Hello from Conroe Texas

[Lone Star Home Dialysis]

Hello my name is Kevin and my mother does Home Hemodialysis in Texas. I also work for Lone Star Home Dialysis, we specialize in Staff Assisted Home Hemodialysis. We believe that while dialysis is not a choice, having the choice to remain at home should be. I worked previously as a medic on an ambulance and I am passionate about bringing the freedom of home hemodialysis to renal patients.














Sp mod Cas

[MooseMom]

Staff assisted home dialysis?  Wow!  May I ask...how much does that cost per dialysis session?

[cassandra]

Welcome to the site Kevin


   




Very pleasantly surprised to read about Staff assisted HHD. Looking forward to your answers.


Take care, Cas

[Simon Dog]

Staff assisted home dialysis?  Wow!  May I ask...how much does that cost per dialysis session?

If you have to ask you can't afford it.

[Jean]

Oh Wow, what a wonderful addition to our site. We welcome you and look forward to you posting your adventures and sharing with us. So,.....   to IHD!!

[Lone Star Home Dialysis]

Hi everyone, it doesn't cost the patient anything, we only bill the insurance.

[MooseMom]

Hi everyone, it doesn't cost the patient anything, we only bill the insurance.

Hold up.  Dialysis is covered by Medicare, so are you saying that you bill Medicare for your services?  And Medicare pays you?  Hmmmmm.

[iolaire]

I swore I heard about this before, here is the link:
http://ihatedialysis.com/forum/index.php?topic=32516.0

[Charlie B53]

Welcome to IHD.  Anyone that is an advocate for Home HD has gotta be a good person to have aboard.

[Simon Dog]

Hi everyone, it doesn't cost the patient anything, we only bill the insurance.

Some insurance companies pay for home assistance, however, Medicare does not.

When I started home hemo, my MD mentioned home assist was available as long as I had private insurance, however, I had no interest in going that route as I am still able to deal with machines.   

Do you have any Medicare patients using home assistance, and if so, do they self pay?

[Lone Star Home Dialysis]

Hello everyone, it is true that not all insurances want cover home hemodialysis with a nurse, but we work with your PCP to get a letter of necessity. Pt also typically receive treatment 3 days a week the same as in-center.

[Simon Dog]

Hello everyone, it is true that not all insurances want cover home hemodialysis with a nurse, but we work with your PCP to get a letter of necessity. Pt also typically receive treatment 3 days a week the same as in-center.

Have you ever had Medicare pay for assisted home hemo?   My guess is no, but I would defer to your expertise and experience.

3x/wk instead of either the 5/6 NxStage protocol, or QOD with a conventional machine defeats one of the biggest benefits of home hemo.

[Lone Star Home Dialysis]

To answer your first question Medicare does not pay for staff assisted home hemodialysis, however if you have Medicare primary and a secondary insurance then typically the secondary will cover your treatment. As for the second part of your question would you mind clarifying? Because we provide a licensed nurse that attends to you every treatment at your home, at a time that is convenient for you. In talking to patients I find that they are unaware of all of their treatment options. I don't want to get political but some Nephrologist's have monetary incentives not to educate their patients on all treatment options. 

[iolaire]

Is this a business advertisement?  I guess since members are interested about how it works its not spam.

[Simon Dog]

As for the second part of your question would you mind clarifying?

There is evidence that strongly suggests that the 3x/week schedule is "minimal", and that the risk of cardiac complications is highest after the two day gap.    It is generally considered better to be on a more frequent schedule, either QOD (every other day) with conventional machines or 5 to 6 days a week with NxStage.    This reduces the amount of inter dialytic weight gain, and thus stress on the heart.   The reduced fluid taken off in each treatment can reduce or eliminate cramping as well as myocardial stunning.

Home assist on a 3x/week schedule is identical to in-center from a medical perspective, although the patient has the benefit of an RN instead of at tech running the show.   It's just not "better" medically (though it is from a lifestyle perspective).

The RN at my clinic tells me they make more $$ on a home patient, because of the reduced need for clinic chair time.   It does, however, require a critical mass of patients to get the economies of scale since the clinic needs to set up the staffing and support structure for a home program.   A lot more goes into nephs not describing all treatments fully, including the attitude some MDs have that it is "too complicated" for a simple person (defined as anyone without a medical degree) to handle.   Fresenius has an effort underway to increase the amount of home patients, and has sent both their head of patient services (an MD) and a film crew to my house, with the later filming comments to be presented to the FMC power brokers.

I am grateful to my MD/RN team, as the reason I have home hemo is they had the confidence that I would be able to master the process.    I work very hard not to disappoint them.

[Xplantdad]

Exactly what Simon Dog said. Also, Fresenius just bought NXStage, too ( http://www.nasdaq.com/article/fresenius-medical-care-to-buy-nxstage-medical-in-2-bln-deal--quick-facts-20170807-00022) . 

We did the home hemo for the exact reasons stated so eloquently above...and 5 days out of 7 produced way better results as well...

[Lone Star Home Dialysis]

Hello everyone, I informed a couple patients who are currently staff assisted home hemodialysis to talk about their experiences. Yes Fresenius bought NXStage, and it is another great option available. @iolaire No I am just trying to inform patients of all of the available modalities.

[MooseMom]

Lone Star, there are two advantages to home hemo:  getting to stay at HOME and being able to have 4-5 treatments a week instead of the usual three you get if you are in-clinic.  Since you already have the "home" part down, can you not offer more than three treatments a week so that your patients get BOTH advantages of home hemo?

[Simon Dog]

All of the same logistical issues (cost, difficulty scheduling QOD treatment staff time, etc.) exist with assisted home hemo.   I would not expect the assist to be available more than the CMS determined minimum "acceptable" dialysis time (3 times a week, 4 in rare cases).