Congress needs to work together to provide quality Medicare for patients

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Further, any move to cut Medicare funding for kidney care would destabilize a benefit that has among the lowest margins in the Medicare program.  The Medicare Payment Advisory Commission (MedPAC) has consistently recognized the extremely narrow Medicare margins of dialysis facilities.   In addition, recent implementation of Medicare’s substantial dialysis payment reforms, including Medicare’s first value-based purchasing program, are underway.  These reforms have already resulted in funding reductions of more than two percent for dialysis care.  Adding an across-the-board Medicare cut on top of these reductions would likely create economic instability in the Medicare ESRD program.
 
In an effort to do our part in the deficit reduction effort, the kidney care community proposes that individuals who develop kidney failure while covered under the newly enacted Health Insurance Exchange plan simply be treated the same as those who have similar private coverage outside the Exchanges today.  This parity would mean that individuals in the Exchanges would have the choice to maintain their private coverage for 30 months after their diagnosis with kidney failure, before Medicare takes over as primary payer, as is done today outside the Exchanges. 

In addition, the subsidies available to assist individuals in purchasing Exchange coverage should also be available to these individuals during that 30-month window.  Independent analysts that we have retained score this provision as raising several billion during the ten-year budget period, all while protecting the integrity of the Medicare ESRD benefit.
 
So, if we’re going to improve the health of the Medicare program for future generations, it is incumbent upon all of us to work as a team towards a more cost efficient and intelligent health care system.  Public health care dollars are precious and should be wisely and efficiently spent, and the kidney community is proud to do our part in putting forth cost-effective, patient-centered solutions that are good for taxpayers by saving the Medicare program billions, while ensuring choice and protecting quality for our citizens who rely on Medicare’s dialysis benefit to live.
 
Ron Kuerbitz is the chair of Kidney Care Partners.