Author: IPRO

ESRD Proposal May Inadequately Reimburse Medicare Advantage Plans

Medicare Advantage proponents are concerned that the new CMS proposal may result in underpayment to Medicare Advantage plans for end-stage renal disease care.  While payers and Medicare Advantage proponents applauded elements of the Medicare Advantage rule that CMS proposed yesterday which will increase plans’ revenues by nearly one percent, many expressed concerns about the proposed rule’s approach to chronic disease management costs for patients with end-stage renal disease (ESRD).

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ACO Care Coordination Toolkit and Beneficiary Engagement Toolkit Available

The Centers for Medicare & Medicaid Services worked with 21 Medicare Accountable Care Organizations (ACOs) and End-Stage Renal Disease Seamless Care Organizations (ESCOs) participating in the Shared Savings ProgramNext Generation ACO Model, and the Comprehensive ESRD Care Model to identify promising practices and innovative strategies for coordinating care for Medicare beneficiaries.

Specifically, the ACO Care Coordination Toolkit focuses on care coordination for Medicare beneficiaries who:

  • Recently received care in an emergency department,
  • Require treatment in a skilled nursing facility,
  • Have recently been discharged home after a hospital or emergency department visit,
  • Have been diagnosed with a chronic condition or have a complex medication regimen, or
  • Have conditions affected by the social determinants of health.

Working with the same methodology, CMS also has released the ACO Beneficiary Engagement Toolkit which highlights strategies used by ACOs and ESRD Seamless Care Organizations (ESCOs) to engage beneficiaries. Specifically, the toolkit explores how ACOs and ESCOs:

  • Engage beneficiaries in ACO governance,
  • Elicit beneficiary and family feedback,
  • Support beneficiaries in self-care management,
  • Enhance beneficiary communication in the clinical setting, and
  • Communicate with beneficiaries about the ACO as a value-based care organization.

These toolkits are part of a broader series of toolkits designed to educate the public about the strategies ACOs use to provide value-based care while also providing actionable ideas to current and prospective ACOs to help them improve or begin operations.

For more information on the toolkits and case studies please visit the ACO General Information webpage.

Kidney Care Choices Model

The Centers for Medicare and Medicaid Services (CMS) released clarifications to the Kidney Care Choices (KCC) Model’s Request for Applications (RFA) that was posted on October 24, 2019.
These clarifications were created in response to questions from applicants regarding the Kidney Care First (KCF) and Comprehensive Kidney Care Contracting (CKCC) Options. This document expands upon eligibility requirements regarding revenue calculations and practices’ Tax Identification Numbers (TINs).
The KCC Model is designed to help health care providers reduce the cost and improve the quality of care for patients with late-stage chronic kidney disease and end stage renal disease by aiming to delay the need for dialysis and encourage kidney transplantation.
The clarifications, full RFA, and additional resources can be found on the Kidney Care Choices websiteThe Model is expected to run from 2020 through December 31, 2023. The deadline to apply is January 22, 2020.

CROWNWeb New User Training

Are you new to CROWNWeb, or just need a refresher on how to use the system? CROWNWeb New User Training is for you! This informative ONE-DAY90-minute course covers all the basic information a new CROWNWeb user would need to begin using the system. January’s New User Training will be held on Tuesday, January 21, 2020 from 2:00 PM ET to 3:30 PM ET.
Click here to register.

2020 NHSN Dialysis Event Updates

The NHSN Dialysis Team will host a webinar on December 4th and December 5th at 3pm EDT that will provide updates to the NHSN Dialysis Component for 2020. These webinars are identical, but are offered on two days to reach the maximum number of NHSN users. We will only be accepting questions and comments via the webinar chat box, and will answer as many questions during the webinar as time allows. Please e-mail the NHSN helpdesk at nhsn@cdc.gov with “Dialysis” in the subject line following the webinar if we do not address your questions, and we will follow up with you directly.

