"Dialysis in the US has become an ossified industry, experiencing little innovation over the past three decades, with in-center, brick-and-mortar hemodialysis the mainstay of treatment."
Spot on! I have seen providers cheat the system regarding patient outcomes. How is that helping patients? When the two LDOs drive policy that impacts competition and patients so they can own the system, how is that good for anyone?
Thanks for sharing, Kim - appreciate your perspectives and question there. I'm still processing most of what Eugene shared with me. I think what I found most surprising (and telling) was the bit around certificate of need laws and conditions for coverage. Those seem like clear opportunities to reverse course without adding more complexity.
Agree 100%. CON is boggling to me. What is wrong with more options for patients? The question is who can be influential with the right people/committees to make change happen. Also, I wonder why CMS/government doesn't have people who work in the industry help decide these parameters around CKD....there are multiple perspectives from different players in the space. For instance, we still have to meet KT/V for adequacy. There are many ways to cheat to meet the minimum standard. How about we look at the patient as a whole instead of a set of labs. We have to put all the pieces together in their entirety when looking at patients (labs, psychosocial, family status, access to care, religious/cultural aspects, etc......how does the patient look and feel.)
![Signals From [Space]](https://substackcdn.com/image/fetch/w_80,h_80,c_fill,f_webp,q_auto:good,fl_progressive:steep,g_auto/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F55686857-6b99-45a6-ac0f-09c9f023f2a0_500x500.png)
![Signals From [Space]](https://substackcdn.com/image/fetch/w_36,h_36,c_fill,f_webp,q_auto:good,fl_progressive:steep,g_auto/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F55686857-6b99-45a6-ac0f-09c9f023f2a0_500x500.png)
![Signals From [Space]](https://substackcdn.com/image/fetch/e_trim:10:white/e_trim:10:transparent/h_72,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F4d588ac1-7fac-4bd4-829d-fc7b4e8f1326_1512x288.png)
Spot on! I have seen providers cheat the system regarding patient outcomes. How is that helping patients? When the two LDOs drive policy that impacts competition and patients so they can own the system, how is that good for anyone?
Thanks for sharing, Kim - appreciate your perspectives and question there. I'm still processing most of what Eugene shared with me. I think what I found most surprising (and telling) was the bit around certificate of need laws and conditions for coverage. Those seem like clear opportunities to reverse course without adding more complexity.
Agree 100%. CON is boggling to me. What is wrong with more options for patients? The question is who can be influential with the right people/committees to make change happen. Also, I wonder why CMS/government doesn't have people who work in the industry help decide these parameters around CKD....there are multiple perspectives from different players in the space. For instance, we still have to meet KT/V for adequacy. There are many ways to cheat to meet the minimum standard. How about we look at the patient as a whole instead of a set of labs. We have to put all the pieces together in their entirety when looking at patients (labs, psychosocial, family status, access to care, religious/cultural aspects, etc......how does the patient look and feel.)