Columns

From the Field: New Frequency of Hemodialysis Local Coverage Determinations

Sarah Tolson Effective March 1, 2019, several Medicare Administrative Contractors (MACs) began processing claims for hemodialysis treatments under new Local Coverage Determinations (LCDs). These LCDs underwent massive revisions after the proposed LCDs released in 2017 would have essentially eliminated reimbursement for more than three treatments per week because they were so strict. Medicare, the largest payer in the United States ... Read More »

From the Board: Lessons from My Father

Kenneth A. Liss, DO Editor’s Note: Scroll down for a response from one of the authors referenced in this column. When I was thirteen or fourteen, I took an acquaintance’s side over my brother’s in an argument. Full of righteous indignation, I bragged to my father how I was sure I had the moral high ground and had done the ... Read More »

From the Field: 40 Years of Lessons from Work and Life

After 19 years at Sceptre Management Solutions, the time has come for me to step aside. My wife and I sold the business last year to our oldest daughter, Jennifer Hicks, who has worked with us since 2001. She has an MBA and is incredibly smart and very talented. I stayed on during the past year to help during the ... Read More »

From the Field: Patient Payments Part 2

Last issue I mentioned that a social worker commented to me that she wishes providers would stop trying to collect from patients. She said providers “make enough money” and wondered why they feel the need to collect from patients who cannot afford their large coinsurances and deductibles. She pointed out that increasing pressure on patients to pay for coinsurances and ... Read More »

From the Chair: Nephrologists are Among the Most Happy Subspecialists in the US

Ajay K. Singh Recent data on happiness among nephrologists should be a reason to celebrate the New Year. In the 2019 Medscape Physician Lifestyle and Happiness Report1 for “happiness outside work,” 55% of nephrologists are happiest outside work (the best ratings were for rheumatologists at 65% and the worst was for neurologists at 45%). If that were not enough, 65% ... Read More »

Growing Pressure on Renal Patients to Pay Out-of-Pocket

By Rick Collins At a conference I attended recently, a social worker lamented how much grief is placed on dialysis patients due to the large bills they receive from renal providers. She openly wondered why providers feel they need to bill patients since they already are paid “a lot” by Medicare and commercial insurance companies. When I first entered the ... Read More »

Initiating Dialysis in the Elderly: When Is Right?

By Ajay K. Singh, MBBS, FRCP, MBA An elderly patient of mine with stage 3 CKD recently had an episode of acute kidney injury while visiting family in Puerto Rico. His bout of gastroenteritis tipped his eGFR into the 10 to 12 mL/min/1.73m2 range and he was initiated on maintenance hemodialysis. In speaking with his nephrologist it seemed quite obvious ... Read More »

From the Field: I LIKE “POP”

Rick Collins CMS’s Patients Over Paperwork (POP) initiative signals welcome relief from decades of increasingly oppressive documentation requirements. While the proposed changes to evaluation and management services (E&M) coding levels have grabbed headlines due to concerns about possible reduced reimbursement, there is great value in allowing providers to focus more on patient care and less on documentation. For years providers ... Read More »

Guest Contributor: Breaking Down the Kidney Care Industrial Complex: Putting Kidney Disease Patients at the Center of Proactive Care

Carmen A. Peralta, MD, MAS Chief Medical Officer, Cricket Health Chronic kidney disease (CKD) affects 30 million adults in the United States—almost 11% of the population. Yet kidney disease patients are at the mercy of a system that is inadequate to care for them—from lack of, or haphazard, diagnosis and little preventative care to the financial incentives that result in ... Read More »