Science / Medicine : Cut in Dialysis Payments Cited in Illness, Deaths

Medicare reimbursement rates for kidney dialysis have steadily decreased and may be indirectly causing more patient hospitalization and deaths, the Institute of Medicine said in a report.

The institute, which is part of the National Academy of Sciences, recommended no more payment cuts for dialysis and urged an extension of the dialysis-transplantation program for end-stage renal disease or kidney failure, so that it covers all citizens and resident aliens on an equitable basis.

“Kidney Failure and the Federal Government,” written by a 16-member Institute of Medicine committee, reviewed the 18-year-old program established by the Social Security Amendments of 1972. Currently, 150,000 patients with kidney disease are enrolled in the program. Because of a shortage of available kidneys for transplantation, most patients receive dialysis, which mechanically eliminates impurities from the blood during kidney failure.

The institute said reimbursement rates to providers of outpatient dialysis have dropped more than 60% between 1974 and 1989.