News from the kidney care community

Dialysis provider DaVita Inc. sent an email blast Dec. 10 with the subject "End-of-Year Medicare Cuts Could Impact Dialysis Patients." The email said: "Medicare cuts being discussed may have a significant and disproportionate impact on dialysis providers and patients nationwide. Currently more than 80% of dialysis patients depend on Medicare for life-sustaining treatment. For these beneficiaries, dialysis providers receive a 'bundled' payment for a multitude of services. Specifically, patients receive four-hour dialysis sessions at least three times a week, which includes lab services, nursing care, medications and more. Medicare barely covers the full cost of dialysis treatments, thus many of our facilities lose money on the majority of patients we serve."

As the country faces the fiscal cliff and struggles to lower health care costs, it's understandable that Congress may see the dialysis industry as a source for revenue when it reads about company profits  and CEO salaries and stock payouts.

In the third quarter, DaVita pulled in $144.7 million in net profit and Fresenius profit fell 3%, but was still $270 million. In the second quarter DaVita made $142.9 million in net profit and Fresenius made $289 million. Modern Healthcare ranked DaVita CEO Kent Thiry the highest paid specialty care provider, making $5,484,495 in annual compensation and more than $24 million in exercised stock options. In this country health care is a business, so it needs to make a profit. But if you agree to be a participant in a taxpayer-funded health care program, you will be subject to a higher level of scrutiny. When the service you are providing comes under question in a public arena Congress may put you at the top of the list for funding cuts.

In a Dec. 4 post on his blog, The Kidney Doctor,  Ajay K. Singh, MBBS, FRCP, MBA  responded to MedPAC's request for comments on the adequacy of the payments to outpatient dialysis providers by showing the income of the two largest dialysis providers and quoting Andrew Lloyd Webber's song "Don't Cry for Me Argentina."

Kidney Care Partners, a group that includes some of the same dialysis providers, has been lobbying to prevent cuts to the ESRD program, and their message may be a little more powerful because it comes with some good news: the efforts of the Performance Excellence and Accountability in Kidney Care campaign have led to a 12% cut in first-year dialysis mortality.

In this post-bundle, Quality Incentive Program world, dialysis providers need to show that they are using the tax dollars they earn to make some significant improvement in the well-being of the patients they are charged to care for, if they want Congress to respond favorably with the purse strings.