NRAA Statement Regarding H.R. 5506 and S. 3090

NRAA, on behalf of independent, regional community-based and hospital-based dialysis providers throughout the United States, thanks Representatives Young (R-IN), Blumenauer (D-OR) and Senators Nelson (D-FL), Heller (R-NV) for their efforts, dedication to kidney care, and the process they utilized to receive stakeholder input for the Dialysis PATIENT Demonstration Act of 2016 or the Patient Access To Integrated-care, Empowerment, Nephrologists and Treatment Demonstration Act of 2016 (H.R. 5506 and S. 3090).  NRAA believes the best route for enhancing care coordination is increasing utilization of the End Stage Renal Disease (ESRD) Seamless Care Organizations (ESCOs) as a current integrated care vehicle or reforming Medicare Advantage ESRD SNP’s and providing incentives and pathways for the inclusion of supportive services such as counseling. Providing financial resources and human capital to another model, especially one with full capitation and risk, will be extremely difficult for smaller dialysis organizations and will lead to further market consolidation. As representatives for these smaller to midsize dialysis centers we would be remised if we didn’t urge safeguards to be put in place to prevent further market consolidation and preserve patient choice.

NRAA members serve a patient population of nearly 127,000 individuals living with chronic kidney disease (CKD) in urban, rural and suburban locations in 44 states and three territories.  Therefore, care coordination is extremely important to our members and their patients. As a result, small to mid-size dialysis organizations have embedded care coordination efforts into their delivery of care organically.  We believe Congressional efforts should focus on addressing issues more upstream such as Acute Kidney Injury and address gap areas such as ESRD care delivered in the pediatric space. 

NRAA looks forward to working with Representatives Young and Blumenauer as well as Senators Nelson and Heller as they continue to work to improve kidney care delivery and are encouraged with their commitment to work with us on prevention and treatment efforts.