Wondering how to cope with your dialysis when you are worried about going to the center? You might want to consider doing home hemodialysis because in the recent past, many changes to Medicare and other systems have encouraged people with ESRD to consider doing their dialysis treatments at home. You might want to as well, because if you are wondering about whether or not your Medicare policy will cover dialysis at home, we have the answer.
Over the previous year, many of the vital components of our everyday lifestyles have either completely changed or come to a screeching halt. Gone are the days where the general population goes out to a dinner and movie on a Friday night. Replaced by takeout, streaming services, outdoor activities, and social distancing, society as a whole has had to adjust as a result of the COVID-19 pandemic.
While abrupt change is scary, and difficult to accept, not all change has been bad. Regarding working in general, employees are reporting a higher level of satisfaction with their jobs due to a work from home (or hybrid model) approach that leaves employees with more time to spend with their loved ones, and a pseudo-raise due to an absence of commuting. We’ve also seen a culture shift in the US with an increased emphasis on personal hygiene and cleanliness.
Despite the rampant case numbers of COVID during the pandemic, reported hospital cases of general trauma and influenza are down. Another positive change that has resulted from the pandemic is in the chronic illness community. Patients with late or end stage chronic kidney disease (going from stage four to five) are transitioning from a tedious dialysis schedule that has them in treatment centers 3-5 times a week, to a home dialysis regimen. Below we will highlight how the renal disease community found an unlikely ally with the Trump administration, and how home dialysis has made a resurgence.
How COVID has Impacted Seniors and Chronic Disease Sufferers
There is no doubt that Americans of all ages, race, and genders felt (and in many cases continue to feel) the ramifications of COVID-19. But perhaps no single demographic felt this impact more than senior citizens. Not only were seniors the most at-risk from the virus (nearly 8 out of 10 COVID-related deaths in the United States are reported to be seniors over the age of 65, per the CDC), but it also restricted their ability to see their families, socialize, and it had a particularly large impact in senior assisted living facilities.
An additional consideration for seniors was that COVID significantly restricted everyone, but specifically those at an advanced age from being able to see their providers (both primary care and specialties) on a consistent basis. Because of the natural deterioration of the body, senior citizens require many more medical consultations than younger people. However, many providers were forced to cut back the number of patients they could see, and the constant volatility of infection rates meant that cancellations were at a high, thus making it difficult for all citizens and especially seniors to be seen.
Luckily, the healthcare industry and healthcare professionals were able to adjust their practices to cater to these hurdles and as a result we’ve seen a dramatic rise in telehealth visits.
Does Medicare Cover Home Dialysis?
Of course, your main question might be is home hemodialysis covered at all by Medicare? The answer is yes! For Medicare to cover dialysis, you will need to have Part B. You receive training on how to complete the home dialysis with a specially trained staff who works with you and the person helping you with the treatment. You also receive the supplies, like the dialysis machine, water treatment system, and all the required items for the safest environment like gloves, wipes and scissors. If you need additional support, that is also covered whether it's a person coming to your house to check on how things are working or face to face interaction with your doctors.
The reason that home hemodialysis is covered by Medicare are many, but we discuss them below. The best part for the patient is the ability to have a less restrictive diet and less restrictions overall for your health.
Telemedicine and Home Dialysis
For end stage renal disease patients, trying to get dialysis during a pandemic is a health and safety risk nightmare. A normal dialysis treatment center schedule has patients coming in anywhere between three and five times a week, and a normal dialysis cycle lasts about 3-4 hours.
However, for senior citizens and especially those in assisted living facilities, there is also the added logistics hurdle of transportation to and from the treatment center. Add that to the heightened risk of being around others while trying to adhere to social distancing guidelines makes for a difficult situation. Currently, between 85-90 percent of dialysis patients receive treatment this way. But in 2019, before the pandemic, the Trump administration announced the adoption of an executive order that has overhauled dialysis for patients, providers, and the Medicare system. This new law has provided incentives for all parties involved to transition to home dialysis – citing three reasons for the approach.
The first centers around cost. Home dialysis is roughly 25 percent cheaper for patients and those on Medicare than receiving treatment at a facility. The next is the flexibility. Patients who receive dialysis at home are able to undergo cycles while they sleep, allowing for more time during the day to live their lives. Finally, the last measure was to increase quality of life. Patients with end stage renal disease must be on dialysis until they are able to receive a kidney transplant. This can sometimes take years, and frustration was mounting for those who had to spend 10-20 hours a week going to and from dialysis treatment facilities.
The momentum of President Trump’s executive order was increased exponentially when the adoption of telehealth became more mainstream from the pandemic. Senior citizens, providers, and really everyone who cited technology hurdles as an inhibitor to adopting telehealth were forced to learn the processes involved with telehealth in order to be seen for their regularly scheduled appointments.
Home Hemo Dialysis Advantages For Seniors
Along with receiving dialysis treatments, kidney disease patients must be mindful of their dietary choices. If you choose to eat foods that are high in specific nutrients (such as protein and potassium), it can cause more stress for your kidneys and decrease ability to properly function and filter. However, on home hemodialysis (HDD) you receive more treatment cycles, thereby more closely mimicking a typically functioning kidney. This allows patients more flexibility with their dietary choices leading to a more comfortable lifestyle.
With traditional dialysis treatment options, end stage renal disease patients were limited to living or traveling to designated cities with treatment centers. Previously, if patients were to visit elsewhere for more than a couple of days, they run the risk of missing treatments, which can do further damage or even worsen kidney failure. Both peritoneal and hemodialysis allow patients to bring their treatment with them, leading to greater flexibility and freedom to live their lives.
Changing The Way Your Dialysis Is Done
We’ve heard anecdotal evidence from CKD patients that home dialysis affords them a greater quality of life while they wait on transplant lists. But we’ve seen hesitance from patients adopting the treatment option for fear of administering the treatment themselves without the same type of supervision they would receive in a traditional center, but with the adoption of telemedicine over the last 12 months, patients are reporting feeling a higher comfort level because their providers or nurses can walk them through the treatments. You can have less restrictions and Medicare will pay for dialysis at home and even the training for you and another person to help, so there are less restrictions for you overall.
Additionally, centers are starting to offer (literal) on-call nurses to help patients who are troubleshooting their machines. With the increased familiarity to technology, senior citizens are also able to participate in online communities with one another to share stories, provide lifestyle advice, and encourage one another.
This article was written for our site by a guest author, Susan Baker. Susan Baker is the founder of Insurancefaq.net. Susan has been writing about health and medicine for five years and covers topics ranging from insurance and wellness to dietary tips.