plugger
Joined: 11 Jan 2003
Posts: 258
Posted: Sat Jan 11, 2003 6:11 am Post subject: HR1759 Document support
--------------------------------------------------------------------------------
(I was rummaging through my computer and found a<
>document I received from Drs. Lockridge and Blagg to<
>support HR1759. I thought since the bill might be <
>coming to life again, it would be worth posting. The last<
>I heard the doctors were working on doing some modifying of the bill before they try it again)<
><
>DAILY THERAPY IS GOOD MEDICINE THAT IS ECONOMICALLY NONVIABLE TODAY WITHOUT <
>REFORMING MEDICARE REIMBURSEMENT<
><
><
><
>*Greater than 75 articles in the literature, over the last 20 years, <
> consistently demonstrate patient benefit and health care savings<
><
>*Improved patient quality of life<
> -Return to work<
> -Fewer hospital in-patient days<
> -Less pharmaceutical requirements<
><
>*The fact that kidneys function twenty four hours a day supports and <
> explains observed results of daily replacement therapy<
><
>*Concept of daily therapy supported by patients (American Association of <
> Kidney Patients ? AAKP), providers (National Renal Administrators Association<
> ? NRAA) and medical professionals (National Kidney Foundation ? NKF)<
><
>*Daily therapy is more expensive to providers and is not appropriately <
> reimbursed, thus this New Modality is?<
><
>*Essentially not available to US patients today although greater than <
> 200 patients over the past 20 years have been treated with daily hemodialysis<
> or its equivalent in the US, Canada, and Europe<
>
********************************************************************
plugger
Joined: 11 Jan 2003
Posts: 258
Posted: Sat Jan 11, 2003 6:59 am Post subject: Part 2
--------------------------------------------------------------------------------
(I'm having a little trouble getting all my columns to<
> match up, but I hope this is readable)<
><
>POTENTIAL BENEFITS TO MEDICARE ARE SIGNIFICANT<
><
>--------COLUMN 1-----------------------COLUMN 2------------COLUMN 3<
><
>-Annual Patient Costs (100%=$67,000)---DAILY THERAPY-------Medicare<
>---------------------------------(Impact of Daily Therapy)-----Benefits<
><
>-----------Hospitalization ($23,000)- 23 to 63% reduction- $5290 to $14,490<
>-------------------------------------------------------------savings<
> <
>-------Epogen/other drugs ($9,000)- 32 to 50% reduction- $2880 to $4500 <
>-------------------------------------------------------------savings<
><
>--Composite Treatment rate ($19,000)<
><
>----------------------Other ($9,000)<
><
><
>-------------------------------------10% to 15% cost shift-- $7000 to <
>-------------------------------------to private insurers---- $10,000<
>-------------------------------------due to patient <
>-------------------------------------employment<
><
>-------------------------------------Additional cost of----- (-$10,000) <
>-------------------------------------daily therapy assuming <
>-------------------------------------50% increase in <
>-------------------------------------reimbursement: <
>-------------------------------------$10,000 per patient <
>-------------------------------------per year<
><
><
>--------------------------------------------------------******Annual<
>--------------------------------------------------------******Savings <
>--------------------------------------------------------******to Medicare <
>--------------------------------------------------------******per patient<
>--------------------------------------------------------******per year: <
>--------------------------------------------------------******$5170 to <
>--------------------------------------------------------******$18990<
><
>Patient Employment? <
>Half of patients under age 65, most unemployed and covered by Medicare? <
>Half can return to work when on daily therapy? 30 month private pay <
>period covers half of expected duration of dialysis?<
> <
>The Case for Daily Dialysis: Its Impact on Cost and Quality of <
>LifeAJKD, Vol 37, No 4 (April), 2001: pp 777-789? <
><
>Canadian Study Comparing ?Conventional Vs HNHD Cost and Quality-of-Life?<
>Presented in New Orleans Fe
uary 2001 at ?The 21st Annual Dialysis <
>Conference?<
>(1) HNHD provided 87% more dialysis treatments, 3.75x more dialysis hours. <
>(2) HNHD costs 82% of IHD annually.<
>(3) Cost reduction of $12,457, ($8304.66 US Dollars) annually per patient. <
>(4) Improves quality-of-life 40%
********************************************************************
Marty
Joined: 28 Oct 2002
Posts: 160
Posted: Sun Jan 12, 2003 12:57 pm Post subject: Good Job
--------------------------------------------------------------------------------
Plugger, Keep up the good work on giving us the information to help get daily dialysis available. Everyone should have a choice and the results are proven.
********************************************************************
jfwag
Joined: 11 Jan 2003
Posts: 140
Posted: Mon Jan 13, 2003 9:55 am Post subject: These...
--------------------------------------------------------------------------------
are types of studies the government needs to see.
********************************************************************
ridgerunner
Joined: 11 Jan 2003
Posts: 101
Posted: Tue Jan 14, 2003 7:37 am Post subject: daily dialysis
--------------------------------------------------------------------------------
i am not trying to fight daily dialysis. if you pay the companies for more treatments they will give shorter treatments i think the way it should be done is use a sliding scale. the more total hours per week the more you are payed. this is the way japan does it. you have first got to have standards no reuse pay by the total hours of treatment. if you don,t the big corps will keep the same quality of treatment.
