Man sits at home and is attached to dialysis machine

A new coalition of healthcare organizations, including Anthem, Outset Medical and Strive Health, is pushing the Centers for Medicare and Medicaid Services (CMS) to make in-home dialysis more accessible. 

Innovate Kidney Care debuted earlier this week with the goal of breaking down the regulatory barriers that it claims are making it harder for patients to get dialysis in their homes instead of at dialysis centers.

Tonya Saffer

“A large subset of those regulations do not apply to home dialysis, particularly now that you have new technology,” Tonya Saffer, head of government affairs for Outset Medical, told McKnight’s Home Care Daily. “Those regulations were written over 15 years ago, so they don’t account for the fact that you could have a device that plugs into a standard grounded outlet and hooks up to a water tap and is able to deliver dialysis to a patient.”

The coalition also wants better training and support for patients who choose to dialyze at home or in a variety of other healthcare settings, such as doctors’ offices.

Efforts to move dialysis into homes has been underway since President Donald Trump launched the Advancing American Kidney Health initiative in 2019. The plan aims to drive dialysis into the home with 80% of new End Stage Renal Disease (ESRD) patients getting home dialysis or transplants in 2025.

In January, CMS launched the End-Stage Renal Disease Treatment Choices model to encourage providers to make greater use of less costly in-home dialysis and transplants through enhanced payments. Roughly 1% of the Medicare population has ESRD, but they account for approximately 7% of Medicare spending.

Medicare Advantage plans are also pushing for more in-home dialysis. Anthem’s CareMore division is encouraging more in-home dialysis, and Humana recently told investors it was hoping to form partnerships with kidney care providers. Saffer said an integrated healthcare company like Humana that provides dialysis could be a game-changer.

“A health management company that is focused on identifying chronic kidney disease early, making sure that patients have access to home dialysis; there’s a lot they can do there,” Saffer said. “These companies like Humana are being very innovative in their approach to comprehensive kidney care.”

Saffer said the Biden administration’s interest in moving care to the home is encouraging to the home dialysis industry.

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