Table 2.

Summary of financial incentives in place in 2012 for home dialysis

Person/ProviderIncentives/Advantages
For dialysis providerSame per-treatment reimbursement as in-center HD
Receive additional reimbursement for providing home training to patients after 120 days on dialysis
Payment retroactive to first day of the month of initiation of home dialysis
Ability to use fewer of the costly medications
Potential to expand census of some centers with trivial or no increase in infrastructure (e.g., can unload full HD census by transfer to home therapy)
For patientLower transportation costs
Less time away from work
Payment to providers retroactive to first day of the month of initiation for Medicare-eligible patients not covered at time of start of dialysis
Lower medication costs (oral vitamin D covered in prospective payment system bundle)
For physicianReimbursement for training home dialysis patients
Same monthly payment for one visit as received for 2–3 visits for in-center HD patients
Can receive payment if patient misses appointment for face-to-face visit (with appropriate documentation)
Payment to physicians retroactive to first day of the month of initiation for Medicare-eligible patients not covered at time of start of dialysis
Increase geographic area of patient referrals (can provide dialysis care for patients who live far away)
  • HD, hemodialysis.