Kidney Care Partners, a coalition of stakeholders and advocacy groups in the renal community, expressed alarm over the cuts to the ESRD bundle outlined in a proposed rule the Centers for Medicare & Medicaid Services issued July 1.The Kidney Care Council, an association of dialysis providers, also expressed concern about the proposed cuts to the ESRD bundle.

“Dialysis providers are proud that CMS’ claims-based data have shown that the quality of care we provide to our patients has not only been maintained under the new and cost-effective payment system, but has improved," said Tom Weinberg, Kidney Care Council chairman. “Hospitalizations, adverse cardiac events, catheter placement, and mortality have been on the decline even after the implementation of the new PPS payment model. The deep cuts proposed today will jeopardize this progress.”

Kidney Care Partners said in a release that they believe these proposed cuts to the ESRD bundle could jeopardize quality and access to life-sustaining dialysis treatments. “People with kidney failure are among our most vulnerable Medicare beneficiaries,” said Kidney Care Partners Chairman Ron Kuerbitz. "Proposed cuts of this magnitude simply go too far.  We are deeply concerned about the implications for dialysis patients and their care providers. For that reason, it is crucial for CMS to get it right as they consider adjustments to the system."

The Kidney Care Council expressed concern for dialysis providers operating with negative Medicare margins. “Adequate Medicare reimbursement is not optional for dialysis facilities,” said Kidney Care Council Executive Director Cherilyn Cepriano. “Medicare barely covers the cost of care for most dialysis facilities and, in fact, nearly 35% of dialysis facilities across the country operate with negative Medicare margins according to the most recently available cost report data. Because more than 85% of our patients are Medicare beneficiaries, of which 40% are dually eligible for Medicaid, any reduction in Medicare reimbursement will have a dramatic and negative impact on our already fragile payment system. Cuts of the size proposed by CMS put access to care for the most vulnerable patients in urban and rural areas at risk.”