6/25 CMS Seeks Comment on Rural Hospital Payment Changes

CMS has proposed that they improve their payments to rural hospitals, in an effort to improve rural health in the US.  While this isn’t directly relevant to ESRD, it will certainly be relevant whenever a kidney patient needs services at a hospital in a rural area.  Find the Proposed Rule and Request for Comment at https://www.govinfo.gov/content/pkg/FR-2018-05-07/pdf/2018-08705.pdf, and a Notice of Corrections at https://www.govinfo.gov/content/pkg/FR-2018-06-20/pdf/2018-13152.pdf.  Comments are due by June 25, 2019.  For background information see https://www.cms.gov/blog/putting-our-rethinking-rural-health-strategy-action and https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/FY2019-IPPS-Proposed-Rule-Home-Page-Items/FY2019-IPPS-Proposed-Rule-Regulations.html?DLPage=1&DLEntries=10&DLSort=0&DLSortDir=ascending.

6/12+ Infection Control Tools

  • In mid-June 2019 a series of presentations on Infection Control, offering free CME/CE credits to physicians, nurses, and pharmacists, will expire.  CDC and Medscape produced them in 2017 with the intention that they’d be valid for two years.  The six presentations include Risk Recognition, Environmental Services, Medical Equipment, Nonsterile Gloves, Hierarchy of Controls, and Injection Safety.  Find them at https://www.cdc.gov/infectioncontrol/training/cme-info.html.

More Care Transitions Resources

The ESRD National Coordinating Center has prepared a list of “Key Messages” for National Care Transitions Week, which you can find at https://s3-us-west-2.amazonaws.com/nwrn.org/files/N/NCC/NCC.NCTA.Keys.pdf.  Other useful materials on the ESRD NCC website include:

11/13 CMS ED Measure Comment Request

As part of a contract with the University of Michigan to develop a quality measure on Hospital Emergency Department Visits, CMS has issued a call for public comments, which are due by 13 November, 2017.  For more information and comment instructions, see https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/MMS/PC-Currently-Accepting-Comments.html#0001 .


A new Harvard Business Review article on “The Value of Teaching Patients to Administer Their Own Care” includes an example of a self-care dialysis program at the Central Texas Nephrology Associates clinic in Waco, Texas.  Some excerpts:

  • “In 2016, nearly 40% of CTNA’s 751 patients performed their own dialysis while experiencing fewer hospitalizations and a lower mortality rate than patients receiving dialysis the conventional way.  Patients delivering their own dialysis experienced better outcomes and the health system minimized costs by avoiding unnecessary hospital visits.”
  • The “Providers’ role changed from performing every step of the process to serving as coaches and supporters of patients doing their own care.  The resulting redeployment of staff resources led to higher productivity and throughput for the clinic.”
  • “Regardless of the setting, a successful approach to patient-administered self-care requires the following:
    • “Patients or caregivers must be prepared and willing… Care organizations need to develop a standard process for training patients… Practitioners must be trained to support patient-administered care, …to see themselves as coaches and the patient as an integral partner, …[to] recognize that patients’ capabilities to provide their own care may differ and evolve over time, and …to connect with the patient…
    • “A standard protocol should be developed [including] …methods for distributing equipment, supplies, and medication …how patients and providers should respond to adverse events …easy access to outpatient and inpatient services to address any needs that arise.
    • “A care organization that has [an outcome]-based-payment system will have a much easier time adopting the self-care model …Patient-administered care realizes savings by avoiding spending in the first place; in a fee-for-service model, this is lost revenue.”

Find the article at https://hbr.org/2017/06/the-value-of-teaching-patients-to-administer-their-own-care .


NW Network Council Call Recordings

A recording of the January 9, 2017 Network Council Call has been placed on the Northwest Renal Network website, along with a pdf of the slides from the webinar.  The call described the current Network contract structure and obligations, with emphasis on this year’s Quality Improvement Activities and CROWNWeb requirements and protocols.  Find the recording at https://healthinsight.adobeconnect.com/p6sn4hjkmow/?proto=true and the slides at https://s3-us-west-2.amazonaws.com/nwrn.org/files/qia/2017/2017NW16NetworkCouncilPresentationFinal.pdf .