By Miriam Godwin, NKF Health Policy Director

Each year, NKF provides input on what is known as the End Stage Renal Disease (ESRD) prospective payment system (PPS). This is an annual regulation put forth by the Centers for Medicare and Medicaid Services (CMS) that determines how dialysis facilities are paid in the coming year. NKF typically offers recommendations on how dialysis facilities can make dialysis safer, less burdensome, and more patient centered.

This year, the regulation includes a proposal that would help dialysis facilities purchase new and innovative home dialysis machines. In short, the plan encourages medical device companies to invest in inventive approaches home dialysis, while creating a pathway for dialysis patients to benefit from them. The plan is called TPNIES (pronounced “TP-O-NIES”), which stands for Transitional Payment for New and Innovative Equipment and Supplies. NKF strongly supports TPNIES – for too long, dialysis patients have not had access to the kind of advances in medical science and technology that are common to every other part of our healthcare system. We don’t think that’s fair to dialysis patients.

Making the plan work relies on ensuring that CMS understands what innovation means to home dialysis patients. In a letter we sent to CMS a few days ago, we shared some examples of what innovation means to patients and patient advocates:

• A lighter home hemodialysis machine that is more portable
• A PD system that generates its own dialysate, so patients don’t need to store and move so many heavy boxes
• A mechanism that make cannulation easier (for example that decreases the risk of needle dislodgement)
• Automating the PD catheter connection process

The future will bring new technology and greater advances to home dialysis. Patient input is vital to making sure these advances and the advances that matter to you and that help you live the life you want. We want to hear from you – what else do you think would be an innovative improvement to home dialysis? Tell us in the comments or email Miriam Godwin at miriam.godwin@kidney.org.