Dialysis At Home

[cmiller]

Hello Everyone!

I am new to this site and want to introduce myself.  My name is Christine and I represent a company called Dialysis At Home.  We do just as our name says - we are a licensed provider of Hemodialysis treatments to patients in the comfort of their homes.  We have seen how difficult it can be for many dialysis patients to travel to a center or clinic to receive their treatments several times per week and we wanted to do something to make it easier for these patients.  We know that needing dialysis is hard enough! 

Our staff includes a Board Certified Nephrologist, RN, Social Worker, Dietician and trained dialysis technicians.  We send a skilled technician to your home to provide short daily treatments 5 times per week.  These short daily treatments last approximately 2-1/2 hours and have proven benefits such as improved recovery time after treatment, less cardiac stress, more flexibility, better lab results and more energy.  Our patients have loved receiving their treatments at home.  Nephrologists have indicated that if they needed dialysis treatments, they would prefer these short daily home treatments themselves.  We feel that we offer a premium service and we want to improve the lives of dialysis patients!

We are located in Salt Lake City, Utah, and can service dialysis patients anywhere along the Wasatch Front area.  It is also our goal to grow and move into other states in the near future.  Most insurance companies will pay for home Hemodialysis treatments and we currently accept United Health Care, Aetna, CIGNA and Health Net insurance.  Some insurance companies will also consider single patient contracts. For more information please check our website at www.dialysisathome.net.  If you or someone you know in the SLC area would be interested in at-home treatments or have any questions, please contact us.  Feel free to reply here or go to our website for contact information.  We would love to be able to improve your quality of life while needing dialysis treatments!!

[cassandra]

Welcome to the site Christine


   


Although I do not live in the USA I think the service your company provides sounds rather neat.
I hope something like that also comes to the UK and than would also be provided by the NHS.
Does Medicare/Medicaid also pay for your treatments?


Take care, Cas

[lulu836]

There are so many things wrong with that advertisement that I don't even know where to start!  Oh..wait.......so Dailysis@Home is a free service?  No, you say?  Well, ummm........there are no costs advertised and there is a plea for insurance customers so it's still not free?  Oh.....and.. "commercial insurance".....would that be Medicare perchance?  No???  Ok, so could you please define the term?   AND.....one last question........are you a US company or international or multinational or ....?  Thanks, awfully, for your answers.

[Simon Dog]

"Commercial Insurance" is a common and well understood term to mean insurance offered through private industry, most typically employer based plans or Obamacare.    It is shorthand for "insurance other than Medicare or Medicaid".

The website indicates it is a service local to the state of UT at this time.

Some commercial policies cover assisted home hemo.   Medicare does not.

Here in the US, Medicare covers 80% of dialysis treatments after 30 months.  One can buy a "medicare supplement" to cover the rest (they have to accept ESRD patients, even though they are money losers), or "medicaid" if indigent.

I wonder about the "5x 2.5 hours each".   That sounds like NxStage marketing, though I know one patient (me) that does 3.5hr 5x/week.  (technically 3:20 because NxStage does not include machine self-test time when in-treatment, though it adds 10 minutes or so to a session).

Assisted home hemo may be helpful to some but, due to finances, is going to be limited to a few.   The number of hours involved means the price is so high they don't even post a rate schedule for private pay patients.

My doc told me home assisted was offered by Fresenius with the BabyK, but he knew me well enough to know my reaction was going to be "what?  and not get to operate the cool machine and stab myself?".

I feel that medical providers have a special obligation to provide patients with honest, complete, and full information even when doing so goes against the profit motive.  It was disappointing that this provider's web site did not mention "Patients may also be trained to self-administer treatments at home, however, we offer the option of a professional assisting you" rather than not even mention the possibility of doing it without paying the service premium.   Also, the website is terribly designed.














Sp mod Cas

[cassandra]

Thanx for the explanation SD. Although I was slightly disappointed by your use of the word 'indigent' which of course I had to look up, (as it is not a commonly used word in my apparently narrow 'communication world') which is pretty derogatively.
And that inspired me to read what excactly Obamacare, and Medicaid and Medicare was and that that word was rather unmerited bordering disparage (meaning quite unneeded bordering insulting  ) as Medicaid provision includes the working poor etc.


I now wish I hadn't read any of it at all. 


Love y'all, Cas

[Simon Dog]

No insult was meant by the use of the term.    My experience with Medicaid has been an individual who is truly penniless ($50 assets) in a nursing home.  I missed the working poor aspect of that program.    Sorry.   I guess I should have used the term "need based".

