AAKP President Brenda Dyson, “Dr. McClellan, please tell Congress what we both know – fistulas are essential medicine for kidney patients and save Medicare money!”

Washington Post Article Documents National Embarrassment of Low Fistula Rate

TAMPA, Fla. December 6, 2005 – Yesterday, the American Association of Kidney Patients (AAKP) wrote to Dr. Mark B. McClellan, Administrator of the Centers for Medicare and Medicaid Services (CMS) in Washington, D.C., asking Dr. McClellan to provide Congress with a legislative proposal to improve use of fistula vascular access among the nation’s dialysis patients by providing incentive or bonus payments to physicians and dialysis facilities. (Text of letter provided below.)

AAKP President Brenda Dyson commented on the letter: “Fistulas are the gold standard of vascular access for the nation’s dialysis patients – patients experience fewer infections and are generally healthier. Yet most kidney patients do not have fistulas.”

Dyson continued, “We are simply asking this: Dr. McClellan, please tell Congress what we both know – fistulas are essential medicine for kidney patients and save Medicare
money!”

Coincidentally, a story in The Washington Post today (12/6/05), “For Kidney Patients, Another Failure: Washington Area Is Worst in Nation at Providing Best Dialysis Practice” (Page HE01), documents the national embarrassment of low fistula use – and the damage to the health of kidney patients and the cost to the Medicare program.

In March 2005, Dr. Mark B. McClellan and the staff of the CMS received the AAKP Public Service Medal for the agency’s efforts on behalf of the nation’s kidney patients. More information on that award is available on the AAKP Web site (Click here).

Dialysis is a medical procedure designed to remove wastes, toxins and fluids from the blood when the kidneys have failed. The site on the human body where the blood is removed and returned and the interface technology is called a “vascular access.” A brochure describing four alternative vascular access options is available on the AAKP Web site (Click here).

Text of the letter to Dr. Mark McClellan follows:

December 5, 2005

The Honorable Mark B. McClellan, M.D., Ph.D.
Administrator
Centers for Medicare & Medicaid Services
U.S. Department of Health & Human Services
Hubert H. Humphrey Building
Room 443-G
200 Independence Avenue, SW
Washington, DC 20201

Dear Dr. McClellan:

On behalf of the American Association of Kidney Patients (AAKP), I am writing on a time sensitive matter – to encourage the Centers for Medicare and Medicaid Services (CMS) to provide Congressional committees with jurisdiction over Medicare a legislative proposal and an actuary score for incentive or bonus payments to physicians and dialysis facilities to establish and maintain fistula vascular access among our nation’s dialysis patients.

Although the window of opportunity is rapidly closing, we believe a fistula incentive provision could still be included on budget reconciliation legislation now pending before the Congress. Increasing the use of fistulas with incentive payments would not only improve the health of our nation’s dialysis patients but save Medicare money – we believe upwards of $1 billion or more (over 5)!

As you know, on August 24, 2005, AAKP wrote to leaders of the Congressional committees of jurisdiction about such a proposal – and AAKP was very pleased with the strong interest shown by Committee leaders. However, we understood the Administration was then committed to Medicaid-only reconciliation legislation, and CMS was not engaged in developing Medicare proposals. Given changed circumstances, we hope CMS might now use its expertise to craft a legislative proposal.

Let me note again, for the record, AAKP is deeply appreciative of both CMS and your personal leadership to improve the rate of fistula access among the nation’s dialysis patients. Fistulas are the “gold standard” of vascular access for dialysis patients, and make a real, proven difference in the health of dialysis patients and save the government money. Unfortunately, most dialysis patients do not have fistulas. But the CMS “Fistula First” initiative has also excited a much broader question in the kidney community: “What else do we know that can improve the health of the nation’s kidney patients – but is not being done?”

If AAKP can be helpful in any way, please contact our Washington representative, Dr. Alec Vachon (202-667-1193); Kris Robinson, AAKP’s Executive Director/CEO; or myself.

With best regards,

Sincerely,

Brenda Dyson
President

AAKP is the voluntary, patient organization, which for more than 35 years, has been dedicated to improving the lives of fellow kidney patients and their families by helping them deal with the physical, emotional and social impact of kidney disease. The programs offeredby AAKP inform and inspire patients and their families to better understand their condition, adjust more readily to their circumstances, and assume more normal, productive lives in their communities.

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