********************************************************************
plugger
Joined: 11 Jan 2003
Posts: 258
Posted: Wed Jan 15, 2003 1:17 pm Post subject: HR1759
--------------------------------------------------------------------------------
Ridgerunner,<
><
>Hopefully if they get this bill going again, they will address your concerns. I'm glad you
ing up questions about where all the money does go. I remember back when a unit manager was telling how they couldn't afford to get a critline (my impression was civilization would collapse if they bought it). I couldn't help but wonder how much of every dollar these companies
ing in actually goes to patient care; and how much goes to fancy buildings, fancy offices, and of course fancy salaries for all the "wonderful" administration they do.
********************************************************************
plugger
Joined: 11 Jan 2003
Posts: 258
Posted: Mon Feb 17, 2003 7:15 am Post subject: HR1759 update
--------------------------------------------------------------------------------
I received this from Dr. Blagg concerning HR1759.<
><
>"The bill will be reintroduced after the recess - i.e. the week of the 24th."<
><
>I still firmly believe this bill has the potential in significantly
inging down the mortality rate in this country.<
><
>(here is a link for writing congress)<
>www.congress.org/congressorg/home/
********************************************************************
plugger
Joined: 11 Jan 2003
Posts: 258
Posted: Mon Feb 17, 2003 7:18 am
Post subject: clickable link
--------------------------------------------------------------------------------
<
>www.congress.org/congressorg/home/ <
><
>
********************************************************************
brenda
Joined: 28 Oct 2002
Posts: 103
Posted: Mon Feb 17, 2003 11:06 am Post subject: I am so proud to be
--------------------------------------------------------------------------------
related to you in that special way. It is a great letter you put out as well as a site with knowledge that will help the person who is just starting to learn what the problems are. two pats on the back and then one
********************************************************************
plugger
Joined: 11 Jan 2003
Posts: 258
Posted: Tue Feb 18, 2003 2:56 am Post subject: HR1759
--------------------------------------------------------------------------------
I believe Sister Klutz is refering to the fact that I recently took a tumble on the ice (cracked a thighbone-it has been getting better pretty quick). Of course it sounds like we may have another relative (I hope you are getting better, Lin!!)<
><
>Also I put a website for those who don't know much about dialysis (I was hoping to get members of my church to take a look, for starters). I wanted to get a little feedback and think about it before I got too public with it. I also wrote a speech I plan to give in front of the congregation.<
><
>But back to HR1759. Ridgerunner (if your computer is back up), it doesn't sound like the sliding scale you were talking about is going to be possible at this time. But I still believe this bill should be supported as a step-in-the-right-direction.
********************************************************************
brenda
Joined: 28 Oct 2002
Posts: 103
Posted: Tue Feb 18, 2003 10:57 pm Post subject: wrong brother ..
--------------------------------------------------------------------------------
I was referring to the fact of us being related by means of DE not the fact that we have problems walking on ice . But then again that wouldn't be to bad either, Lin hope you are healing well, <
>Now back to the site you put up. Have sent a couple people over there from work that are just starting to become involved in Dialysis, one with an Uncle, the other with her mother. They both said it was very interesting and helpful.
********************************************************************
plugger
Joined: 11 Jan 2003
Posts: 258
Posted: Thu Feb 20, 2003 4:36 am Post subject: HR1759
--------------------------------------------------------------------------------
I have to admit, I'm wavering back and forth about I feel about this bill. I would hate to see a scenario where people are being transported to clinics more, hooked up to machines more, and taken off more. But it turns out, since the hours haven't increased, it isn't much better than the 3X a week.<
><
>My sense is the short, frequent dialysis is a bit controversial. What hasn't wavered with me in the 2 1/2 years I've watched this, is that more dialysis equals better health. Maybe if people are writing about this bill, they ought to mention it could be greatly improved by paying for HOURS of dialysis.<
><
>(I did mention on my website a blurb about what the Italians have found. But I was reminded it was 8 years old. This short frequent dialysis reminds me of protein vs. carbs in your diet - I think protein is winning right now -. But I will go into my website and modify it, I think the server is either down for maintenance, or the forces of Satan have entered it, I hate it when the forces of Satan enter my computer system).
********************************************************************
Nonsense
Joined: 21 Feb 2003
Posts: 1
Posted: Fri Feb 21, 2003 12:45 am Post subject: Pay by the Hr.
--------------------------------------------------------------------------------
Plugger, it would be shear nonsense for the government to pay to by the hr. for dialysis. Can you imagine the bill for home slow nocturnal patients on an hourly basis. But then on the other hand it would probably get home slow nocturnal programs popping up all over the place. Daily and Nocturnal dailysis are to be modality choices just as convention 3x a week. Patients aren't to be "forced" into more treatments. If the going back and forth several times a week isn't paying off for the patient all they have to do is choose the conventional modality.
********************************************************************
plugger
Joined: 11 Jan 2003
Posts: 258
Posted: Fri Feb 21, 2003 1:54 am Post subject: by the hour
--------------------------------------------------------------------------------
I was wondering if reimbursing less after a certain number of hours would be appropriate. But maybe then the government would be less inclined to back something like slow nocturnal. But I worry about the other extreme where hours are kept the same or cut back. This has been a tough one for me. Maybe Drs. Blagg and Lockridge have come up with the best comprimise, and I ought to leave it alone. But hey, that is what a forum like this is great for, hashing things like this out.
********************************************************************