Please pre-register via one of the links below:

Title: NHSN Dialysis Surveillance Call
Date: 12/4/2019
Time: 3:00 PM EST
Duration: 1 hour
Audience Listen By Phone: 706-418-5005(United States)
Passcode: 77572898#
Conference URL: https://globalmeetwebinar.webcasts.com/starthere.jsp?ei=1272194&tp_key=38d01fc74f

Title: NHSN Dialysis Surveillance Call
Date: 12/5/2019
Time: 3:00 PM EST
Duration: 1 hour
Audience Listen By Phone: 706-418-5005
Passcode: 47347711#
Conference URL: https://globalmeetwebinar.webcasts.com/starthere.jsp?ei=1272202&tp_key=d2a3e8f9bf

ESRD QIP Call: Audio Recording and Transcript

An audio recording and transcript are available for the August 20 Medicare Learning Network call on the End Stage Renal Disease (ESRD) Quality Incentive Program (QIP): CY 2020 ESRD PPS (Prospective Payment System) Proposed Rule Call. Learn about the legislative framework, the proposed rule, and methods for reviewing and commenting on the rule.

ESRD Spanish Webinar: Basic Nutrition Guide for People with Kidney Disease

Upcoming ESRD webinar on renal nutrition will be presented in Spanish, please share the information with Spanish-speaking patients, families and facilitates who might be interested.

The webinar will be presented on August 22 and will discuss information about the renal diet including sodium, protein, potassium and phosphorus and how to choose foods that are kidney-friendly. The presentation will be given in Spanish by a renal dietitian, María E Rodriguez. She has worked with dialysis patients for the past 10 years and with chronic kidney disease patients for the past 6 years.

Guía Básica de Alimentación para Personas con Enfermedad Renal

Presentado por María E. Rodríguez, MS, RD, CSR

Aprende:

  • ¿Qué es la dieta renal?
  • Lo que necesitas saber sobre proteína, sodio, potasio y fósforo
  • ¿Cómo hacer una buena selección de alimentos?

Regístrate para los detalles de la llamada: https://www.dpcedcenter.org/news-events/education-webinars/signup/

Imprima el folleto de promoción: https://www.dpcedcenter.org/wp-content/uploads/2019/07/201908_flier.pdf

The Kidney Innovation Accelerator (KidneyX) – Patient Innovator Challenge

The Kidney Innovation Accelerator (KidneyX) is a public-private partnership between the U.S. Department of Health and Human Services (HHS) and the American Society of Nephrology (ASN) seeking to improve the lives of the 850 million people worldwide currently affected by kidney diseases. KidneyX aims to accelerate breakthroughs to promising new technologies for people with kidney diseases by addressing barriers innovators commonly identify as they develop new products for the prevention, diagnosis, and treatment in kidney care. To do this, KidneyX hopes to create a better collaborative relationship among patients and innovators.

KidneyX Patient Innovator Challenge (Prize Competition)
The Patient Innovator Challenge, funded by the National Kidney Foundation, is looking for ideas and fixes that people living with kidney diseases have developed through their own experiences and ingenuity. In this competition there are two submission categories:

  • Category 1: “Solutions in Practice,” which are solutions already tried or put into practice
  • Category 2: “New Ideas,” which are solutions that have not yet been created or tried.

Anyone can apply for the competition and some key areas submissions may focus on are how to manage the side effects of dialysis or transplant treatment, ways to gain patient independence, successful diet and fluid regimens, techniques to increase physical activity, and methods which help sustain family and social life or improve overall quality of life.

Up to 25 winners will be awarded – 10 winners in Category 1 will receive $4,000 each, and up to 15 winners in Category 2 will receive $2,000.

