Home hemodialysis system maker NxStage Medical (NSDQ:NXTM) urged the Centers for Medicare & Medicaid Services to increase coverage for home hemodialysis training for patients with end-stage renal disease.
Lawrence, Mass.-based NxStage was responding to a CMS Proposed Rule for Changes to the End-Stage Renal Disease Prospective Payment System for 2014, in which the agency put forward an add-on payment of $33.44 per required training session.
The company argued that the increase is inadequate, because an actual home hemodialysis training session runs to $250-$260, based on Medicare’s own updated cost report data.
"It is no surprise, then, that most centers don’t offer HHD, that so few patients know it is a real option for them, that the percentage of patients on HHD is so vastly different than what physicians and nurses say they would choose for themselves," NxStage said.
Its System One device is an FDA-home-use-cleared portable hemodialysis system that can be combined with the company’s Pureflow SL dialysis preparation system to turn tap water into dialysis fluid. Under physician guidance, patients can use System One with their trained partners as needed in any setting, according to the company.
NxStage cited a number of reasons Medicare should boost the add-on payment for HHD training, apart from the discrepancy between the proposed increase and the actual cost of training.
Clinical data supports superior patient outcomes with HHD, including more frequent hemodialysis when patients can do it at home vs. at a conventional dialysis center, the company said.
In 3rd-party surveys, healthcare professionals said they would choose HHD most often for themselves if they had end-stage renal disease, in sharp contrast "with the small percentage of beneficiaries with access to HHD today," NxStage noted.
And Congress has ordered Medicare to develop policies to encourage more patients to be rehabilitated and treated in the home setting, according to the company.
"Given the clear and compelling benefits of home hemodialysis and the decades-old Congressional intent to encourage home dialysis and rehabilitation, it is essential that CMS update its policies for training payment to ensure beneficiary access to this modality," NxStage Medical President Joe Turk said in prepared remarks. "It is a disservice to patients to allow this situation to remain unresolved."
NxStage Medical founder & CEO Jeff Burbank told MassDevice.com earlier this year that essentially all private payers have already moved to "usual and customary payment" for NxStage therapy, but noted that "some work" with CMS is in order.