It is very surprising that a study presented at the Annual Dialysis Conference found that a sudden and dramatic shift from Home Hemodialysis to Peritoneal Dialysis has occurred in the Chronic Kidney Disease Community. What is even more stunning is that the change is taking place even though previous studies have shown, "that the five-year survival rate for home Hemodialysis is at 85% while the survival rate for peritoneal dialysis patients was 44%," according to Nephrology News. So why the change?
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"Possible explanations for the trend," reported Renal and Urology News, "include a higher profit margin potentially associated with Peritoneal Dialysis and lack of adequate reimbursement for Home Hemodialysis training." Lead researcher, Eric D. Weinhandl, suggested that Peritoneal Dialysis is reimbursed at the same rate as In-Center Hemodialysis (three treatments per week), “So there certainly is the potential for added profit margin with Peritoneal Dialysis,” he noted.
The numbers highlight rapid transition from Home Hemodialysis to Peritoneal Dialysis. For instance, Home Hemodialysis patients annual growth rate was 24.9% in 2004 to 2010 but suddenly decreased to 7.9% in 2010 to 2014. On the other hand, Peritoneal Dialysis patients annual growth rate was only 2.8% in 2004 to 2010, and then suddenly jumped to 10.1% in 2010 to 2014. This is right around the time that the "debut of the Medicare Prospective Payment System (method of reimbursement in which Medicare payment is made based on a predetermined, fixed amount) took place for Dialysis care in 2011. Hence, lack of significant reimbursement for Home Hemodialysis training may cause decision makers to direct patients to Peritoneal Dialysis which offers more substantial Medicare reimbursements.
Hence, even though a Kidney International study found that daily Home Hemodialysis is associated with fewer hospital admissions and a lower risk of modality (treatment) failure than Peritoneal Dialysis, Home Hemodialysis growth rates have declined and Peritoneal Dialysis growth rates have increased after 2010. Therefore, Chronic Kidney Disease and Dialysis patients who are interested in conducting a Home Dialysis option should thoroughly explore both Home Hemodialysis and Peritoneal Dialysis to determine which is best for their lifestyles.
What do you think of the new trend away from Home Hemodialysis toward Peritoneal Dialysis? Is it unsettling that reimbursement may play a role in recommended treatments for patients? Share your response with the over 36,900 Facebook Friends. Share this article with others and join the over 115,000 monthly individual viewers who enjoy reading the hundreds of articles which provide news and information to teach those with Chronic Kidney Disease, Dialysis, Kidney Transplant, Diabetes, and High Blood Pressure how to better manage and improve their lives. A regular KidneyBuzz.com viewer, Gregory Rice said, Hi, great website...Keep up the great work! :)