Payment adjustment for home dialysis and transplant for Kidney Failure, Chronic

Phase-Based Progress Estimates
1
Effectiveness
1
Safety
Massachusetts Institute of Technology, Cambridge, MA
Kidney Failure, Chronic+2 More
Payment adjustment for home dialysis and transplant - Other
Eligibility
65+
All Sexes
Eligible conditions
Select

Study Summary

This study is evaluating whether a mandatory-participation program for ESRD patients can change treatment modality choice.

See full description

Eligible Conditions

  • Kidney Failure, Chronic
  • End Stage Renal Disease (ESRD)

Treatment Effectiveness

Effectiveness Progress

1 of 3

Other trials for Kidney Failure, Chronic

Study Objectives

This trial is evaluating whether Payment adjustment for home dialysis and transplant will improve 1 primary outcome, 2 secondary outcomes, and 4 other outcomes in patients with Kidney Failure, Chronic. Measurement will happen over the course of The 90-day period beginning on the date of the first dialysis claim..

Year 1
Pre-Dialysis Elixhauser Index
9 months
Dialysis Rate per Capita
Total Number of Dialysis Patients
The 90-day period beginning on the date of the first dialysis claim.
Percentage of Dialysis Sessions at Home in First 90 Days
Percentage of Patients Receiving Any Home Dialysis in First 90 Days in 2020
Percentage of Patients Receiving Any Home Dialysis in the First 90 Days
Percentage of Weeks Receiving Any Home Dialysis in First 90 Days

Trial Safety

Safety Progress

1 of 3

Other trials for Kidney Failure, Chronic

Trial Design

2 Treatment Groups

Control
1 of 2
Treatment
1 of 2
Active Control
Experimental Treatment

This trial requires 19000 total participants across 2 different treatment groups

This trial involves 2 different treatments. Payment Adjustment For Home Dialysis And Transplant is the primary treatment being studied. Participants will all receive the same treatment. There is no placebo group. The treatments being tested are not being studied for commercial purposes.

Treatment
Other
Control

Trial Logistics

Trial Timeline

Approximate Timeline
Screening: ~3 weeks
Treatment: Varies
Reporting: 1 year before first dialysis session
This trial has the following approximate timeline: 3 weeks for initial screening, variable treatment timelines, and roughly 1 year before first dialysis session for reporting.

Closest Location

Massachusetts Institute of Technology - Cambridge, MA

Eligibility Criteria

This trial is for patients born any sex aged 65 and older. There are 4 eligibility criteria to participate in this trial as listed below.

Mark “yes” if the following statements are true for you:
All Medicare-certified ESRD facilities and Medicare-enrolled managing clinicians located in HRRs in the United States are required to participate.
Patient is receiving dialysis or other services for ESRD
Patient is new to dialysis, defined as not having received dialysis for at least 12 months prior to their first observed dialysis claim
Patient is enrolled in Medicare Part B

Patient Q&A Section

What are the signs of kidney diseases?

"Many kidney diseases are easily diagnosed, such as glomerulonephritis /minimal change disease and acute tubular necrosis. However, for others, it is difficult to determine the diagnosis. In addition to kidney disease-specific signs, patients who have been evaluated for kidney disease should be required to know the signs and symptoms of a number of nontraumatic conditions, such as glaucoma, diabetes and chronic liver disease, that may be confused with kidney disease." - Anonymous Online Contributor

Unverified Answer

What is kidney diseases?

"Kidney disease is a disease of the kidney, and is characterised by alterations in one or more factors regulating the water balance in the kidney tubules. This may cause an abnormality in the removal of sodium and water from the body and a consequent rise in blood pressure. Some of these kidney diseases have major and disabling (and possibly life-threatening) effects. Chronic kidney disease (CKD) refers to any impairment of kidney function, irrespective of the severity and the cause of loss of kidney function. Most people with CKD have no symptoms and it can be delayed until after the death of the kidney. Treatment of CKD aims to slow or halt deterioration of kidney function by treating the underlying cause." - Anonymous Online Contributor

Unverified Answer

How many people get kidney diseases a year in the United States?

