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Patients will trade ASCs for hospitals if Congress doesn't block 62% reimbursement cut, coalition says

The Dialysis Vascular Access Coalition is urging Congress to block CMS' proposed cuts to reimbursement for vascular access services, saying the proposal threatens access to care for end-stage renal disease patients.

Here's what you should know:

1. In the 2019 ASC Proposed Rule, CMS proposed a 62 percent reduction in reimbursement for vascular access services.

2. The coalition said a 39 percent reimbursement cut in 2017 caused patient access issues and office closures throughout the U.S. The coalition believes additional cuts would devastate ESRD patients who need dialysis — and by extension, vascular access — to manage kidney failure.

3. Physician offices and ASCs developed vascular access centers to meet increasing demand after the benefits of fistulas became widely known. The shift helped minimize scheduling delays and enabled ESRD patients to receive vascular access services from highly specialized practitioners, according to DVAC.

4. DVAC member David Mahoney, MD, said he fears the reimbursement cut would force ESRD patients to seek vascular access services in hospitals and overcrowded emergency rooms instead of outpatient settings.

"Many of us in kidney care have grave concerns regarding CMS's proposed reimbursement cuts for dialysis vascular access procedures," said Dr. Mahoney of Vernon Hills, Ill.-based Lifeline Vascular Access. "The loss of specialized and immediately available vascular access services will result in a cascade of delays in dialysis, increased hospitalizations and worse patient outcomes."

5. DVAC favors Medicare policies that promote the migration of patients to non-hospital settings.

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