NEW DATA ANALYSIS: Improved Dialysis Care Nationwide Leads to Healthier Patients, Reduced Hospital Admissions, and More Savings for Medicare
March 18, 2019
During National Kidney Month, the kidney care community celebrates improved care and how resultant reductions in healthcare utilization are benefitting both individuals with kidney failure and taxpayers
MARCH 18, 2019 (Washington, D.C.) – Sustained improvements in dialysis care nationwide are keeping patients healthier and out of hospitals, a positive trend that is generating billions of dollars in savings to Medicare, as described in a new data analysis by Discern Health using data from the government’s United States Renal Data System (USRDS).
More than 30 million Americans are living with kidney diseases. Kidneys diseases are silent killers that, left untreated, can develop into kidney failure – requiring dialysis or a kidney transplant to sustain life. Nearly 500,000 Americans rely on dialysis today for their long term-care needs or as they await a transplant.
“As a whole, the U.S. healthcare community has become much more focused on streamlining fragmented care and focusing on critical problem areas such as infections related to the necessary dialysis vascular access. When individuals with kidney failure who rely on dialysis care can avoid infections – such as by implementing best practices using the preferred form of access, arteriovenous fistulas – they can also avoid hospitalizations, which has saved Medicare $775 million since 2010 alone,” said Dr. Allen Nissenson, Chair of Kidney Care Partners (KCP). “The kidney care community is proud that, even with our complex Medicare population with multiple disease conditions and a Medicare system that reimburses less than the cost of care for most individuals on dialysis, we have been able to make measurable progress in reducing hospital admissions, average lengths of stay, complications, and readmissions – to the benefit of our patients and the nation’s Medicare program.”
Kidney Care Partners, the nation’s largest kidney coalition comprised of physician groups, providers, patient advocacy groups, manufacturers, and researchers, has worked alongside lawmakers to help formulate and implement quality improvement initiatives to advance access, care, and choice.
Discern Health’s recent analysis of USRDS data shows a 14 percent drop in hospitalization rates for patients with End Stage Renal Disease (ESRD) between 2007 and 2016. The average number of days spent in the hospital also dropped, with patients who receive dialysis care spending an average of 2.6 to 3.4 fewer days in the hospital per between 2007 and 2016. Likewise, the proportion of patients who are readmitted to the hospital also dropped by 2.7 percent for patients receiving hemodialysis and 3.2 percent for patients receiving peritoneal dialysis from 2007 to 2016.
“Logically, when we see a patient population grow in numbers – as has happened with Americans living with kidney failure – we might also expect to see increased utilization rates and growth in expenditures from complications,” said Guy D’Andrea, Managing Partner at Discern Health. “The fact the USRDS data show reductions in hospital stays and complications demonstrates improved quality of care and quality of life.”
“During National Kidney Month this March, it’s important to recognize that although we have made significant progress, the number of Americans who require dialysis is still on the rise – and we have more work to do,” Nissenson added. “KCP is committed to engaging lawmakers and regulators on enacting legislation and policies to support innovations for patients who rely on dialysis and ensure the Medicare program provides sufficient coverage and reimbursement for the adoption of new treatments and therapies.”
Costly complications requiring complex care are also on the decline. Cardiovascular event hospitalizations for patients receiving dialysis fell by 18.9 percent from 2007 to 2016, while hospitalizations due to vascular access infection fell by 54.6 percent during the same period.
“While this information is positive and encouraging, there is still much more work to be done,” concluded Dr. Nissenson. “This is a public-private partnership that will continue to show positive improvements as we work toward our common goals of improved clinical outcomes and quality of life for patients, incentivizing research and innovation, and improving and expanding education about the epidemic of kidney disease in the U.S. and the available treatment options when kidney failure occurs including active medical management, home dialysis, and transplantation.