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  Sept. 27, 2016
DCI, the Largest Non-Profit Dialysis Provider, Is Joined by Other Groups To Oppose the Dialysis PATIENTS Demonstration Act
Information from Dialysis Clinics Inc. (DCI). Also see DCI letter to Senators Heller and Nelson (3-page pdf), letter from the Non-Profit Kidney Care Alliance (3-page pdf), and letter from the American Society of Transplant Surgeons, American Society of Transplantation, and American Association of Kidney Patients (2-page pdf). The bill is H.R.5942 / S.3090.

Statement from DCI:

While on its face the Dialysis PATIENTS Demonstration Act seems beneficial, based on our review, we believe its passage is not in the best interest of kidney patients, and we strongly oppose its passage. 
 
Under the provisions in the Dialysis PATIENTS Demonstration Act, patient choice is limited and the legislation fails to provide patients, at a time of great personal duress and health concern, adequate time to make a reasonable decision on their care.  We also have concerns that patients do not have the option to depart the model they have been assigned to whenever they choose based on any concerns about the quality of care they are receiving.  In addition, there is a risk of disruption in the patient-physician-clinic relationship with closed networks, as proposed in the legislation.
 
The Dialysis PATIENTS Demonstration Act fails to address three critical aspects of kidney care including chronic kidney disease, transplant, and end of life care.  Without these pieces included in the model, we are not providing patients with the best care options.  Inclusion of these pieces is necessary in order to truly provide integrated care throughout all phases of the disease and achieve savings in the Medicare program.

Editor's note: I found only two organizations supporting this legislation. Press releases supporting the legislation are from DaVita and Dialysis Patient Citizens (formerly DaVita Patient Citizens). Both of these press releases refer to the same Senate bill number (S 3090), but reference a different House bill number, HR 5506. The DCI press release instead references HR 5942.
Morbidity, Mortality And Quality of Life in the Aging Hemodialysis Population: Results from the ELDERLY Study
Free, Open Access, Advance Access article from Clinical Kidney Journal.
New Hurdles in the Sprint for Transplant
Posting from the KidneyViews blog.
Free, Full-Text Article from Hemodialysis International:
Mending a Broken Heart but Breaking the Kidney
Free, full-text review article from Nephrology.
Free October 2016 Issue of Clinical Kidney Journal
16 full-text articles.
Initiation of Erythropoiesis-Stimulating Agents and Outcomes: a Nationwide Observational Cohort Study in Anaemic Chronic Kidney Disease Patients
Advance Access abstract from NDT.

The Challenge of Controlling Phosphorus in Chronic Kidney Disease
(Registration required, but free.) Free, full-text, article from NDT via Medscape Nephrology.

Early Infection Risk with Primary Versus Staged Hemodialysis Reliable Outflow (HeRO) Graft Implantation
Article in Press abstract from Journal of Vascular Surgery.
Exercise Speeds Seniors' Recovery From Disability
Article from HealthDay. Online First abstract and full-text Summary for Patients from Annals of Internal Medicine.
A Trip to a Roller Coaster Park to Clear Kidney Stones?
Five Recent Medical News Stories That Invite Cynicism
(Registration required, but free.) Commentary from Medscape Nephrology.

"I'm honestly more concerned about the folks who aren't cynical right now because either they're desperately misinformed, terrible critical thinkers, or it's a sign that marketing strategies are working or they've given in and become irreparably apathetic." - Commment by Dr. Deborah Proctor
21 Free, Full-Text, Online First Articles from the Journal of the American Medical Association; Sept. 26th Articles Include:
MACRA Flexibility Changes Draw Praise, but Providers Must Move Forward
Article from Medical Economics.

Previous News Stories
Why U.S. Dialysis Care Has Been Stagnant
Understanding Tassin
Nephrologists Can't Have It Both Ways (2015)
Ten Issues Nephrologists Do Not Want To Discuss with Dialysis Patients (2014)
The Missing Half of Excellence in
Dialysis Care 2013)
Human-Centered Care (2013)
Fix Dialysis
Boston ESRD Conference (2009)
New Views (2008)
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