"Approximately 60 people in the United States get kidney diseases per year. This is an increasing number as an aging population develops chronic kidney disease. In 2011, there was about 6.5 million people who had chronic kidney disease or end-stage kidney disease." - Anonymous Online Contributor

Unverified Answer

What causes kidney diseases?

"The most important causes of kidney disease in the developing world were Sjögren syndrome, diabetes, and ischaemia. These conditions were usually associated with chronic kidney disease, which has been identified as a problem in the developing world. This was manifested by progressive loss of kidney function and a high prevalence of end-stage kidney disease. As a result of kidney disease, the patients were most prone to the infections and malnutrition that were frequently associated with renal diseases of the developing world. It was, therefore, concluded that renal diseases were associated with all of the diseases mentioned above." - Anonymous Online Contributor

Unverified Answer

Can kidney diseases be cured?

"[Immunosuppression by nephrotoxins or immunodeficiency by chronic renal failure will lead to organ damage, infection, high mortality, and in some instances to malignancy. The use of immunosuppressive regimens increases the risk of malignancy, but this risk may be justifiable if the therapy is necessary to prevent immunologic rejection of a transplanted organ. The immune system is not the only regulator of transplantation. There is still little information available on the role of the rennin-angiotensin system, which may play an important role in the renal allograft rejection process." - Anonymous Online Contributor

Unverified Answer

What are common treatments for kidney diseases?

"Treatment for kidney diseases depends on the age of the patient, and the exact type of diseased kidney. If there is only one abnormality, and not a large array of abnormalities, then medication may be used instead of surgery." - Anonymous Online Contributor

Unverified Answer

Does payment adjustment for home dialysis and transplant improve quality of life for those with kidney diseases?

"For patients receiving home hemodiafiltration or home peritoneal dialysis, there are clinically important improvements in patient-reported HRQoL and QOL as measured by SF-36. Payment incentives are associated with improvements in patient-reported HRQoL and QOL after adjustment for insurance type and medical comorbidities." - Anonymous Online Contributor

Unverified Answer

What is payment adjustment for home dialysis and transplant?

"There is growing recognition that the financial incentives in home dialysis do not cover the cost for which patients are reimbursed. The extent of reimbursement is subject to great debate and warrants the consideration of a new type of reimbursement arrangement. Findings from a recent study provides baseline payment data for home dialysis patients and provides the opportunity to inform policymaking concerning the potential value of a payment plan design that better reflects the clinical and economic importance of home dialysis." - Anonymous Online Contributor

Unverified Answer

How serious can kidney diseases be?

"The CKD prevalence is increasing over time. We should think of the CKD prevalence, not only as an index of a worsening kidney disease, but also as an index of poor outcome." - Anonymous Online Contributor

Unverified Answer

Does kidney diseases run in families?

"Knowledge of such a gene modifier would provide insights into the mechanisms of disease progression. It is crucial that the gene underlying this modifier's action be identified and sequenced." - Anonymous Online Contributor

Unverified Answer

How does payment adjustment for home dialysis and transplant work?

"The financial impact of home dialysis and transplantation is large on hospitals. Current payments for inpatient and physician costs do not adequately reflect the overall costs. Hospital payers in our community-based system should address the need to increase and standardize payment for home dialysis and transplantation." - Anonymous Online Contributor

Unverified Answer

What are the common side effects of payment adjustment for home dialysis and transplant?

"There are common side effects during the first month in the home dialysis or transplant outpatient office waiting list, and they are similar to those reported in out-patient transplant clinics. The long-term side effects are important because of the need for payment adjustment in the future and the difficulty of defining short-term side effects. An essential part of the home dialysis or transplant outpatient clinic is to develop a clear concept of the type and frequency of the side effects that occur, the reasons for them, and the impact they may have on the quality of daily life." - Anonymous Online Contributor

Unverified Answer
Please Note: These questions and answers are submitted by anonymous patients, and have not been verified by our internal team.
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