Kidney Care Partners (KCP) expressed concern that a combination of flat payments and increased regulatory pressures proposed by the Centers for Medicare and Medicaid Services (CMS) may negatively impact stability and affect quality of care in Medicare’s end-stage renal disease (ESRD) program. KCP is a coalition of patient advocates, clinicians, care professionals, dialysis providers, researchers, and manufacturers working together to improve quality of and access to care for individuals with chronic kidney disease (CKD) and ESRD.

“On initial review, KCP appreciates the agency’s interpretation of the kidney provisions contained in the Protecting Access to Medicare Act of 2014 (PAMA) to stabilize rates through 2015, though we remain concerned that despite these actions, Medicare reimbursement for dialysis care is not keeping pace with the rising costs of delivering quality health care to individuals with kidney disease,” said Dr. Edward R. Jones, Chair of KCP. “While the proposed rule implemented Congressional intent by modifying deep cuts planned for 2015, many dialysis facilities continue to face economic hardship.”

In recent years, the Medicare ESRD benefit has not received an inflation adjustment from CMS, which when coupled with sequestration cuts and other reductions by CMS, has resulted in Medicare reimbursement that is below the cost of care for most patients. Without adequate Medicare funding, providers and physicians are forced to make difficult choices regarding staffing, quality improvement interventions, and ultimately whether to keep a center’s doors open to patients.

“KCP supports efforts to ensure that payments reflect the actual cost of providing care so that our community can continue delivering high quality dialysis care and sustained quality improvements,” added Dr. Jones. “We will continue our diligent work with the broader kidney care community to submit detailed comments to the proposed rule during the public comment period.”

Additionally, Dr. Jones said that KCP will devote significant time and attention to the portion of the proposed rule pertaining to quality. “The Quality Incentive Program (QIP) has tremendous implications for care quality and economic stability. We look forward to working with CMS to ensure that the final rule contains policies that continue to elevate the quality of patient care,” Dr. Jones concluded.