New medicare initiatives

[Eyak1971]

During my doctor visit, the doctor shared that his clinic is now working with another facility to provide mental and information support for transplant and kidney patients to satisfy new protocol for services to be medicare acceptable and must show good job in providing services to patients to get bonuses from the government. Which sounds good. But he also said that medicare is promoting fistulas rather catheters for pd as a cost saver. Anyone having additional information on the new program or more explanation?

[RhenDutchess123]

Not sure what the question is...are you saying that Medicare is promoting Hemo instead of Peritoneal Dialysis as a cost saver ?

[Darlenia]

I believe some nephrology practices are indeed bringing in outside entities to offer support services to their patients; insurances do seem to pay for it.

Medicare encourages the use of in-home dialysis - both PD and home HD - since in-center HD is very expensive. With regard to HD, Medicare is promoting the use of fistulas, not catheters, since catheters can have very serious and life ending consequences. For example, when my hubby had a chest catheter for HD, there was a constant concern about infections since the chest cath and heart were located right there together. An infection can travel to the heart amazingly fast. It seems you and your nephrologist are looking into you possibly going on HD. Here's an article on Medicare and the fistula/catheter outcomes for HD. journals.lww.com/jasn/pages...

[Eyak1971 in reply to Darlenia]

Thanks for the clarification. Not having to make that choice just yet. My transplant is ok for now. But if the time comes, I will probably try to go pd. Had both hemo and pd before transplant. Preferred pd.

[Darlenia in reply to Eyak1971]

Nice! Glad you don't have to consider going on dialysis now. My hubby, too, experienced HD as well as PD and definitely preferred PD. He also has a transplant today. You and he are taking similar paths. Cheers!

[Eyak1971 in reply to Darlenia]

Thanks for sharing.