Submissions are due by 5:00 ET on September 16, 2019. For more information, go to https://www.kidneyx.org/WhatWeDo/PrizeCompetitions/patientinnovatorchallenge

REMINDER: Register for ESRD QIP Training July 11, 2019

Thursday, July 11, 2019 at 2:00 PM ET is the first of two ESRD QIP training sessions. Each of these informative 1-hour courses will cover the information needed to begin using the ESRD QIP System. A second session will be held on Monday, July 22, 2019 at 2:00 PM ET. During these sessions, the CROWNWeb Outreach, Communication, and Training (OCT) Team will provide the basics of how to use the ESRD QIP system, including how to effectively submit a clarification question and a formal inquiry, if needed, prior to the end of the preview period.

To join the online event, click on the dates above to register.  Note, both training sessions will contain the same information, users only need to attend one event.

 

 

Recall: Baxter Revaclear Dialyzers

The FDA has announced a Class II recall of 59 lots of Baxter Revaclear 300 Dialyzer, Product Code 114745L, and 3 lots of Baxter Revaclear 400 Dialyzer, Product Code 114746L, totaling 1.3 million units. These HD dialyzers may leak blood during dialysis because there is potential for fibers in the dialyzer to rupture. For details see https://www.accessdata.fda.gov/scripts/ires/index.cfm?Product=173325 for the Revaclear 300, and https://www.accessdata.fda.gov/scripts/ires/index.cfm?Product=173326 for the Revaclear 400.

Warning: Medtronic MiniMed Insulin Pumps

The FDA has warned that certain Medtronic MiniMed Insulin Pump models are not protected from hackers, who could alter the insulin settings. Medtronic is replacing the inadequately protected pumps. For recommendations on protecting yourself while awaiting a replacement, a list of models and software versions involved, and more information, see https://www.fda.gov/medical-devices/safety-communications/certain-medtronic-minimed-insulin-pumps-have-potential-cybersecurity-risks-fda-safety-communication.

“Welcome to Medicare” Preventive Visit and Yearly “Wellness” Visits

Individuals new to Medicare should schedule a “Welcome to Medicare” preventive visit. Medicare Part B covers a FREE comprehensive screening within the first 12 months of having Part B.

Individuals who have had Medicare Part B for longer than 12 months can get a FREE yearly “Wellness” visit once every year to develop or update a personalized prevention plan.

Patients pay nothing if their doctor or other qualified health care provider accepts assignment. The Part B deductible doesn’t apply. However, patients may have to pay coinsurance, and the Part B deductible may apply, if doctors or other health care providers perform additional tests or services during the same visit that are not covered under the preventive benefits.

When making the appointment, patients should let the doctor’s office know a “Welcome to Medicare” preventive visit would like to be scheduled. It is also important to know what to bring to the “Welcome to Medicare” preventive visit.

The preventive visit includes a review of medical and social history related to the patient’s health, along with education and counseling about preventive services. It can also include:

  • Certain screenings, flu and pneumococcal shots, and referrals for other care, if needed.
  • Height, weight, and blood pressure measurements.
  • A calculation of your body mass index.
  • A simple vision test.
  • A review of your potential risk for depression and your level of safety.
  • An offer to talk with you about creating advance directives.
  • A written plan letting you know which screenings, shots, and other preventive services you need. Get details about coverage for screenings, shots, and other preventive services.

The yearly “Wellness” visit is designed to help prevent disease and disability based on current health and risk factors. Providers will ask patients to fill out a questionnaire, called a “Health Risk Assessment,” as part of this visit. It can also include:

  • A review of your medical and family history.
  • Developing or updating a list of current providers and prescriptions.
  • Height, weight, blood pressure, and other routine measurements.
  • Detection of any cognitive impairment.
  • Personalized health advice.
  • A list of risk factors and treatment options for you.
  • A screening schedule (like a checklist) for appropriate preventive services.
  • Advance care planning

By collaborating with physicians/practices that performs a comprehensive review of health status, the medical team at the dialysis clinic can be assured that patients have an established resource for healthcare issues that are not specifically related to ESRD. This is a great opportunity to coordinate care for essential services like immunizations, diabetes management and cardiac related issues, just to name a few.