporting innovation in kidney care could lead to breakthroughs in treatment, improving patient outcomes and reducing healthcare costs in the long term. The case for reform also underscores the importance of aligning payment systems with advancements in medical technology to ensure patients receive the best possible care.