[cmiller]

Thanks for the welcome Cas - sorry we are not in the UK!  We do not post an exact rate for our home Hemodialysis treatments because we have a billable rate which we submit to the insurance companies and they typically come back with an allowable rate that they will pay.  This can vary by company.  We would offer to train patients to do treatment on themselves at home, and should probably mention that on our site, but we have yet to find a single patient who wants to be sticking themselves.  It can also be difficult to find a care partner who is willing to perform these treatments on a regular basis.  That is why we wanted to offer a solution - by bringing a technician to your home.  We are not yet Medicare approved but look to get this approval down the road.

[Simon Dog]

But, but ...... sticking one's own needles is part of the fun.   The way I explain it "You can have a gen-u-whine high school graduate with a 6 week course stick you, or you can learn to be a better technician for your arm than any medical professional".   My stress level is lower putting them in myself than watching someone else do it, which is one of the reasons I still do it myself even when temporarily relegated to in-center.

I expect you will be able to get Medicare approval for the "treatment" fee but not for the surcharge that is necessary to cover several hours of professional time per treatment.   If you manage to pull that off, you will fundamentally change the dialysis model.

What would be ideal is a hybrid approach, offering patients the choice of assisted or unassisted.   This would help those who reach the end of private insurance and are subject to Medicare limits.

Also, note that the FDA has recently cleared the NxStage system for solo treatment without a care partner.

[Paul]

Umm, isn't this post spam? And as so, against the rules?





Please note: I just modified this post, the quote in the next post shows the original version, sans comma.

[lulu836]

Umm, isn't this post spam? And as so against the rules?

Absolutely!

[Blake nighsonger]

But, but ...... sticking one's own needles is part of the fun.   The way I explain it "You can have a gen-u-whine high school graduate with a 6 week course stick you, or you can learn to be a better technician for your arm than any medical professional".   My stress level is lower putting them in myself than watching someone else do it, which is one of the reasons I still do it myself even when temporarily relegated to in-center.

Also, note that the FDA has recently cleared the NxStage system for solo treatment without a care partner.

i agree, sticking one self is the way to go. Took awhile for me to really understand when and why , what angle, hence direction of fistula ( to keep of wall for best V. & A Pressures via calling home D. nurse ( note;Filipino ).

My question is , would we still be able to have or keep our home dialysis nurse if deciding or getting to, go sole.?
 

[Simon Dog]

My question is , would we still be able to have or keep our home dialysis nurse if deciding or getting to, go sole.?
 

Solo or not, you are going to need a home D nurse for monitoring, support, RX coordination, etc.   I have a care partner, however, I do it "solo" - no help from partner unless I run into a problem, need someone to hold the flashlight in a blackout etc.

[Blake nighsonger]

HI SimonDog, same here did it solo completely, lab ect.... that part. Have back up Gen.  had monitoring device  (Baby monitor) for service purpose., sandwiches.

My doctor (neph) when asked once said "if i went sole I would loose my home dialysis nurse."

I would? Is my Question.....Surly not.  Would the type of Insurance come in to play? Private insurance, Medicare, and could Francica (spelling) still
provide having HD nurse to support, monitor eletronicly now a days or would one be totally Independent and Responsible for all Aspects ...Being solo.?

Thanks, take care.

[Charlie B53]

Assistance with home Hemo could benefit a number of people once we get past that cost thing.

Myself, I would need someone to help stick and pull the needles as I cannot begin to imagine myself doing it alone.  My needle-phobia hasn't resolved well enough to stick, and I can't figure out how to pull and cover the site one-handed.  I can be a clutz sometimes.  I would be sure to make a mess every time.

Daily Hemo could make it so much easier with diet and fluid restriction much like when I was doing PD.  Far easier and felt much more like a normal person.

I expect it may take a while before Insurance Companies begin to come around and offer coverage, they are far too cheap to just give in a pay out the money.

[Simon Dog]

My doctor (neph) when asked once said "if i went sole I would loose my home dialysis nurse."

That might have been your doc's way of saying the clinic would not support solo home D; not that you would do home D without RN support.   I know that Fresenius will kick you off the home program if you lose a care partner.   Interesting policy - they will help you with hospice if you cannot stand clinic treatment, but will not help you with solo D because of the purported risk.

There is mounting evidence that more frequent dialysis extends life expectancy.  If the evidence keeps coming in, eventually, docs may have to start telling patients this directly when they are considering modalities.    I believe the life extending benefits of home D are undersold because any doc selling that point is also saying "in center will shorten your life".

As to home assist - taking needles out is easier than putting them in.  It would be interesting for a home assist operation to offer "setup assistance" where the get the patient up and running, but do not stay for the entire treatment.   That would considerably reduce the number of professional staff hours required per treatment, and therefore, cost.