The emperor has no clothes (but has a catheter): a perspective on the state of chronic kidney disease care.
Dialysis providers are capable and interested in participating in the care of CKD patients. But dialysis providers do not, for the most part, become involved in the patients' care until CMS Form 2728 is completed and signed by the attending nephrologist. We believe that dialysis providers are interested in broadening their role, but only if the nephrology community believes this role is appropriate and supports such a resource collaboration. If CMS wants dialysis providers to get more involved in CKD patient management, it is extremely important that this effort not be another unfunded mandate that will result in an increase in the burden on current nursing, dietary, and social work dialysis staff providing current ESRD care. If dialysis providers are to collaborate on CKD care with the nephrology community, they must staff appropriately and there must be a definitive change in the Medicare reimbursement system to support the use of CKD guidelines that will result in a healthier and less costly patient presenting to the dialysis program at the point that they reach end-stage renal disease.
Lazarus
J Michael
JM
Fresenius Medical Care North America, Lexington, MA, USA.
Hakim
Raymond M
RM
Maddux
Franklin W
FW
Amedia
Chester A
CA
D019468:Disease Management; D006301:Health Services Needs and Demand; D006801:Humans; D007349:Insurance, Health, Reimbursement; D007676:Kidney Failure, Chronic / Q000628:therapy*; D017146:Models, Organizational; D011787:Quality of Health Care; D012017:Referral and Consultation; D006435:Renal Dialysis; D014481:United States