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Protecting Our Seniors
Kidney failure is a growing crisis in the U.S. — especially in nursing homes
The Kidney Failure Crisis In the US
- In 2018, 786,000 Americans were living with ESRD ( end-stage renal disease)
- 80% of patients with ESRD are age 65+
- The Financial Impact of Kidney Disease
- In 2018, total Medicare spending on patients with ESRD reached $49 billion — Up 11% from 2009 (adjusted for inflation)
- Hemodialysis: $93,191 per patient per year
- Peritoneal dialysis: $78,741 per patient per year
- Transplant care: $37,304 per patient per year
- Patients with ESRD make up 1% of Medicare beneficiaries, but account for 7% of Medicare spending
- Yet mortality risk for kidney failure is higher in the United States than in countries that spend less on kidney care
- 15% higher than in Europe
- 33% higher than in Japan
Dialysis Treatment Options
70% of patients with ESRD are undergoing dialysis — 30% have functioning kidney transplants
Location
- 86% – Outpatient Hemodialysis
- Patient travels to clinic multiple times for treatment
- Clinical staff is present during treatments
- 12% – At Home Peritoneal Dialysis
- Patient receives treatment in the comfort of own home
- Clinical staff provide training, oversight, and equipment
- <2% – At Home Hemodialysis
- Patient receives treatment in the comfort of own home
- Clinical staff provide training, oversight, and equipment
Home Hemodialysis Treatment Options (Weekly treatment time)
- Option one:
- Conventional (3-day) Dialysis
- Option two:
For too long, the industry has focused on the needs of active, middle-aged dialysis patients and failed to address the needs of a growing nursing home population
The Nursing Home Dialysis Dilemma
- The Limits of Outpatient Services
- Outpatient dialysis clinics are not designed for nursing home residents
- Outpatient treatment poses an infection risk — for dialysis patients, staff, and other residents
- Highly acute residents struggle to find placement at outpatient clinics
- Traveling to a dialysis clinic is disruptive, confusing, and time consuming
- Outpatient providers have failed to address the needs of an aging population of patients with ESRD, especially nursing home residents
Nursing Homes Need 3-Day On-Site Dialysis (Not Daily)
- Benefits for Residents with ESRD
- Conventional dialysis is provided on-site, eliminating outpatient drawbacks
- 98% of nursing home dialysis patients are already accustomed to 3-day outpatient dialysis
- Switching to daily dialysis requires prescription changes
- Changes may cause confusion and disrupt continuity of care
- On-site, 3-day dialysis requires 17% less treatment time than daily dialysis and eliminates hours of travel time per week
- More time for therapies and social activities
- Decreased risk of infection and complications
- Daily dialysis carries greater risk potentially leading to hospitalization or surgery, and greater opportunity for missed treatments
- Greater opportunity for missed treatments
- Higher risk of complications
- Difficulty with the blood-access site
- Blood clots
- Aneurysms
- Benefits For Nursing Home Operators
- On-site dialysis is at the forefront of clinical innovation
- Better collaboration of care
- Fewer hospital readmissions
- Stronger relationship with hospital partners
- Nursing homes with on-site dialysis can accept higher acuity patients
- Eliminate transportation costs
- Providing ambulance transportation for outpatient dialysis may cost nursing home operators up to $411 per round trip
For the same initial investment on-site, 3-day dialysis provides treatment to 3x more patients than daily dialysis
6 chairs can support
- 3-day dialysis can support 36 patients
- Daily dialysis can support only 12 patients
Large dialysis providers have failed to deliver effective and flexible treatment for nursing home patients, highlighting the need for a different model
Concerto Renal Services is the Solution
Nursing homes need in-house dialysis care designed for geriatric patients
Why Choose Concerto?
- Founded by experienced skilled nurse facility (SNF) operators who saw a need for quality on-site dialysis in nursing homes
- Provides on-site 3-day hemodialysis in a home-like setting Embraces all patient comorbidities (vent, trach, LVAD, etc.)
- Collaborates closely with SNF team to
- Ensure continuity of care
- Create customized care plans
- Offer nursing, nutritional, and psycho-social care
- All without the need for transportation
Capital investment spent on building a 6-chair den will support the needs of 36 patients in a Concerto 3-day dialysis model vs 12 patients total supported in a daily dialysis model
Nursing home dialysis is not an arm to our business – It IS our business
Sources:
https://adr.usrds.org/2020/end-stage-renal-disease/1-incidence-prevalence-patient-characteristics-and-treatment-modalities
https://pharm.ucsf.edu/kidney/need/statistics
https://www.niddk.nih.gov/health-information/health-statistics/kidney-disease
https://www.kidney.org/atoz/content/homehemo
https://pharm.ucsf.edu/kidney/need/statistics
https://skillednursingnews.com/2020/04/as-hospitals-struggle-to-free-up-beds-and-nursing-homes-lock-down-in-house-dialysis-provides-relief/
https://www.sciencedirect.com/science/article/pii/S2590059520302065
https://www.mcknights.com/news/cms-cuts-to-ambulance-pay-for-dialysis-will-devastate-access-for-some/
https://www.medicinenet.com/script/main/art.asp?articlekey=167667
https://renprors.com/benefits-of-nursing-home-dialysis-over-outpatient-clinic/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4393476/
