Medicare Change May Impact Black Kidney Patients

WEDNESDAY April 22, 2009 -- Black kidney patients may have more difficulty getting dialysis under a new Medicare payment policy, researchers warn.

The Centers for Medicare & Medicaid Services will make a single payment to dialysis units to cover both dialysis and injectable medications. These services were previously reimbursed separately.

Because black kidney patients more often experience anemia (low hemoglobin) than white patients, they're more likely to require more treatment with expensive erythropoiesis stimulating agents (ESAs) to boost their hemoglobin levels, noted Dr. Areef Ishani, of the University of Minnesota. For example, an analysis of 12,000 dialysis patients revealed that black patients required an 11 percent higher average dose of ESAs over the first two months on dialysis than white patients do.

Since Medicare will no longer reimburse dialysis centers for higher ESA doses, the new policy could create a "financial disincentive" for centers to accept black patients, said Ishani and colleagues.

"The CMS has suggested that the new reimbursement scheme will adjust for a variety of factors. If race is not included as a payment adjuster, African-American patients could be disadvantaged by this policy change," the researchers concluded.

The study was expected to be published in an upcoming issue of the Journal of the American Society of Nephrology.

More information

The National Kidney Foundation has more about dialysis.

Posted: April 2009


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